What is fecal impaction? Fecal impaction is the formation of a large mass of hard stool in the rectum. While this stool may be too large to pass, loose, watery stool may be able to get by, leading to diarrhea or leakage of fecal material. Fecal impaction is a potential complication of chronic constipation. The development of constipation can be related to a diet low in fiber, limited fluid intake, medication side effects, lack of physical activity, or conditions affecting the colon, rectum or anus. Constipation can perpetuate itself as painful bowel movements, and can lead to the avoidance of further bowel movements. Frequent constipation is a very common problem, affecting more than four million people in the United States. Eating a diet rich in fiber, drinking fluids that do not contain caffeine or alcohol, increasing your activity level, and not avoiding bowel movements can improve constipation. Laxatives or enemas may be recommended when lifestyle changes do not correct the problem. However, you must use laxatives with caution, as overreliance can lead to a dependence on them. If constipation does not improve and fecal impaction occurs, enemas may be used to soften the stool, which can be broken up and removed manually. Impacted stool may be removed in increments to reduce the risk of injuring the rectum. Suppositories may be used between each step of the manual extraction to help empty the rectum. Once fecal impaction has been treated, it is important to take steps to reduce the risk of future constipation. Prolonged fecal impaction can lead to an enlargement or obstruction of the colon, requiring emergency treatment. Seek immediate medical care (call 911) for serious symptoms such as severe abdominal pain; high fever (higher than 101 degrees Fahrenheit); vomiting blood; rectal bleeding or bloody stool; rigidity of the abdomen; the inability to pass stool or gas; or a change in the level of consciousness or alertness (such as passing out or unresponsiveness). Seek prompt medical care if you have sudden diarrhea or fecal leakage after constipation, prolonged constipation (more than three days), the feeling of incomplete emptying of the rectum, if you pass mucus with or without stool, or other symptoms that concern you.