A condition in which the diminished mobility of the intestine may lead to the accumulation of the feces in the rectum followed by the blockage of the expulsion of the fluids is commonly called fecal impaction. There is another related term known as fecal stacking which is may characterized by the accumulation of the feces of varying consistencies in the premises of rectum followed by the blockage. Both terms are considered to be highly relevant to each other.
A worse condition of the fecal impaction is may called a fecaloma which is characterized by a high accumulation of the stool in the rectum which may appear as a tumor in the premises. This kind of accumulation is progressed step by step and may deteriorate and spread the harm to the whole digestive system leading to the impairment of the system.
It might happen in the incessant obstacle of stool travel, as in megacolon and interminable obstruction.
The diagnosis is may be carried by the following techniques;
- CT scan
- Projectional radiography
Careful intercession as a sigmoid colectomy or proctocolectomy and ileostomy might be required just when every single preservationist proportion of departure falls flat. Endeavors at expulsion can have serious and even deadly impacts, for example, the crack of the colon divider by the catheter or an intense point of the fecaloma (stercoral aperture), trailed by sepsis. It might likewise prompt stercoral puncturing, a condition portrayed by entrail aperture because of weight corruption from a fecal mass or fecaloma.
It may include the following signs and symptoms;
- Incorporate interminable obstruction
- There can be fecal incontinence and incomprehensible or flood the runs (encopresis) as fluid stool goes around the deterrent.
- Stress may lead to the blockage of feces.
- Stomach agony and swelling could likewise be available relying upon the seriousness of the condition.
- Loss of craving can likewise happen.
There are numerous potential causes including;
- Physical inertia
- Poor diet (especially of fiber)
- Less water intake
- Holding in the defecations can cause this condition as manual expulsion of fecal impaction is frequently required with large patients in footing, after a barium bowel purge, and in ineffectively hydrated more established grown-ups.
Few medications such as; narcotic agony relievers including fentanyl, buprenorphine, methadone, codeine, oxycodone, hydrocodone, morphine, hydromorphone, etc. and certain tranquilizers may cause this condition.
Few medical conditions, for example, touchy inside disorder, neurological clutters, incapacitated ileus, gastroparesis, diabetes, lack of hydration, expanded prostate organ, extended colon, ingested remote item, and provocative gut infections, Crohn’s sickness, and colitis, and immune system maladies, for example, amyloidosis, celiac ailment, lupus, and scleroderma can cause obstruction. Hypothyroidism can cause a ceaseless stoppage because of drowsy, slower, or more fragile colon withdrawals. Spinal line injury is a typical reason for clogging, because of ileus.
The proper treatment of fecaloma may involve both the cure of the condition as well as the remission of the disease in the future. This proper treatment may involve a few techniques for the expulsion of fecal impaction from the body which may involve; diluting the stools by the administration of osmotic intestinal medications or bowel purges for easy removal, lubrication of the feces and segregation of the stool may also help in this regard.
Osmotic diuretics: include magnesium citrate which may take the time of almost 08 hours to start the processing and considered to be not enough for the expulsion of feces from the body. Notwithstanding, since it might take 24 to 48 hours for it to produce results, it isn’t appropriate to situations where the impaction should be evacuated quickly because of the danger of intricacies or extreme agony.
Bowel purges: involves the administration of few chemicals such as; hyperosmotic saline and suppositories, (glycerine suppositories) that helps in the progression of peristalsis by enhancing the water content in the stool which ultimately leads to the expulsion of feces. It works better and faster than the diuretics which are administered orally. Regardless of whether the bowel purge is fruitful at dislodging the affected stool, the affected stool may remain too enormous to even think about being removed through the butt-centric waterway.
Mineral oil douches: can help by greasing up the stool for simpler entry. In situations where purifications neglect to evacuate the impaction, polyethylene glycol can be utilized to endeavor to mellow the mass more than 24–48 hours, or if quick expulsion of the mass is required, manual disimpaction might be utilized.
Manual disimpaction: involves a technique in which the anal hole is lubricated and then a gloved finger is inserted inside the hole by applying round movements with the help of that finger to separate the fecal masses.