Fecal impaction - Revision history

Ostermayer: Prepared the page for translation

2026-01-04T22:54:45Z

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← Revisión anterior		Revisión del 22:54 4 ene 2026
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			<languages/>
			<translate>

	==Background==		==Background==

	[[File:Rectum anatomy en.png\|thumb\|Anatomy of the anus and rectum.]]		[[File:Rectum anatomy en.png\|thumb\|Anatomy of the anus and rectum.]]
	*Typically a complication of chronic constipation that results in the accumulation of hardened/inspissated fecal matter in the colon or rectum that cannot be spontaneously evacuated		*Typically a complication of chronic constipation that results in the accumulation of hardened/inspissated fecal matter in the colon or rectum that cannot be spontaneously evacuated
	*Incidence greatly increases with age and polypharmacy; common in the inpatient or institutionalized setting		*Incidence greatly increases with age and polypharmacy; common in the inpatient or institutionalized setting


	===Risk Factors===		===Risk Factors===

	*Elderly and young age		*Elderly and young age
	*Chronic [[constipation]]		*Chronic [[Special:MyLanguage/constipation\|constipation]]
	*Lifestyle factors (immobility/bedbound, low fiber diet, dehydration)		*Lifestyle factors (immobility/bedbound, low fiber diet, dehydration)
	*Medications that impair GI motility ([[anticholinergics]], [[antipsychotics]], [[opioids]])		*Medications that impair GI motility ([[Special:MyLanguage/anticholinergics\|anticholinergics]], [[Special:MyLanguage/antipsychotics\|antipsychotics]], [[Special:MyLanguage/opioids\|opioids]])
	*Metabolic disorders ([[hypothyroidism]], [[Diabetes]]		*Metabolic disorders ([[Special:MyLanguage/hypothyroidism\|hypothyroidism]], [[Special:MyLanguage/Diabetes\|Diabetes]]
	*Anatomic abnormalities ([[colorectal cancer\|malignancy]], [[anorectal disorders\|anorectal disease]], [[Hirschsprung's disease]])		*Anatomic abnormalities ([[Special:MyLanguage/colorectal cancer\|malignancy]], [[Special:MyLanguage/anorectal disorders\|anorectal disease]], [[Special:MyLanguage/Hirschsprung's disease\|Hirschsprung's disease]])
	*Neurologic conditions ([[dementia]], [[spinal cord injury]], [[cerebral palsy]])		*Neurologic conditions ([[Special:MyLanguage/dementia\|dementia]], [[Special:MyLanguage/spinal cord injury\|spinal cord injury]], [[Special:MyLanguage/cerebral palsy\|cerebral palsy]])


	==Clinical Features==		==Clinical Features==


	===History===		===History===
	*[[Abdominal pain]], bloating, distention, or early satiety
	*[[Nausea and vomiting]]		*[[Special:MyLanguage/Abdominal pain\|Abdominal pain]], bloating, distention, or early satiety
			*[[Special:MyLanguage/Nausea and vomiting\|Nausea and vomiting]]
	*Overflow stool incontinence as diarrhea		*Overflow stool incontinence as diarrhea
	*Obstipation		*Obstipation
	*[[Agitation]]/[[confusion]] (elderly patients with neuropsychiatric conditions)		*[[Special:MyLanguage/Agitation\|Agitation]]/[[Special:MyLanguage/confusion\|confusion]] (elderly patients with neuropsychiatric conditions)
	*[[Tachycardia]] may be present due to pain or dehydration		*[[Special:MyLanguage/Tachycardia\|Tachycardia]] may be present due to pain or dehydration
	*[[Urinary incontinence]]		*[[Special:MyLanguage/Urinary incontinence\|Urinary incontinence]]


	===Physical exam===		===Physical exam===
	*Abdominal distention and/or [[abdominal pain\|tenderness]]
			*Abdominal distention and/or [[Special:MyLanguage/abdominal pain\|tenderness]]
	*Palpable firm stool balls or copious amounts of stool found on digital rectal exam		*Palpable firm stool balls or copious amounts of stool found on digital rectal exam
	**Note that for proximal impactions (proximal rectum or sigmoid colon), DRE may not be diagnostic		**Note that for proximal impactions (proximal rectum or sigmoid colon), DRE may not be diagnostic


