Bowel impaction is an uncomfortable condition in which a large, compacted mass of stool lodges in the rectum or colon, causing a partial or complete blockage. Bowel impaction, also known as fecal impaction, can occur at any age but most frequently affects seniors. Risk factors for bowel impaction include chronic or severe constipation, prolonged use of narcotic pain relievers, spinal cord injury, Parkinson disease, multiple sclerosis and long-term laxative abuse, among others. By definition, a person with a bowel impaction cannot pass the blocked stool without treatment. It’s important to recognize the symptoms of a bowel impaction to avoid possible complications.
Constipation or Diarrhea
Most people with a bowel impaction experience constipation -- an inability to pass stool. This is often accompanied by an uncomfortable feeling of rectal fullness and lower abdominal pain. While all people with a fecal impaction are unable to pass formed stool, some experience frequent passage of small amounts of watery diarrhea. As fecal material backs up, pressure builds in the lower bowel and/or rectum and stretches these tissues. Small amounts of liquid stool and mucus escape around the bowel impaction, leading to watery diarrhea. This fluid often seeps out involuntarily because the rectum is too stretched to voluntarily control stool passage.
Abdominal Pain, Bloating, Nausea and Vomiting
Abdominal pain is the most common symptom experienced by people with a bowel impaction, as noted in a January 2016 study report published in "BMC Geriatrics." The pain is sometimes accompanied by abdominal bloating, due to accumulation of fluid and stool in the bowels. Nausea, with or without vomiting, also commonly occurs along with a loss of appetite. Attempts to pass stool usually involve intense straining, which may increase abdominal and rectal pain.
Urinary and Back Symptoms
The bladder, rectum and lower colon lie in close proximity to one another. With a bowel impaction, the large mass of stool might press against the bladder. This reduces the amount of urine the bladder can hold, leading to a more frequent need to empty the bladder. Pressure on the bladder from a fecal impaction can also trigger involuntary bladder contractions that might lead to urinary incontinence. Back pain might occur if the impacted bowel presses on nearby nerves, although this is uncommon compared to other signs and symptoms.
Other Signs and Symptoms
Among people with dementia or another severe neuropsychiatric condition, bowel impaction may lead to unexplained agitation or confusion. The reflexes of the involuntarily nervous system might also be affected, leading to abnormalities in blood pressure and heart function. These signs and symptoms of a bowel impaction are rare other than among ailing, older seniors who require daily at-home or residential nursing care.
Warnings and Precautions
A bowel impaction requires prompt treatment to avoid potentially life-threatening complications, such as a hole or ulcer in the rectum or colon. See your doctor right away if you experience signs or symptoms that might indicate a bowel impaction. Seek emergency medical care if you develop any warning signs or symptoms that might signal a bowel impaction complication or another serious condition mimicking a bowel impaction, including:
-- fever or chills
-- severe or worsening abdominal pain
-- bloody diarrhea
-- inability to keep food down
-- rapid heart rate
-- dizziness, lightheadedness or fainting
Reviewed and revised by: Tina M. St. John, M.D.