How do hospitals treat impacted stool?
Enema for fecal impaction
The most common treatment for a fecal impaction is an enema, which is a special fluid that your doctor inserts into your rectum to soften your stool.
The physician will many times insert a tube to help decompress the bowel which also provides the patient with significant relief. All in all, it is imperative to learn and understand that the stool is waste matter.
When is disimpaction achieved? Most children will have achieved disimpaction when their stools are loose and watery for at least 24 hours – type 7 on the 'Bristol Stool Scale' on the last page. It is normal for this to take 7 to 14 days . If it takes longer than 14 days make an appointment to see your child's GP.
This process may take up to two weeks, and sometimes longer.
Surgery typically involves removing the obstruction, as well as any section of your intestine that has died or is damaged. Alternatively, your doctor may recommend treating the obstruction with a self-expanding metal stent.
The mass may have to be broken up by hand. This is called manual removal: A provider will need to insert one or two fingers into the rectum and slowly break up the mass into smaller pieces so that it can come out. This process must be done in small steps to avoid causing injury to the rectum.
If your constipation is severe or accompanied by diarrhea, rectal bleeding, abdominal pain, or if you can't have a bowel movement after trying all natural laxatives, it's time to see your physician. If you are unable to have a bowel movement in one week (six days), it's time to seek help from a doctor.
Less serious cases of constipation have very little or bearable pain to say the least. All they cause is discomfort. If you ever experience severe abdominal pain which is almost unbearable, then you need to go visit an emergency room as soon as possible.
Some people prefer to speed up the disimpaction process by using a combination of laxatives – a macrogol and a stimulant. Stimulant laxatives increase the muscular squeezing of the bowel, speeding up evacuation. The medicine prescribed might be called Senna, or Sodium Picosulphate, or Bisacodyl – or there are others.
The medication will gradually soften the hard poo and may take anything from a few days to a few weeks. Your child may require some time off school. What to do next: After disimpaction you should decrease the medication by 2 sachets every 2nd day until your child is passing a soft, formed poo every day.
Can nurses perform digital Disimpaction?
Digital removal of faeces should be performed only by a nurse deemed competent, with the correct knowledge, skills and ability required for safe practice (Nursing and Midwifery Council, 2018).
If you're constipated and vomiting, it might be a sign of fecal impaction. Fecal impaction occurs when a large, hard mass of stool gets stuck in the colon and can't be pushed out. This is an extremely dangerous situation and requires immediate medical attention.
For mild and moderate fecal impaction, recommended treatments include stool softeners, oral mineral and olive oil, and edema; for severe fecal impaction, manual removal is needed and sometimes laparotomy may be indicated if medical therapies are not effective.
Most patients stay in the hospital for between five and seven days following bowel obstruction surgery. It can take several weeks or months to fully return to normal activities. Your medical team with work with you to manage post-surgical pain.
Enemas of air or fluid can help clear blockages by raising the pressure inside your bowels. A mesh tube called a stent is a safe option for people who are too sick for surgery. Your doctor puts it in your intestine to force the bowel open. Some people may not need anything more than a stent.
After laparoscopic surgery for an intestinal blockage, many patients can leave the hospital in two or three days. At home, they're encouraged to get up and move around as much as possible, but should avoid heavy lifting or strenuous activity until they're cleared by their physician.
An impacted bowel can have serious health complications if left untreated. Treatment is typically minimally invasive and involves softening and removing the hardened stool from the colon. Early signs can include an inability to pass stool, abdominal pain, and bloating.
“It would be an emergency if you hadn't had a bowel movement for a prolonged time, and you're also experiencing major bloating or severe abdominal pain,” notes Dr. Zutshi. Slight symptoms will not take you to the emergency room. You should go to the emergency room if your symptoms are severe.
References
- https://www.britishjournalofnursing.com/content/clinical/rationale-and-procedure-for-performing-digital-removal-of-faeces/
- https://www.mountsinai.org/health-library/diseases-conditions/fecal-impaction
- https://www.clinicalguidelines.scot.nhs.uk/media/2014/macrogol-disimpaction-regime-3-info-for-parents-september-2019.pdf
- https://www.nhsaaa.net/publications/information-leaflets/f-faecal-impaction-in-children/
- https://www.wsh.nhs.uk/CMS-Documents/Patient-leaflets/PaediatricDepartment/5986-1LaxativeSachetDisimpactionPlan.pdf
- https://victoriaer.com/can-constipation-result-trip-er/
- https://www.valeofyorkccg.nhs.uk/seecmsfile/?id=3029
- https://bellaireer.com/go-emergency-room-constipation/
- https://www.webmd.com/digestive-disorders/what-is-fecal-impaction
- https://health.clevelandclinic.org/how-to-know-when-constipation-is-an-emergency/
- https://www.regionalonehealth.org/blog/2021/01/21/ask-the-experts-what-are-my-treatment-options-if-i-have-an-intestinal-blockage/
- https://www.verywellhealth.com/surgery-for-a-bowel-obstruction-796815
- https://www.webmd.com/digestive-disorders/what-is-bowel-obstruction
- https://www.mayoclinic.org/diseases-conditions/intestinal-obstruction/diagnosis-treatment/drc-20351465
- https://www.healthline.com/health/fecal-impaction
- https://www.healthline.com/health/when-is-constipation-an-emergency
- https://frontlineer.com/when-to-go-to-urgent-care-for-constipation/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2879854/