	==Differential Diagnosis==		==Differential Diagnosis==

			</translate>
	{{Constipation DDX}}		{{Constipation DDX}}
			<translate>


	==Evaluation==		==Evaluation==

	[[File:PMC5318312 12245 2017 134 Fig1 HTML.png\|thumb\|Pelvic CT scan showing a large fecal impaction (arrow).]]		[[File:PMC5318312 12245 2017 134 Fig1 HTML.png\|thumb\|Pelvic CT scan showing a large fecal impaction (arrow).]]

	===Workup===		===Workup===

	*Digital rectal exam		*Digital rectal exam
	*Abdominal panel		*Abdominal panel
	**CBC		**CBC
	**Chemistry ([[hypokalemia]] or [[hypercalcemia]])		**Chemistry ([[Special:MyLanguage/hypokalemia\|hypokalemia]] or [[Special:MyLanguage/hypercalcemia\|hypercalcemia]])
	**LFTs + lipase		**LFTs + lipase
	**Consider coagulation studies (PT, PTT, INR), as a marker of liver function		**Consider coagulation studies (PT, PTT, INR), as a marker of liver function
	*Consider [[TSH]] if concern for [[hypothyroid]] related [[constipation]]		*Consider [[Special:MyLanguage/TSH\|TSH]] if concern for [[Special:MyLanguage/hypothyroid\|hypothyroid]] related [[Special:MyLanguage/constipation\|constipation]]
	*Consider [[lactate]] if concern for [[stercoral colitis]]		*Consider [[Special:MyLanguage/lactate\|lactate]] if concern for [[Special:MyLanguage/stercoral colitis\|stercoral colitis]]
	*CT if abdominal tenderness, elderly, or severe presentation		*CT if abdominal tenderness, elderly, or severe presentation
	**'''Constipation should not cause abdominal tenderness on exam'''		**'''Constipation should not cause abdominal tenderness on exam'''
	**CT may show large stool burden in colon/rectum		**CT may show large stool burden in colon/rectum
	**[[Stercoral colitis]] is CT finding caused by impacted fecal material causing pressure edema and ischemia on the bowel wall. Left untreated, the condition can lead to wall ischemia, ulceration, and perforation.<ref> Ünal E, Onur MR, Balcı S, Görmez A, Akpınar E, Böge M. Stercoral colitis: diagnostic value of CT findings. Diagn Interv Radiol. 2017;23(1):5-9.</ref>		**[[Special:MyLanguage/Stercoral colitis\|Stercoral colitis]] is CT finding caused by impacted fecal material causing pressure edema and ischemia on the bowel wall. Left untreated, the condition can lead to wall ischemia, ulceration, and perforation.<ref> Ünal E, Onur MR, Balcı S, Görmez A, Akpınar E, Böge M. Stercoral colitis: diagnostic value of CT findings. Diagn Interv Radiol. 2017;23(1):5-9.</ref>
	***Findings include colonic wall thickening, pericolonic fat stranding, and extraluminal bubbles of gas or abscess (signs of perforation); all of which are not found in uncomplicated fecal impaction.		***Findings include colonic wall thickening, pericolonic fat stranding, and extraluminal bubbles of gas or abscess (signs of perforation); all of which are not found in uncomplicated fecal impaction.


