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The treatment of fecal impaction requires both the remedy of the impaction and treatment to prevent recurrences. Decreased motility of the colon results in dry, hard stools that in the case of fecal impaction become compacted into a large, hard mass of stool that cannot be expelled from the rectum. [citation needed]
Constipation is more concerning when there is weight loss or anemia, blood is present in the stool, there is a history of inflammatory bowel disease or colon cancer in a person's family, or it is of new onset in someone who is older. [12] Treatment of constipation depends on the underlying cause and the duration that it has been present. [4]
Bowel obstruction, also known as intestinal obstruction, is a mechanical or functional obstruction of the intestines which prevents the normal movement of the products of digestion. [2] [5] Either the small bowel or large bowel may be affected. [1] Signs and symptoms include abdominal pain, vomiting, bloating and not passing gas. [1]
Biofeedback has been shown to improve symptoms (improved frequency of bowel movements, reduced straining) and also reduce need for laxatives, [16] and patients stop needing to self-digitate. [24] Biofeedback can successfully treat abnormal contraction and relaxation of muscles in the anorectum during defecation. [24]
The result can be impaired nutrient absorption, excessive water and mineral loss through the stools due to breakdown of the control mechanisms in the intestinal tissue that normally remove water from the stools, and in severe cases, the entry of pathogenic organisms into the bloodstream. Anemia may also arise due to the blood loss through diarrhea.
Tenesmus is characterized by a sensation of needing to pass stool, accompanied by pain, cramping, and straining. Despite straining, little stool is passed. [3] Tenesmus is generally associated with inflammatory diseases of the bowel, which may be caused by either infectious or noninfectious conditions. Conditions associated with tenesmus include:
The signs and symptoms of protein losing enteropathy include diarrhea, fever, and general abdominal discomfort. [4] Swelling of the legs due to peripheral edema can also occur; however, if the PLE is related to a systemic disease such as congestive heart failure or constrictive pericarditis, then these symptoms could be due directly to the underlying illness. [2]
Identification of the exact causes usually begins with a thorough medical history, including detailed questioning about symptoms, bowel habits, diet, medication, and other medical problems. Digital rectal examination is performed to assess resting pressure and voluntary contraction (maximum squeeze) of the sphincter complex and puborectalis.
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