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At least 19 recordsLinked to original sources
PubMed1986

The geriatric implications of fecal impaction.

Fecal impactions are a common problem in debilitated elderly people and may present as a life-threatening event. The atypical presentations of fecal impactions are not well-recognized, and the incidence, morbidity and mortality of fecal impactions in the elderly are largely unknown. Elderly debilitated people have reduced organ system reserve. An acute illness may worsen underlying chronic diseases. Fecal impactions may upset the fragile homeostasis of an elderly debilitated person. The signs and symptoms of fecal impaction may not be manifested in the gastrointestinal system; rather, the patient may present with circulatory, cardiac or respiratory symptoms. If the diagnosis of fecal impaction is unrecognized and untreated, signs and symptoms may progress, leading to death. The causes, mechanisms, appropriate history, physical examination, diagnostic techniques, therapy and prevention of fecal impactions in elderly people are presented.

Aged↗
PubMed1991

Pulsed irrigation enhanced evacuation: new method for treating fecal impaction.

Fecal impaction is a common problem in patients with neurologic impairment. The pulsed irrigation enhanced evacuation (PIEE) procedure is a new method of clearing fecal impactions using pulses of small amounts of warm water to rehydrate stool and improve peristalsis. Thirty-seven PIEE procedures were performed on 28 patients with a variety of neurologic problems. The PIEE procedure was observed to be effective and safe. It should be a useful adjunct to a proper bowel management program.

Enema↗
PubMed2000

Functional bowel disorders in the geriatric patient: constipation, fecal impaction, and fecal incontinence.

Functional bowel disorders, including constipation, fecal impaction, and fecal incontinence, are common gastrointestinal diseases in the elderly and a major source of morbidity. Often the etiology is multifactorial. Evaluation should investigate presenting symptoms and important historical clues. An appropriate workup, including radiological studies, endoscopy, and physiological testing should be individualized. Therapy should be directed against relieving the major complaint and treating the underlying pathophysiological mechanism.

Aged↗
PubMed1989

Fecal impaction.

Fecal impaction is a common disorder with variable presentation and many potential complications. Its pathophysiology is complex, and the treatment is often difficult and frustrating. Preventive measures are likely to be cost effective in populations at high risk, such as institutionalized or debilitated elderly people, mentally ill patients, those with chronic renal failure or cancer, and those who are neurologically impaired.

Aged↗
PubMed1990

Fecal impaction.

Explore the source record for details and available documents.

Fecal Impaction↗
PubMed1997

Use of oral GoLytely solution in relief of refractory fecal impaction.

Constipation and fecal impaction are common disorders with multiple treatment options. We describe the use of GoLytely oral solution in 10 patients admitted to a community hospital and referred to a single gastroenterologist for fecal impaction refractory to conventional medical treatment. Seven women and three men received enemas, bisacodyl suppositories, and digital fragmentation either solely or in combination prior to the administration of GoLytely oral solution. The patients had no clinical and radiological evidence of bowel obstruction. All had underlying cardiovascular problems. Their mean age was 78.1 years (range 49-100 years). GoLytely oral solution (Braintree Laboratories, Inc.) was administered at a rate of 100 ml/hr per orem to three patients, via nasogastric tube in six patients, and via gastrostomy tube in one patient. All 10 patients were able to regularly pass feces and show radiographical colorectal clearing within 6.0 to 57.25 hr (mean 23.60 hr). No significant complications were observed. Eight patients were discharged from the hospital within 24 hr of termination of treatment while two patients remained for unrelated medical conditions. GoLytely oral solution effectively relieved fecal impaction in 10 patients refractory to conventional medical treatment.

Administration, Oral↗
PubMedDate not supplied

Fecal impaction: a review.

TOPIC: Fecal impaction, a review of the literature. PURPOSE: To review the definition, diagnosis, causes, signs and symptoms, and treatment of fecal impaction. SOURCES: Published literature. CONCLUSIONS: While a great deal has been published on fecal impaction, there is limited research. Clarification of when constipation changes to impaction is ambiguous. Causes of fecal impaction are multiple, and people can be affected at all ages. Signs and symptoms of and problems associated with fecal impaction are varied. Research-based treatment of fecal impaction is very limited, and nonresearch based treatment varies. There is a need for additional research to clarify terminology, diagnosis, and interventions.

Cathartics↗
PubMed1992

Intestinal button implantation for obstipation and fecal impaction in children.

Chronic obstipation and fecal impaction in children can be difficult management problems for pediatricians. We describe a novel approach to the management of obstipation and fecal impaction: the implantation of the button gastrostomy device in the appendiceal stump or the terminal ileum. We report the procedure in two children. One child had pseudoobstruction syndrome complicated by recurrent obstipation; the other had cystic fibrosis complicated by recurrent obstruction from meconium ileus equivalent. Both children received a polyethylene glycol/electrolyte solution, with or without pancreatic enzymes, which was administered through the button. The children have remained essentially asymptomatic for at least 10 months. We believe that this is the first report of the use of a button gastrostomy device to successfully manage chronic obstipation and recurrent fecal impaction in children.

Adolescent↗
PubMed2000

Fecal impaction causing megarectum-producing colorectal catastrophes. A report of two cases.

PURPOSE: Massive fecal impaction leading to surgical catastrophes has rarely been reported. We present 2 such patients to remind physicians that neglected accumulation of fecal matter in the rectum may lead to ischemia and perforation of the colon and rectum. METHODS: Report of 2 patients and a MEDLINE search of the literature. RESULTS: In the 1st case massive fecal impaction produced an abdominal compartment syndrome and rectal necrosis. In the 2nd patient fecal impaction resulted in colonic obstruction and ischemia. In both, an operation was life-saving. CONCLUSION: Neglected fecal impaction may lead to a megarectum causing an abdominal compartment syndrome and colorectal obstruction, perforation or necrosis. Measures to prevent fecal impaction are of paramount importance and prompt manual disimpaction before the above complications develop is mandatory. Appropriate operative treatment may be life-saving.