	===Diagnosis===		===Diagnosis===

	*Diagnosis is frequently clinical		*Diagnosis is frequently clinical
	*In patients with concerning symptoms/risk factors, CT can confirm diagnosis and rule out more emergent conditions		*In patients with concerning symptoms/risk factors, CT can confirm diagnosis and rule out more emergent conditions


	==Management==		==Management==

	*Surgery if there are signs of perforation, peritonitis, or stercoral colitis		*Surgery if there are signs of perforation, peritonitis, or stercoral colitis
	**In severe cases refractory to mainstay treatments, manual disimpaction under anesthesia in OR may be requried<ref>Setya A, Mathew G, Cagir B. Fecal Impaction. [Updated 2023 Jul 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.</ref>		**In severe cases refractory to mainstay treatments, manual disimpaction under anesthesia in OR may be requried<ref>Setya A, Mathew G, Cagir B. Fecal Impaction. [Updated 2023 Jul 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.</ref>
Línea 60:		Línea 84:
	*Proximal impactions typically respond better to oral laxatives		*Proximal impactions typically respond better to oral laxatives
	*After initial disimpaction, address risk factors (especially medications) and initiate a maintenance bowel regimen		*After initial disimpaction, address risk factors (especially medications) and initiate a maintenance bowel regimen


	==Disposition==		==Disposition==
	*Consider admission for patients with [[stercoral colitis]] for aggressive bowel regimen and washout
			*Consider admission for patients with [[Special:MyLanguage/stercoral colitis\|stercoral colitis]] for aggressive bowel regimen and washout
	*First-time fecal impaction may prompt colonoscopy or flexible sigmoidoscopy to assess for anatomic causes<ref>Obokhare I. Fecal impaction: a cause for concern? Clin Colon Rectal Surg. 2012 Mar;25(1):53-8. doi: 10.1055/s-0032-1301760. PMID: 23449376; PMCID: PMC3348734.</ref>		*First-time fecal impaction may prompt colonoscopy or flexible sigmoidoscopy to assess for anatomic causes<ref>Obokhare I. Fecal impaction: a cause for concern? Clin Colon Rectal Surg. 2012 Mar;25(1):53-8. doi: 10.1055/s-0032-1301760. PMID: 23449376; PMCID: PMC3348734.</ref>


	==See Also==		==See Also==
	*[[Constipation]]
	*[[Stercoral colitis]]		*[[Special:MyLanguage/Constipation\|Constipation]]
			*[[Special:MyLanguage/Stercoral colitis\|Stercoral colitis]]


	==References==		==References==

	<references/>		<references/>

	[[Category:GI]]		[[Category:GI]]
			</translate>

Rossdonaldson1: /* Workup */

2024-02-14T18:15:09Z

Workup

← Revisión anterior		Revisión del 18:15 14 feb 2024
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	**Chemistry ([[hypokalemia]] or [[hypercalcemia]])		**Chemistry ([[hypokalemia]] or [[hypercalcemia]])
	**LFTs + lipase		**LFTs + lipase
			**Consider coagulation studies (PT, PTT, INR), as a marker of liver function
	*Consider [[TSH]] if concern for [[hypothyroid]] related [[constipation]]		*Consider [[TSH]] if concern for [[hypothyroid]] related [[constipation]]
	*Consider [[lactate]] if concern for [[stercoral colitis]]		*Consider [[lactate]] if concern for [[stercoral colitis]]

Rossdonaldson1: /* Evaluation */

2024-02-14T18:05:06Z

Evaluation

← Revisión anterior		Revisión del 18:05 14 feb 2024
Línea 39:		Línea 39:
	**Chemistry ([[hypokalemia]] or [[hypercalcemia]])		**Chemistry ([[hypokalemia]] or [[hypercalcemia]])
	**LFTs + lipase		**LFTs + lipase
	*Consider [[TSH]] if concern for [[hypothyroid]] related constipation		*Consider [[TSH]] if concern for [[hypothyroid]] related [[constipation]]
	*Consider [[lactate]] if concern for [[stercoral colitis]]		*Consider [[lactate]] if concern for [[stercoral colitis]]
	*CT if abdominal tenderness, elderly, or severe presentation		*CT if abdominal tenderness, elderly, or severe presentation

