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Fecal Impaction


What is fecal impaction?

Fecal impaction is a buildup of hardened bowel movements in your rectum that you cannot pass. Your bowel movements may form one large mass or several smaller masses.

What increases my risk for fecal impaction?

  • Constipation
  • Lack of fiber or liquids in your diet
  • Ignoring the urge to pass a bowel movement
  • Being older than 80
  • Certain medical conditions, such as multiple sclerosis (MS) or Parkinson disease
  • Lack of physical activity
  • Certain pain medicines, iron supplements, or antidepressants

What are the signs and symptoms of fecal impaction?

  • Cannot pass a bowel movement or feeling like you did not pass the entire bowel movement
  • Abdominal pain, bloating, or cramps
  • Some diarrhea or gas that you cannot control, increased urge to urinate, or loss of control of urine
  • Nausea or vomiting
  • Loss of appetite or weight loss
  • Confusion or agitation
  • Headache or a general ill feeling

How is fecal impaction diagnosed?

Your healthcare provider will ask which medicines you take. You may need any of the following:

  • A digital rectal exam will be done by your healthcare provider to check for a fecal impaction. Your healthcare provider will put a gloved finger inside your anus to feel for the bowel movement.
  • Blood tests will be done to check for anemia, infection, and high levels of iron in your blood.
  • An x-ray may show a blockage in your bowel or rectum.
  • A barium enema is an x-ray of the colon. A tube is put into your anus, and a liquid called barium is put through the tube. Barium helps your colon show up better on the x-ray.
  • A sigmoidoscopy is a scope used to check for any changes in your bowels that may be causing your condition. A long, thin tube with a tiny camera on the end is put into your rectum. A small tissue sample may be taken from your bowel and sent to a lab for tests. Follow your healthcare provider's instructions for what to do before, during, and after the test.

How is fecal impaction treated?

  • Manual removal of your bowel movement blockage may need to be done. Your healthcare provider will use his hand to remove the bowel movement. He may have to break it into smaller pieces with his fingers. He will use lubricant to help make the removal smoother.
  • Enemas help relieve constipation and soften your bowel movement so you are able to pass it. You may receive an enema during the manual removal or by itself. Your healthcare provider will inject liquid into your rectum.
  • Suppositories are small cone-shaped pills that you insert into your rectum to help loosen your bowel movements.
  • Laxatives are drinks or drink mixtures that help loosen your bowel movement blockage so you can pass it with ease.
  • Mineral oils are lubricants for your bowels that help soften your bowel movements so they pass smoothly. These may be used if your healthcare provider could not completely remove the blockage.

What are the risks of fecal impaction?

You could lose the urge to pass bowel movements. Constipation and other symptoms could return after treatment, or if you do not follow your healthcare provider's plan. Long-term blockages of your bowel movements could lead to sepsis (a serious blood infection). It could also lead to low blood pressure, bleeding, or torn bowels. These conditions could be life-threatening.

How can fecal impaction be prevented?

  • Set up a regular toileting schedule at the same time every day. Try to pass a bowel movement when you first wake up, or half an hour after you eat. This may help you control your bowel movements and help you know when they will happen.
  • Take fiber supplements daily as directed. Fiber supplements will help you have a regular bowel movement schedule.
  • Use enemas, laxatives, or constipation medicines as directed. Ask your healthcare provider how often to take medicine when you begin to feel constipated.

How can I manage my symptoms?

  • Eat foods that are high in fiber. Healthy high-fiber foods include fruits, vegetables, whole-grain breads, and beans. Ask if you need to be on a special diet and how much fiber you should eat each day.
  • Drink liquids as directed. You may need to drink 1.5 to 2 liters of water each day. Water will help keep your bowel movements soft and help you pass them with less pain. Ask your healthcare provider how much liquid to drink each day and which liquids are best for you.
  • Try to pass a bowel movement as soon as you get the urge. This will help prevent more constipation.
  • Exercise regularly. This will help keep your bowels working well and may help you pass bowel movements more often.
  • Keep a diary of your bowel movement schedule. Write down the date and time of each bowel movement. Also write down if you had trouble passing it. This will help you know if you are passing bowel movements as you should.

When should I contact my healthcare provider?

Contact your healthcare provider if:

  • You are not able to pass a bowel movement, even after treatment, or you pass fewer than 3 bowel movements in a week.
  • You feel lightheaded, dizzy, or faint.
  • You have nausea, vomiting, or diarrhea that will not stop.
  • You have a fever.
  • You have questions or concerns about your condition or care.

When should I seek immediate care?

Seek immediate care or call 911 if:

  • You have swelling in your abdomen.
  • You have bloody bowel movements.
  • You bleed from your rectum.
  • You have severe pain.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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