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PubMed1994

Treatment of fecal impaction with pulsed irrigation enhanced evacuation.

PURPOSE: A new method of treating fecal impaction is described, selecting patients that would otherwise have required operative disimpaction. METHOD: Using the pulsed irrigation enhanced evacuation device, individuals were selected for treatment based on evidence of massive fecal impaction on physical examination or abdominal x-ray. RESULTS: Fourteen individuals were treated for fecal impaction. The patients ranged in age from 13 to 86 years. Only one patient required intravenous sedation, an elderly patient with Alzheimer's disease. The treatment was successful in each case, although repeated treatment was often necessary. No morbidity arose from the treatment. By the midpoint in our study, because of the success of this treatment, no patient required hospitalization for impaction. CONCLUSION: Pulsed irrigation enhanced evacuation has been in our experience a simple, quick, and effective treatment for severe fecal impaction.

Adolescent↗
PubMed2001

Fecal impaction: a cause of isolated small bowel dilatation on abdominal radiographs.

OBJECTIVE: The purpose of this study was to assess the frequency of isolated small bowel dilatation on abdominal radiographs in patients with colonic fecal impaction and also to elucidate the cause of this finding. METHODS: A computerized search of radiology files revealed 515 patients with colonic fecal impaction on abdominal radiographs. The radiologic reports described isolated small bowel dilatation not related to other known causes of ileus or obstruction in 18 (3.5%) of the 515 patients. The films were reviewed to determine the distribution of fecal impaction and the degree and extent of small bowel dilatation. In 16 cases, medical records were reviewed to determine the clinical presentation, treatment, and course. Finally, follow-up radiographs were reviewed in four cases to determine the response to treatment of the impaction. RESULTS: All 16 patients with available medical records had abdominal symptoms. The average diameter of the dilated small bowel on abdominal radiographs was 3.7 cm. Fourteen patients (78%) had a diffuse colonic fecal impaction (nine) or a predominantly right-sided fecal impaction (five) that involved the cecum, and the remaining four (22%) had a left-sided colonic fecal impaction. All 12 patients with clinical follow-up had resolution of symptoms and all four with follow-up radiographs had resolution of small bowel dilatation after treatment of the underlying impaction. CONCLUSION: Fecal impaction should be considered in the differential diagnosis of small bowel dilatation on abdominal radiographs, as treatment of the underlying impaction usually produces a dramatic clinical response with resolution of the small bowel dilatation on follow-up radiographs.

Adult↗
PubMed1975

Releif of severe fecal impactions with water-soluble contrast enemas.

High fecal impaction resulted in complete bowel obstruction in 2 children following renal transplantation and in one adult on chemotherapy and narcotics. The usual methods of relief failed, and water-soluble contrast enemas with a high osmolality were employed. Fluoroscopic control assured placement of the enema fluid at the site of obstruction, where it was very effective in relieving the impaction. It is suggested that such high-osmolality enemas be considered in patients with severe high fecal impactions before surgery is contemplated.

Cecum↗
PubMed1991

Acute renal failure secondary to fecal impaction.

A 23-year-old man presented with a massive fecal impaction, and was subsequently found to be in renal failure along with the presence of intraperitoneal free air on x-ray. Following disimpaction, the renal failure rapidly resolved and exploratory laporotomy revealed no colonic perforations. Obstructive renal failure resulting from fecal impaction is a rare but reported complication. In this report acute renal failure is attributed to severe fecal impaction.

Acute Kidney Injury↗
PubMed2000

Urethral obstruction and bilateral ureteral hydronephroses secondary to fecal impaction.

We present a case report of the first adult woman reported to suffer from both urethral obstruction and bilateral ureteral hydronephroses secondary to fecal impaction. The work-up suggested that hypothyroidism might be the cause for fecal impaction. Urinary tract obstruction caused by hypothyroidism-induced fecal impaction has never been reported. Fecal impaction should be considered as one of the causes for urinary tract obstruction.

Aged↗
PubMed1975

Diagnostic and therapeutic considerations for fecal impaction.

During an 18-month period, 18 patients were admitted to the Beth Israel Hospital because of fecal impaction or its complications. The records of the 18 patients were reviewed to determine the presenting signs and symptoms, radiologic findings, course and etiology of fecal impaction. Prior use of drugs that slow gastrointestinal motility was found in seven cases, and seven of the 18 patients had severe neuropsychiatric illness. The presenting signs and symptoms in almost all instances were consistent with a diagnosis of intestinal obstruction. The difficulty in differentiating intestinal obstruction caused by fecal impaction from obstruction resulting from other lesions is discussed. The diagnosis of fecal impaction should be entertained only after other causes of intestinal obstruction have been excluded.

Adolescent↗
PubMed1988

Constipation and fecal impaction in the long-term care patient.

Constipation is a significant problem in the long-term care patient. There is a high prevalence of both primary and secondary causes of constipation in this population. Common primary causes include deficient dietary fiber, deficient fluid intake, and immobility. Common secondary causes include carcinoma, constipating medications, and neurologic and endocrine diseases. Moreover, complications of constipation such as fecal impaction, fecal incontinence, stercoral ulceration, and obstruction can be catastrophic in the debilitated elderly patient. Many cases of constipation can be treated by supplementing dietary fiber and fluid intake, with attention to nonmedical forms of intervention. In some patients, therapies such as bulk-forming agents, emollients, and periodic enemas may be necessary. In addition, there are some newer therapies available. Chronic stimulant laxative therapy should be reserved for patients with certain conditions that warrant their use.

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