Rossdonaldson1: /* Diagnosis */

2024-02-14T18:04:17Z

Diagnosis

← Revisión anterior		Revisión del 18:04 14 feb 2024
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	**[[Stercoral colitis]] is CT finding caused by impacted fecal material causing pressure edema and ischemia on the bowel wall. Left untreated, the condition can lead to wall ischemia, ulceration, and perforation.<ref> Ünal E, Onur MR, Balcı S, Görmez A, Akpınar E, Böge M. Stercoral colitis: diagnostic value of CT findings. Diagn Interv Radiol. 2017;23(1):5-9.</ref>		**[[Stercoral colitis]] is CT finding caused by impacted fecal material causing pressure edema and ischemia on the bowel wall. Left untreated, the condition can lead to wall ischemia, ulceration, and perforation.<ref> Ünal E, Onur MR, Balcı S, Görmez A, Akpınar E, Böge M. Stercoral colitis: diagnostic value of CT findings. Diagn Interv Radiol. 2017;23(1):5-9.</ref>
	***Findings include colonic wall thickening, pericolonic fat stranding, and extraluminal bubbles of gas or abscess (signs of perforation); all of which are not found in uncomplicated fecal impaction.		***Findings include colonic wall thickening, pericolonic fat stranding, and extraluminal bubbles of gas or abscess (signs of perforation); all of which are not found in uncomplicated fecal impaction.

	~~===Diagnosis===~~
	*Diagnosis is frequently clinical
	*In patients with concerning symptoms/risk factors, CT can confirm diagnosis and rule out more emergent conditions

	===Diagnosis===		===Diagnosis===

Rossdonaldson1: /* Workup */

2024-02-14T18:04:02Z

Workup

← Revisión anterior		Revisión del 18:04 14 feb 2024
Línea 35:		Línea 35:
	===Workup===		===Workup===
	*Digital rectal exam		*Digital rectal exam
	*CBC		*Abdominal panel
	*Chemistry ~~to evaluate for~~ [[hypokalemia]], [[hypercalcemia]]~~, or prerenal [[acute kidney injury]]~~		**CBC
			**Chemistry ([[hypokalemia]] or [[hypercalcemia]])
			**LFTs + lipase
	*Consider [[TSH]] if concern for [[hypothyroid]] related constipation		*Consider [[TSH]] if concern for [[hypothyroid]] related constipation
	*Consider [[lactate]] if concern for [[stercoral colitis]]		*Consider [[lactate]] if concern for [[stercoral colitis]]
	*CT if abdominal tenderness, elderly, or severe presentation		*CT if abdominal tenderness, elderly, or severe presentation
			**'''Constipation should not cause abdominal tenderness on exam'''
	**CT may show large stool burden in colon/rectum		**CT may show large stool burden in colon/rectum
	**[[Stercoral colitis]] is CT finding caused by impacted fecal material causing pressure edema and ischemia on the bowel wall. Left untreated, the condition can lead to wall ischemia, ulceration, and perforation.<ref> Ünal E, Onur MR, Balcı S, Görmez A, Akpınar E, Böge M. Stercoral colitis: diagnostic value of CT findings. Diagn Interv Radiol. 2017;23(1):5-9.</ref>		**[[Stercoral colitis]] is CT finding caused by impacted fecal material causing pressure edema and ischemia on the bowel wall. Left untreated, the condition can lead to wall ischemia, ulceration, and perforation.<ref> Ünal E, Onur MR, Balcı S, Görmez A, Akpınar E, Böge M. Stercoral colitis: diagnostic value of CT findings. Diagn Interv Radiol. 2017;23(1):5-9.</ref>
	***Findings include colonic wall thickening, pericolonic fat stranding, and extraluminal bubbles of gas or abscess (signs of perforation); all of which are not found in uncomplicated fecal impaction.		***Findings include colonic wall thickening, pericolonic fat stranding, and extraluminal bubbles of gas or abscess (signs of perforation); all of which are not found in uncomplicated fecal impaction.

