Fecal Impaction Removal Health Article

Definition

Fecal impaction removal is the digital (using the finger) means of breaking up and removing a fecal impaction, or mass of hardened, clay-like stool lodged in the rectum.

Purpose

Fecal impaction is the result of extreme constipation. As the patient is unable to expel the stool, it further accumulates into a larger, harder mass that is impossible to pass by normal defecation. This accumulated stool can extend up into the sigmoid colon, the loop of large bowel above the rectum. Impaction is most common in inactive elderly people, but there are other causes beside inactivity. Among the other causes are:

• medications, including antacids that have aluminum as an ingredient; calcium and iron supplements; a category of anti-hypertensive drugs known as calcium channel blockers; allergy medicines (antihistamines); such psychotropic medications as antidepressants and tranquilizers; such hormones as estrogen and progestin; and medications to reduce spasms such as those used in treating Parkinson's disease
• poor bowel habits; not having a regular schedule for evacuating the bowel
• inadequate fluid intake
• a diet that is lacking in such fibers as bran, fruit, and vegetables
• such rectal disorders as rectocele

In addition to the discomfort this condition creates, untreated fecal impaction can also become a serious health problem, producing a chronically over-dilated bowel, or megacolon, that can require surgical correction. It is possible for rectal tissue to become damaged, ulcerated, or even necrotic (lose its blood supply due to the pressure of the stool). The most serious potential complication is that the lower bowel can become completely obstructed. Such intestinal obstruction is potentially fatal.

The possibility that the patient has a fecal impaction should be considered if he or she shows any or all of the following symptoms:

• complaints of inability to have a bowel movement despite frequently feeling the urge to defecate
• upon defecation, the stool appears to be either diarrheic or thin and pencil-like
• abdominal pain
• bloating and a swollen or hard abdomen
• anorexia, or lack of appetite; nausea; and vomiting
• complaints of general malaise, or not feeling well
• the presence of hard stool in the rectum
• increased restlessness in patients suffering from Alzheimer's disease or other forms of dementia