Treatment of a fecal impaction involves removal of the impacted stool, as well as measures to prevent constipation and further development of a fecal impaction.
MEDICATIONS:
Medications may be used to prevent further development of a fecal impaction. Stool softeners such as docusate may be recommended to aid in the passage of soft, formed stools. Additionally, bulk fiber laxatives such as Metamucil may be used to add fluid and bulk to the stool.
Glycerin or bisacodyl suppositories or other gentle laxatives may be used in conjunction with a bowel retraining program to establish a pattern of regular bowel movements. Nutritional adjustments may be helpful in those with a limited diet or immobility.
SURGERY:
Surgery is rarely required to treat a fecal impaction. However, if the fecal impaction is not removed, the colon may become overly dilated (megacolon) or the bowel can become completely obstructed. Both of these conditions will require emergency surgery to remove the impaction and possibly part of the injured bowel.
DIET:
Dietary measures such as increasing fiber intake from whole-wheat grains, fresh fruits and vegetables, and bran may help add bulk to the stool, thus promoting normal bowel movements. Special efforts should be made toward increasing daily fluid intake.
EXERCISE:
Regular exercise is very important in establishing regular bowel movements. People who are confined to a wheelchair or bed should change position frequently and perform abdominal contraction exercises and leg raises, if possible, several times throughout the day. A physical therapist can recommend a program of exercises appropriate for your physical abilities.
OTHER THERAPY:
The treatment of fecal impaction is aimed at removing the fecal impaction and initiating a program to maintain normal bowel function. Often a warm mineral oil enema is used to soften and lubricate the fecal impaction. However, enemas alone are frequently not enough to remove a large, hardened impaction.
The mass may have to be manually broken up. A health care provider will need to insert one or two fingers into the rectum and slowly break up the mass into smaller pieces so that it can be expelled. Manual removal of a fecal impaction is usually performed in small steps to reduce the risk of injuring the rectal tissues. A series of suppositories may be given between manual removal attempts, to help clear the bowel.