			===Diagnosis===
			*Diagnosis is frequently clinical
			*In patients with concerning symptoms/risk factors, CT can confirm diagnosis and rule out more emergent conditions

	===Diagnosis===		===Diagnosis===

Rossdonaldson1: /* Workup */

2024-02-14T17:51:18Z

Workup

← Revisión anterior		Revisión del 17:51 14 feb 2024
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	*Chemistry to evaluate for [[hypokalemia]], [[hypercalcemia]], or prerenal [[acute kidney injury]]		*Chemistry to evaluate for [[hypokalemia]], [[hypercalcemia]], or prerenal [[acute kidney injury]]
	*Consider [[TSH]] if concern for [[hypothyroid]] related constipation		*Consider [[TSH]] if concern for [[hypothyroid]] related constipation
			*Consider [[lactate]] if concern for [[stercoral colitis]]
	*CT if abdominal tenderness, elderly, or severe presentation		*CT if abdominal tenderness, elderly, or severe presentation
	**CT may show large stool burden in colon/rectum		**CT may show large stool burden in colon/rectum

Rossdonaldson1: /* Evaluation */

2024-02-14T17:41:29Z

Evaluation

← Revisión anterior		Revisión del 17:41 14 feb 2024
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	==Evaluation==		==Evaluation==
	[[File:PMC5318312 12245 2017 134 Fig1 HTML.png\|thumb\|Pelvic CT scan showing a large fecal impaction (arrow).]]		[[File:PMC5318312 12245 2017 134 Fig1 HTML.png\|thumb\|Pelvic CT scan showing a large fecal impaction (arrow).]]
			===Workup===
	*Digital rectal exam		*Digital rectal exam
	*CBC		*CBC
	*Chemistry to evaluate for [[hypokalemia]], [[hypercalcemia]], or prerenal [[acute kidney injury]]		*Chemistry to evaluate for [[hypokalemia]], [[hypercalcemia]], or prerenal [[acute kidney injury]]
	*~~Lacate, depending on abdominal exam~~		*Consider [[TSH]] if concern for [[hypothyroid]] related constipation
	*TSH if ~~indicated~~		*CT if abdominal tenderness, elderly, or severe presentation
	*[[~~Abdominal X-ray~~]] ~~to evaluate for air-fluid levels and free-air~~
	*CT if severe presentation
	**CT may show large stool burden in colon/rectum		**CT may show large stool burden in colon/rectum
	**[[Stercoral colitis]] is CT finding caused by impacted fecal material causing pressure edema and ischemia on the bowel wall. Left untreated, the condition can lead to wall ischemia, ulceration, and perforation.<ref> Ünal E, Onur MR, Balcı S, Görmez A, Akpınar E, Böge M. Stercoral colitis: diagnostic value of CT findings. Diagn Interv Radiol. 2017;23(1):5-9.</ref>		**[[Stercoral colitis]] is CT finding caused by impacted fecal material causing pressure edema and ischemia on the bowel wall. Left untreated, the condition can lead to wall ischemia, ulceration, and perforation.<ref> Ünal E, Onur MR, Balcı S, Görmez A, Akpınar E, Böge M. Stercoral colitis: diagnostic value of CT findings. Diagn Interv Radiol. 2017;23(1):5-9.</ref>
	***Findings include colonic wall thickening, pericolonic fat stranding, and extraluminal bubbles of gas or abscess (signs of perforation); all of which are not found in uncomplicated fecal impaction.		***Findings include colonic wall thickening, pericolonic fat stranding, and extraluminal bubbles of gas or abscess (signs of perforation); all of which are not found in uncomplicated fecal impaction.

