Fecal Impaction indicates the accumulation of fecal matter at some point in the large intestine or rectum which resists the ordinary efforts of expulsion or the effects of laxatives. These accumulations may be of enormous size and hardness which water fails to dissolve and often produce symptoms of intestinal obstruction, although the more common symptoms of a protracted diarrhea are present, the result of local irritation. The disease occurs in children, the result of malformations of the anus or the rectum or partial stricture following some inflammatory process. Adults who have been confined in bed as the result of fractures, or any protracted illness as typhoid fever, suffer from fecal impaction. The condition is associated with the various forms of stricture, cancer, pressure from some other organ and to intestinal adhesion People who live upon coarse cereals which form foreign bodies, and those having intestinal weaknesses due to spinal cord lesions, such as loco motor ataxia, often suffer from this affection, and it may result from the formation of enteritis caused by lime salts in the drinking water.

Opium, lead, alum, tannin acid and lime salts are the drugs very prone to the production of fecal impaction, the result of lessened secretions and activity in the intestinal tract.

Symptoms. The disease will present the symptoms due to partial obstruction of the bowel dependent upon the size of the accumulation and its situation. From our knowledge of the nerve supply of the lower rectum, the symptoms of the presence of a foreign body soon follow its arrest at that point, but when the impaction occurs in the colon or sigmoid a long time may elapse before the irritation will cause symptoms referable to that portion of the bowel. If the patient is thin, the mass may be felt through the abdominal wall, otherwise the diagnosis will have to be made from the history, tenderness over the region involved, symptoms of auto-intoxication, and the presence of a diarrhea which resists the ordinary treatment.

Treatment, The treatment of these cases should be directed to the thorough irrigation of the entire colon with plain water and the administration of a laxative for a few days. The alkaline salts administered during the day and the occasional use of cascara as a muscular stimulation is generally sufficient. The origin of the trouble may necessitate a continuous treatment to thoroughly empty the bowel. When it is possible, the administration of broths and plenty of drinking water should be encouraged and in some instances strychnine with cascara given for a protracted period. When the impaction occurs in the rectum its removal can be easily accomplished with the fingers or rectal scoop.

Obstipation

Constipation is the result of a mechanical obstruction to the natural passage of the intestinal contents and is a relative term used to describe a partial intestinal obstruction. The condition arises as the result of some deformity, impaction, growth, or stricture in the intestine that simply causes a mechanical obstruction from pressure or otherwise. In most instances fecal impaction results in constipation, the causes being the same and it is impossible to clearly separate one from the other.

When fecal impaction and constipation are due to hypertrophy of Houston's valves which occlude the lumen of the rectum and so obstruct the intestinal canal as to present symptoms of these conditions, Valvoline or partial removal of one or more of the valves is necessary. The Pennington, Ant’s or some one of the variety of clips made for this purpose is applied to the selected valve and allowed to cut through by pressure necrosis. The sides of the valve after its severance retracts so greatly as to permit the emptying of the bowel contents. A specially devised handle is made for these clips and the results are generally very satisfactory.