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Fecal Impactions and Bowel Obstruction

Abdominal Surgery, Bowel Obstruction, Psychotropic Medications, Rectum

Causes of and Digital Removal of Impactions:

This is a condition where the stool or fecal matter cannot pass by normal defecation. This happens as the result of extreme constipation. We all know that we need large amounts of fiber and liquid in our diets to keep our bowels functioning normally. Sometimes, we become constipated and the stool is hard to pass. As we get older, and less active, constipation can become more serious. Sometimes the accumulated stool can extend up into the sigmoid color which is the loop of large intestine above the rectum. This condition is extremely uncomfortable and can be very painful and dangerous if not corrected.

Untreated fecal impaction can lead to serious health problems that must be surgically corrected. Untreated impactions can cause the bowel to become chronically over-dilated (called megacolon), a condition requiring surgery. Other conditions caused by an obstruction can include possible damage to the bowel tissue, ulceration or even necrosis–death of the tissue by loss of blood supply from the pressure of the stool pushing against the tissue There are several causes of impaction, These include:

A diet lacking in such fibers as bran, vegetables and fruit

Poor bowel habits; not having a regular schedule for bowel movements

Medications such as antacids (that have aluminum as an ingredient); calcium and iron supplements; anti-hypertensive drugs known as calcium channel blockers; allergy medications (antihistamines); psychotropic medications such as antidepressants and tranquilizers; hormones like estrogen and progestin; and medications to reduce spasms like Parkinson’s medications; narcotic pain medications; Methadone; anticholinergic medications, antidiarrheal medications; excessive laxative use; and in bedridden patients and people with limited mobility.

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Sometimes the sufferer can remove a fecal impaction him/herself. This is called digital removal, and the finger is inserted into the rectum. wear a latex glove and use liberal amounts of a lubricant. Insert the longest, lubricated finger into the rectum to break up and manually remove pieces of the mass of hardened, clay-like stool that is lodged in the rectum.

In some cases, when it is impossible to remove the impaction at home, it must be removed manually by a doctor or nurse in the emergency room or physician’s office. Medications can be used to help prevent reoccurrences. In rare cases, surgery is required and sometimes, part of the bowel must be removed.

There are several things to help prevent bowel impaction. These include:

Drink plenty of water

Eat a diet rich in fiber

Do not use laxatives on a regular basis

Avoid prolonged bed rest

Avoid medications that can cause fecal impaction (see above)

Exercise on a regular basis

Bowel Obstruction:

A bowel obstruction is when the bowel (this can be either the large intestine or the small intestine) becomes partially or completely blocked so that the fecal matter (stool) cannot pass through.

. Many things can cause a bowel obstruction. One of them is called paralytic ileus. This is when the bowel doesn’t function correctly and the stool cannot move normally through the intestines to the rectum. Some causes of paralytic ileus can include:

Medication (see the list above for bowel impaction)

Infections of the intestines (intraperitoneal infection)

Mesenteric ischemia (decreased blood supply to the intestinal and abdominal tissues)

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Injury to the abdominal blood supply

Complications of intra-abdominal surgery

Kidney or thoracic disease

Metabolic disturbances such as decreased potassium levels

Ruptured appendix (peritonitis)

Obstructions such as hernias, adhesions (scar tissue), impacted stool, gallstones, tumors, abnormal tissue growth, twisted intestine (volvulus), foreign bodies that have been swallowed and obstruct the intestines.

A bowel obstruction is a very serious condition. If the obstruction blocks the blood supply to the intestines, the tissue can die. This can cause serious infection and even gangrene.