			===Diagnosis===
			*Diagnosis is frequently clinical
			*In patients with concerning symptoms/risk factors, CT can confirm diagnosis and rule out more emergent conditions

	==Management==		==Management==

Patricklin at 16:11, 1 February 2024

2024-02-01T16:11:22Z

← Revisión anterior		Revisión del 16:11 1 feb 2024
Línea 1:		Línea 1:
	==Background==		==Background==
	[[File:Rectum anatomy en.png\|thumb\|Anatomy of the anus and rectum.]]		[[File:Rectum anatomy en.png\|thumb\|Anatomy of the anus and rectum.]]
	*Typically a complication of chronic constipation that results in the accumulation hardened fecal matter in the colon or rectum that cannot be spontaneously evacuated		*Typically a complication of chronic constipation that results in the accumulation of hardened/inspissated fecal matter in the colon or rectum that cannot be spontaneously evacuated
			*Incidence greatly increases with age and polypharmacy; common in the inpatient or institutionalized setting

	===Risk Factors===		===Risk Factors===
	*Elderly and young age		*Elderly and young age
	*Chronic [[constipation]]		*Chronic [[constipation]]
	*Lifestyle factors (immobility, low fiber diet, dehydration)		*Lifestyle factors (immobility/bedbound, low fiber diet, dehydration)
	*Medications that impair GI motility ([[anticholinergics]], [[antipsychotics]], [[opioids]])		*Medications that impair GI motility ([[anticholinergics]], [[antipsychotics]], [[opioids]])
			*Metabolic disorders ([[hypothyroidism]], [[Diabetes]]
	*Anatomic abnormalities ([[colorectal cancer\|malignancy]], [[anorectal disorders\|anorectal disease]], [[Hirschsprung's disease]])		*Anatomic abnormalities ([[colorectal cancer\|malignancy]], [[anorectal disorders\|anorectal disease]], [[Hirschsprung's disease]])
	*Neurologic conditions ([[dementia]], [[spinal cord injury]], [[cerebral palsy]])		*Neurologic conditions ([[dementia]], [[spinal cord injury]], [[cerebral palsy]])
Línea 13:		Línea 15:
	==Clinical Features==		==Clinical Features==
	===History===		===History===
	*[[Abdominal pain]] or ~~bloating~~		*[[Abdominal pain]], bloating, distention, or early satiety
	*[[Nausea and vomiting]]		*[[Nausea and vomiting]]
			*Overflow stool incontinence as diarrhea
	*Obstipation		*Obstipation
	*[[Agitation]]/[[confusion]] (elderly patients with neuropsychiatric conditions)		*[[Agitation]]/[[confusion]] (elderly patients with neuropsychiatric conditions)
			*[[Tachycardia]] may be present due to pain or dehydration
	*[[Urinary incontinence]]		*[[Urinary incontinence]]
	*Overflow stool incontinence

	===Physical exam===		===Physical exam===
	*Abdominal distention and/or [[abdominal pain\|tenderness]]		*Abdominal distention and/or [[abdominal pain\|tenderness]]
	*Palpable firm stool balls on digital rectal exam		*Palpable firm stool balls or copious amounts of stool found on digital rectal exam
			**Note that for proximal impactions (proximal rectum or sigmoid colon), DRE may not be diagnostic

