Definition
The term fecaloma, extracted from the medical language, refers to a mass of fecal material, of hard and dry consistency, whose evacuation is complex and painful, often impossible: the fecaloma, massed at the level of the rectum and the upper part of the colon, requires therefore a precise medical intervention consisting in the implementation of specific crushing and evacuation measures, often unpleasant for the patient assisted.
Causes
The excessively lazy intestine, which results in insufficient motility of the colon, increases the residence time of the fecal cluster in the intestinal tract; this causes a progressive drying up of the intestinal contents, up to creating the fecaloma. Among the predisposing causes, we recall: abuse of drugs such as opiates, anticholinergics and antidiarrheal, unbalanced diet in terms of fiber (both in excess and in defect) and poor in liquids, hemorrhoids, anal fistulas, intense sweating, vomiting.
Symptoms
The symptomatic picture of fecal impaction takes the form of: chronic constipation, abdominal cramps, blood supply with faeces, lower back pain, hard stools, loss of appetite, pollakiuria, tachycardia, vomiting. Paradoxically, the patient with fecal impaction suffers from sporadic episodes of liquid diarrhea. The symptoms that characterize the fecaloma are almost the same as those analyzed for intestinal obstruction.
Information on Fecaloma - Drugs for the Treatment of Fecaloma is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Fecaloma - Medications for Fecaloma Treatment.
drugs
The treatment of faecal impaction consists in the removal of the fecal content, in addition to subsequently adopting some simple tricks to prevent the aforementioned condition. Normally, intestinal release therapy starts with an enema or glycerine-based suppository or mineral oil, useful for softening the stool; however, this practice - very used for the treatment of minor constipation - does not always allow to obtain the desired result with one or two applications, especially if the fecaloma has been piled up for quite a long time.
The next step, which so embarrasses and discourages the patient, is the manual (digital) crushing of the fecal content, carried out gently by specialized nursing staff. In some patients, this practice is also contraindicated, especially if they have recently undergone operations at the anal and rectal level; furthermore, the digital crushing of the fecal impaction should be avoided in case of ascertained or presumed intestinal inflammatory pathology, heart disease or rectal bleeding.
To understand ... why is a cardiac patient not advised to use digital crushing in case of fecal impaction? During the medical maneuver, it is not uncommon for the anal mucosa to become irritated, to the point of stimulating the sacral branch of the vagus nerve, thus decreasing the heart rate.
Surgical removal of the fecal impaction is an extreme attempt, even if possible: some patients, especially those affected by megacolon or intestinal obstruction, are unable to evacuate the fecal impaction either by manual crushing of the fecal content, nor by the application of glycerin binds. In such situations, surgical removal of the fecal impaction is the only possible treatment option.
Following the treatment, both surgical and manual, it is recommended to follow some simple food and behavioral precautions to prevent any reappearance of the fecal impaction.
Drugs with emollient and lubricating action : liquid paraffin is the protagonist of this category; its administration is indicated to soften the fecal content, therefore in the treatment of constipation and in the treatment of faecal impaction. The administration of these active ingredients is especially indicated for children and the elderly who struggle to comply with the precise instructions given by the doctor for the prevention / reappearance of the fecal impaction.
- Liquid paraffin (eg Lacrilube, Paraf L BIN): the indicative dosage is 10-30 ml, when necessary.
- Peanut oil: formulated in the form of clisms, it lubricates and softens the intestinal content (compact), favoring intestinal motility.
- Glycerin (eg. San Pellegrino glycerine suppositories): in the form of bladders, take 5.6 grams of drug rectally; alternatively, insert a 2-3 gram suppository as needed.
Do not abuse lubricating drugs: excessive use can alter the absorption of fat-soluble vitamins and some minerals, such as calcium and phosphorus.
Oral laxative drugs : in general, patients with fecal impaction tend to suffer from chronic constipation. In this regard, it is possible to occasionally take laxatives orally, to facilitate intestinal motility. It is recommended, however, not to abuse laxatives, as they can cause important electrolyte alterations, intestinal atony and, paradoxically, favor fecal impaction.
- Lactulose (eg. Duphalac, Epalfen, Normase): the drug acts with an osmotic mechanism, holding liquids in the intestine or modulating their distribution within the fecal mass. It is recommended to start the treatment with a low dose (15 ml of solution at 62-74%), twice a day. The dose should be modified according to the severity of the condition. Abuse of osmotic laxatives can induce abdominal cramps and abdominal distention.
Here are some tips to put into practice to prevent fecal impaction and its eventual reappearance:
- follow a balanced diet, healthy and rich in fruits and vegetables
- drink plenty of fluids
- avoid introducing too many fibers
- do not ingest excessive amounts of food (spread the food intake into many small snacks)
