Fecal impaction

Fecal impaction is a gastrointestinal condition in which a large mass of dry, hard stool becomes lodged in the rectum, most often in people with long-term constipation. Risk rises with low mobility, diseases of the nervous system that damage the nerves supplying the bowel muscles, and medicines that slow bowel transit, including anticholinergics and opioid painkillers. Common symptoms are abdominal cramping and bloating, straining, small stools, rectal bleeding, and leakage of liquid stool around the blockage that can look like diarrhoea. Complications include rectal ulceration and tissue injury. A rectal examination confirms a hard mass of stool, and colonoscopy may be added when bowel habits have changed recently. Treatment starts with removing the mass, using enemas, suppositories, stronger laxatives or manual removal by a clinician; surgery is rarely needed. A bowel retraining programme with diet changes, laxatives or stool softeners and lifestyle measures then aims to prevent recurrence.

Seek urgent care for vomiting blood, black or bloody stools, severe abdominal pain, or difficulty swallowing. See a doctor for heartburn more than twice a week, a change in bowel habit lasting more than three weeks, or unexplained weight loss. Call the local emergency number for any symptom that is sudden and severe. This page is a reference for healthcare professionals and does not replace an assessment.