	==Differential Diagnosis==		==Differential Diagnosis==
Línea 30:		Línea 34:
	[[File:PMC5318312 12245 2017 134 Fig1 HTML.png\|thumb\|Pelvic CT scan showing a large fecal impaction (arrow).]]		[[File:PMC5318312 12245 2017 134 Fig1 HTML.png\|thumb\|Pelvic CT scan showing a large fecal impaction (arrow).]]
	*Digital rectal exam		*Digital rectal exam
	*Chemistry to evaluate for [[hypokalemia]] or [[~~hypercalcemia~~]]		*CBC
			*Chemistry to evaluate for [[hypokalemia]], [[hypercalcemia]], or prerenal [[acute kidney injury]]
			*Lacate, depending on abdominal exam
	*TSH if indicated		*TSH if indicated
	*[[Abdominal X-ray]] to evaluate for air-fluid levels and free-air		*[[Abdominal X-ray]] to evaluate for air-fluid levels and free-air
	*CT if severe presentation		*CT if severe presentation
			**CT may show large stool burden in colon/rectum
	**[[Stercoral colitis]] is CT finding caused by impacted fecal material causing pressure edema and ischemia on the bowel wall. Left untreated, the condition can lead to wall ischemia, ulceration, and perforation.<ref> Ünal E, Onur MR, Balcı S, Görmez A, Akpınar E, Böge M. Stercoral colitis: diagnostic value of CT findings. Diagn Interv Radiol. 2017;23(1):5-9.</ref>		**[[Stercoral colitis]] is CT finding caused by impacted fecal material causing pressure edema and ischemia on the bowel wall. Left untreated, the condition can lead to wall ischemia, ulceration, and perforation.<ref> Ünal E, Onur MR, Balcı S, Görmez A, Akpınar E, Böge M. Stercoral colitis: diagnostic value of CT findings. Diagn Interv Radiol. 2017;23(1):5-9.</ref>
	***Findings include colonic wall thickening, pericolonic fat stranding, and extraluminal bubbles of gas or abscess (signs of perforation); all of which are not found in uncomplicated fecal impaction.		***Findings include colonic wall thickening, pericolonic fat stranding, and extraluminal bubbles of gas or abscess (signs of perforation); all of which are not found in uncomplicated fecal impaction.
Línea 39:		Línea 46:
	==Management==		==Management==
	*Surgery if there are signs of perforation, peritonitis, or stercoral colitis		*Surgery if there are signs of perforation, peritonitis, or stercoral colitis
	*Distal impactions - manual disimpaction and/or rectal suppositories or enemas		**In severe cases refractory to mainstay treatments, manual disimpaction under anesthesia in OR may be requried<ref>Setya A, Mathew G, Cagir B. Fecal Impaction. [Updated 2023 Jul 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.</ref>
			*Distal impactions - manual disimpaction and/or rectal suppositories or enemas (Fleet, mineral oil, warm water, docusate)
			**Administration of small-volume enemas over a longer time may be more beneficial and comfortable for patient
			**In small studies, Fleet (sodium phosphate) enemas led to to increased rate of electrolyte derangements in the elderly<ref>Ori Y, Rozen-Zvi B, Chagnac A, Herman M, Zingerman B, Atar E, Gafter U, Korzets A. Fatalities and severe metabolic disorders associated with the use of sodium phosphate enemas: a single center's experience. Arch Intern Med. 2012 Feb 13;172(3):263-5. doi: 10.1001/archinternmed.2011.694. PMID: 22332159.</ref>
	*Proximal impactions typically respond better to oral laxatives		*Proximal impactions typically respond better to oral laxatives
	*After initial disimpaction, address risk factors and initiate a maintenance bowel regimen		*After initial disimpaction, address risk factors (especially medications) and initiate a maintenance bowel regimen

	==Disposition==		==Disposition==
	*Consider admission for patients with [[stercoral colitis]] for aggressive bowel regimen and washout		*Consider admission for patients with [[stercoral colitis]] for aggressive bowel regimen and washout
			*First-time fecal impaction may prompt colonoscopy or flexible sigmoidoscopy to assess for anatomic causes<ref>Obokhare I. Fecal impaction: a cause for concern? Clin Colon Rectal Surg. 2012 Mar;25(1):53-8. doi: 10.1055/s-0032-1301760. PMID: 23449376; PMCID: PMC3348734.</ref>

	==See Also==		==See Also==

Rossdonaldson1: /* See Also */

2023-08-02T15:50:54Z

Rossdonaldson1: /* Background */

2021-07-24T13:49:11Z

Background

← Revisión anterior		Revisión del 13:49 24 jul 2021
Línea 1:		Línea 1:
	==Background==		==Background==
			[[File:Rectum anatomy en.png\|thumb\|Anatomy of the anus and rectum.]]
	*Typically a complication of chronic constipation that results in the accumulation hardened fecal matter in the colon or rectum that cannot be spontaneously evacuated		*Typically a complication of chronic constipation that results in the accumulation hardened fecal matter in the colon or rectum that cannot be spontaneously evacuated

← Revisión anterior		Revisión del 15:50 2 ago 2023
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	==See Also==		==See Also==
	*[[Constipation]]		*[[Constipation]]
			*[[Stercoral colitis]]

	==References==		==References==