Fecal loading

Dr Balint Botz and Dr Yahya Baba et al.

Fecal loading, also called fecal impaction, refers to the accumulation of solid feces in the rectum and the large bowel.

Fecal loading is common, and usually seen among elderly, bedridden patients or incapacitated people, but many risk factors are recognized including chronic constipation, sedentary lifestyle, low fiber diet, medication intake, e.g. opioids.

Patients may complaint from :

  • abdominal tenderness
  • meteorism
  • proctalgia
  • infrequent defecation of solid stool

Fecal loading may be seen as a speckled low density soft tissue mass, within a distended large bowel.

Distension of the small bowel loops may be observed.

Untreated fecal loading may lead to an increase in large bowel pressure with possible bowel obstruction or stercoral perforation.

It may also exert pressure on adjacent organs and vessels with a reported case of bilateral pelvic venous thrombosis 2.

Fecal loading removal may be performed manually, with water irrigation, enema, laxatives or with rectal cleansing under sigmoidoscopy.

Physical activity, fiber-rich diet, sufficient fluid intake and prokinetic drugs are prescribed to stimulate transit and to change the stool consistency, thus preventing recurrence.

Article information

rID: 84805
Section: Pathology
Synonyms or Alternate Spellings:

ADVERTISEMENT: Supporters see fewer/no ads

Cases and figures

  • Case 1
    Drag here to reorder.
  • Case 2
    Drag here to reorder.
  • Case 3
    Drag here to reorder.
  • Case 4
    Drag here to reorder.
  • Case 5
    Drag here to reorder.
  • Updating… Please wait.

     Unable to process the form. Check for errors and try again.

     Thank you for updating your details.