Fecal Impaction of the Colon: Overview, Symptoms & Diagnosis

Fecal Impaction of the Colon

What Is Fecal Impaction of the Colon?

When you eat food, it breaks down in your stomach and passes through your intestines. This process is known as digestion. The walls of your intestines absorb nutrients from the food. What remains as waste passes along to your colon and rectum. At times, things may go wrong in this process and the waste becomes stuck in the colon. This is known as fecal impaction of the colon.

When you have an impacted colon, your feces become dry and won’t budge, making it impossible to excrete them from your body. Impacted feces block the way for new waste to leave the body, causing it to back up.

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What Are the Symptoms of Fecal Impaction?

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All symptoms of fecal impaction are serious and warrant prompt medical attention. They include:

  • leakage of liquid stool
  • abdominal discomfort
  • abdominal bloating
  • abdominal pain
  • feeling the need to push
  • nausea
  • vomiting
  • a headache
  • unexplained weight loss
  • not wanting to eat

Severe symptoms include:

  • a rapid heart rate
  • dehydration
  • hyperventilation, or rapid breathing
  • a fever
  • confusion
  • becoming easily agitated
  • incontinence, or passing urine without trying

What Causes Fecal Impaction of the Colon?

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The primary cause of fecal impaction of the colon is constipation. Constipation is difficulty passing stool or the infrequent passing of stool. Constipation is often the result of:

  • medication side effects
  • insufficient nutrient intake
  • dehydration
  • not consuming enough fiber
  • an illness
  • frequent bouts of diarrhea
  • problems in the digestive system
  • diseases such as diabetes or thyroid disease
  • an obstruction of the intestinal tract
  • continuous vomiting
  • a spinal cord injury
  • mental stress
  • jet lag

Constipation is painful, and people who have it often feel bloated and uncomfortably full. You may also feel the need to go to the bathroom but are unable to do so. When stool doesn’t pass through the intestinal system, it can become dry and hard and lodge in the colon. This is called fecal impaction of the colon.

Once fecal impaction occurs, your colon won’t be able to remove the feces from the body using its normal contraction process.

How Is Fecal Impaction of the Colon Diagnosed?

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If you suspect you have fecal impaction or if you have persistent symptoms of constipation that aren’t getting any better, see your doctor at once. Your doctor will perform a physical exam, which includes an examination of your abdomen to confirm the diagnosis. They’ll press down on your abdomen to feel for any masses or hardened areas, which can help them locate the affected parts of your digestive system.

After this, your doctor will administer a digital rectal exam (DRE) to check for fecal impaction. In this test, your doctor will put on a glove, lubricate one of their fingers, and insert it into your rectum. This procedure doesn’t usually cause pain, but you may feel some discomfort.

If your doctor suspects impaction after performing the DRE and physical examination, they may order an X-ray of the abdomen. Other possible procedures are an abdominal ultrasound or a viewing of the colon using a tiny microscope, which is called a sigmoidoscope. A barium enema can also highlight the problem areas. A barium enema involves inserting a dye into your rectum and then taking an X-ray of the colon and rectum.

What Are the Treatment Options for Fecal Impaction of the Colon?

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The first method of treatment for fecal impaction will most likely be an oral laxative. There are many over-the-counter laxatives that can help stimulate a clearing of the colon. Sometimes, a medicated suppository, which is medicine that’s placed into the anus, may help.

Manual Removal

If a laxative or a suppository doesn’t unblock the feces from your colon, your doctor will remove the feces manually. To do this, your doctor will insert their gloved finger into your rectum and remove the blockage.


If your doctor is unable to remove the entire blockage, they’ll use an enema or water irrigation to remove it. An enema is a small, fluid-filled bottle with a nozzle attached. The nozzle inserts into the rectum. Then, your doctor will squeeze the bottle, releasing the liquid into the rectum and colon. This lubricates the colon and moistens the feces, making it easier to dislodge.

Water Irrigation

Water irrigation involves pushing a small hose up through the rectum and into the colon. The hose connects to a machine that emits water through the tube. After the irrigation, your doctor will massage your abdomen, moving the waste out your rectum through another tube.

What Are the Complications Associated with Fecal Impaction of the Colon?

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Complications of fecal impaction of the colon include:

  • tears in the colon wall
  • hemorrhoids
  • anal bleeding
  • anal tears

It’s important to pay attention to your bowel and visit a doctor if you suspect any problems.

How Do I Prevent Fecal Impaction of the Colon?

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One way to prevent fecal impaction of the colon is to avoid becoming constipated. Some diseases and certain medications make it impossible to avoid constipation, but making small lifestyle changes can help.

  • Drink plenty of water every day to prevent dehydration.
  • Eat foods that are high in fiber, such as whole wheat, pears, oats, and vegetables.
  • Reduce your intake of foods that are high in sugar, which can cause constipation.
  • Exercise daily to help keep your digestive system running well.

You Asked, We Answered

  • What is the likelihood that someone who has had fecal impaction may experience it again? What can they do to avoid a recurrence?
  • People who have fecal impaction are at higher risk of getting it again. If you want to avoid fecal impaction, you should avoid any risk of constipation. Having good fluid and fiber intake, getting proper exercise, and avoiding constipating medications such as opiate painkillers like Vicodin and Percocet will certainly help decrease the risk of repeat fecal impaction.

    - Modern Weng, DO

Learn more: Find out how to relieve IBS constipation »

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