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A fecal impaction or an impacted bowel is a solid, immobile bulk of feces that can develop in the rectum as a result of chronic constipation [1] (a related term is fecal loading which refers to a large volume of stool in the rectum of any consistency). [2]
It can form secondary to fecal impaction. A fecaloma is a more severe form of fecal impaction, and a hardened fecaloma may be considered a giant fecalith. The term is from the Greek líthos =stone.
Many patients are diagnosed late in the course of disease after additional symptoms are seen. Mortality is also difficult to accurately determine. One retrospective study estimated mortality to be between 10 and 25% for chronic intestinal pseudo-obstruction (CIPO) and to vary greatly depending on the etiology of the condition. [5]
ODS often occurs together with fecal incontinence, especially in geriatric people. [39] Where ODS occurs with fecal incontinence, it may represent fecal impaction combined with overflow diarrhea (overflow incontinence). [39] Self-digitation (digital help) is the use of the digits (fingers) to apply pressure in order to achieve defecation.
ICD-9 chapters; Chapter Block Title I 001–139: Infectious and Parasitic Diseases II 140–239: Neoplasms III 240–279: Endocrine, Nutritional and Metabolic Diseases, and Immunity Disorders IV 280–289: Diseases of the Blood and Blood-forming Organs V 290–319: Mental Disorders VI 320–389: Diseases of the Nervous System and Sense Organs ...
Rectal hyposensitivity may manifest as constipation, FI, or both. Rectal hyposensitivity was reported to be present in 10% of people with FI. [14] Pudendal neuropathy is one cause of rectal hyposensitivity and may lead to fecal loading/impaction, megarectum and overflow FI. [15] Normal evacuation of rectal contents is 90–100%. [2]
Additionally, fecalomas may be seen as masses in the colon. In the case of ulceration, the part of the colon adjacent to the fecaloma will be thickened. This thickening of the bowel will help differentiate from stercoral colitis and stercoral ulcer from fecal impaction as the colon is typically not thickened in cases of fecal impaction. [2]
Patients with rectal obstruction (e.g., from fecal impaction, obstruction due to a vaginal pessary) may also present with pseudodiarrhea, since only liquid stool can make it through. [2] [3] Pseudodiarrhea may be more common than chronic diarrhea and should always be considered in patients complaining of chronic diarrhea. [citation needed]
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