This is when stool fills the rectum to such a degree that it gets stuck, and can’t de defecated out. It occurs primarily in elderly persons whose rectums lose the ability to sense fullness due to nerve weakness from age. It also occurs in anyone with neurological diseases that interfere with defecation.
Constipation is the main symptom. However, it’s not unusual for the rectum to become so full that liquid stool leaks out the sides, and a person thinks they have diarrhea. The danger of fecal impactions is that they can cause pressure ulcers in the rectum, leading to internal infections and even fatal Sepsis.
Diagnosis is made by the examiner feeling a large amount of stool on rectal exam. However, if the impaction is too high up, we may be misled. If we suspect the condition but the rectum seems empty on exam, a simple x-ray can find it.
Treatment involves removing the stool, which usually has to be done by the health care provider scooping it out by finger. Enemas can help; oral laxatives will only make things worse at first. Once the impaction has been removed, certain medications can help prevent reoccurrence.