Fecal Impaction vs. Constipation: What to Know

Medically Reviewed By Qin Rao, MD

Constipation is difficulty passing stool or infrequently, and fecal impaction is when hardened stool blocks the large intestine. Constipation is the primary cause of fecal impaction. Fecal impaction and constipation are gastrointestinal conditions linked to bowel function. The conditions are similar but have different causes, treatments, and effects on health.

Read on to learn more about fecal impaction vs. constipation, including their symptoms, treatment, and diagnosis.

Fecal impaction vs. constipation 

A roll of toilet paper fixed to the wall.
Photography by Melanie Kintz/Stocksy United

Constipation is when you have difficulty passing stool or have infrequent bowel movements. Constipation is common and can range from mild to severe.

Fecal impaction is a severe condition in which a hardened mass of stool becomes stuck in the large intestine or rectum. Fecal impaction can make it difficult to have a bowel movement.

Severe or persistent constipation may lead to fecal impaction.

You can treat mild cases of constipation with self-care, but fecal impaction typically requires medical treatment.

Learn more about the side effects of constipation and their treatment.

Symptoms 

Typical symptoms of constipation include:

  • having fewer than three bowel movements a week
  • hardy, dry, or lumpy stools
  • pain when having bowel movements
  • a feeling that not all the stool has passed
  • straining when having a bowel movement
  • stools that are smaller or larger than usual for you
  • stomach aches or cramps
  • bloating
  • nausea or loss of appetite

Symptoms Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source of fecal impaction are similar to constipation and other gastrointestinal conditions. However, they can differ from constipation and cause more severe effects.

Fecal impaction symptoms include:

Fecal impaction can sometimes lead to diarrhea. Watery stools build up behind the trapped stool and leak from around the blockage.

Causes

Severe or long-lasting constipation can cause fecal impaction.

Causes of constipation include:

  • not eating enough fiber
  • dehydration
  • not getting enough physical activity
  • behavioral factors, such as ignoring the urge to pass a bowel movement
  • pelvic floor disorders
  • gastrointestinal conditions, such as irritable bowel syndrome (IBS)
  • conditions that affect the spinal cord, brain, or spine
  • metabolic conditions, such as diabetes
  • physical blockages in the intestines
  • anatomical differences in your digestive tract
  • some medications and supplements
  • hormonal changes or conditions, such as pregnancy and hypothyroidism

Other than constipation, causes of fecal impaction can include:

  • anatomical differences in the digestive tract, anus, or rectum
  • some medications and substances, such as nonsteroidal anti-inflammatory drugs and opioids
  • previous surgery in the gastrointestinal tract

Fecal impaction is common among older adults, especially those in the hospital or residential care homes.

Diagnosis

Your doctor will ask about your symptoms and medical history and perform a physical exam, which may include a digital rectal exam (DRE).

To perform a DRE, a doctor will insert a gloved, lubricated finger into your rectum to feel for hard spots. A DRE usually takes a few minutes and is typically not painful.

Your doctor may also order tests such as:

  • imaging scans of the abdomen, including X-rays, CT and MRI scans
  • blood tests
  • colonic transit studies, which measure how fast food and waste pass through the digestive system
  • stool samples

These tests help doctors identify constipation or fecal impaction, rule out other causes, and learn more about your condition.

Treatment

Treatments for constipation can include:

  • eating more fiber
  • staying hydrated
  • regular physical activity 
  • biofeedback therapy
  • over-the-counter or prescription medications, such as:
    • fiber supplements
    • laxatives
    • lubiprostone (Amitzia)
    • linaclotide (Linzess)
    • prucalopride (Motegrity)

Sometimes, mild constipation can be treated at home with over-the-counter products. However, always talk with a pharmacist or doctor before trying to treat constipation yourself or trying new medications or supplements.

Fecal impaction treatment usually requires visiting a doctor. Treatments they may recommend include Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source :

  • Enema: An enema involves inserting fluids into your rectum to help empty your bowels. Your medical team may use an abdominal X-ray to locate the fecal impaction before providing an enema.
  • Suppositories: These are medications you insert into your rectum. They work by moisturizing the rectum to help a bowel movement.
  • Manual disimpaction: A doctor uses a lubricated, gloved finger to gently remove the impacted stool.
  • Surgery: A doctor may recommend surgery for some cases of severe fecal impaction.

Your medical team may also recommend constipation treatments to help prevent further fecal impaction, such as laxatives and fiber supplements.

Learn more about fecal impaction, including its symptoms, causes, and treatment.

When to see a doctor

Contact a doctor for any severe, concerning, or persistent symptoms of constipation. Also contact a doctor right away for symptoms of fecal impaction.

Some symptoms are linked to health conditions that require urgent medical care. Call 911 for any of the following symptoms alongside constipation or fecal impaction symptoms:

  • dark, tarry stool
  • passing significant amounts of blood in the stool or when going to the bathroom
  • severe or sudden pain
  • vomiting bile or stool

Summary 

Constipation refers to infrequent or difficult-to-pass stools. Fecal impaction is when a large or hard mass of stool cannot be passed.

Fecal impaction can be caused by severe or prolonged constipation.

Though some cases of mild constipation can be managed at home, fecal impaction usually requires medical treatment.

Talk with a doctor as soon as possible if you have any severe or persistent symptoms of constipation or have fecal impaction symptoms.

Was this helpful?
3
Medical Reviewer: Qin Rao, MD
Last Review Date: 2024 May 28
View All Digestive Health Articles
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.