Definition
The term fecaloma, extracted from medical language, refers to a mass of fecal material, of hard and dry consistency, whose evacuation is complex and painful, often impossible: fecaloma, massed in the rectum and 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 being assisted.
Causes
The excessively sluggish intestine, which results in insufficient motility of the colon, increases the residence time of the fecal mass in the intestinal tract; this causes a progressive drying up of the intestinal contents, to the point of creating fecal impaction. Among the predisposing causes, we recall : abuse of drugs such as opiates, anticholinergics and antidiarrheals, unbalanced diet in terms of fibers (both in excess and in defect) and poor in liquids, hemorrhoids, anal fistulas, intense sweating, vomiting.
Symptoms
The symptomatological picture of fecaloma is expressed in: chronic constipation, abdominal cramps, emission of blood with the stool, lumbar pain, hard stools, inappetence, pollakiuria, tachycardia, vomiting. Paradoxically, the patient suffering from fecaloma complains of sporadic episodes of liquid diarrhea. The symptoms that characterize fecal impaction are almost comparable to those analyzed for intestinal obstruction.
The information on Fecaloma - Medicines 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 - Medicines for the Treatment of Fecaloma.
Medicines
The treatment of fecal impaction consists in the removal of the fecal contents, in addition to subsequently adopting some simple measures to prevent the aforementioned condition. Normally, intestinal liberation therapy begins with an enema or a suppository based on glycerin or mineral oil, useful for softening the stool; however, this practice - widely used for the treatment of mild constipation - does not always allow to obtain the desired result with one or two applications, especially if the fecal impaction has been accumulated for quite a long time.
The next step, which embarrasses and discourages the patient so much, is the manual (digital) crushing of the fecal content, carried out delicately by specialized nurses. In some patients, this procedure is also contraindicated, especially if they have recently undergone anal and rectal interventions; furthermore, the digital shattering of fecal impaction should be avoided in case of ascertained or presumed inflammatory bowel disease, heart disease or rectal bleeding.
To understand… why digital crushing is not indicated for a heart patient in the 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, albeit possible: some patients, especially those suffering from megacolon or intestinal obstruction, are unable to evacuate the fecal impaction either with the manual crushing of the fecal contents, much less with the application of glycerin enemas 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 dietary and behavioral precautions to prevent the possible reappearance of fecal impaction.
The following are the classes of drugs most used in fecaloma therapy, and some examples of pharmacological specialties; it is up to the doctor to choose the most suitable active ingredient and dosage for the patient, based on the severity of the disease, the state of health of the patient and his response to treatment:
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 fecaloma. The administration of these active ingredients is particularly indicated for children and the elderly who struggle to comply with the precise indications dictated by the doctor for the prevention / reappearance of 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 enemas, it lubricates and softens the intestinal contents (compact), promoting intestinal motility.
- Glycerin (eg. San Pellegrino glycerin suppositories): in the form of enemas, take 5.6 grams of the 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 by mouth, to facilitate intestinal motility. However, it is recommended 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, retaining liquids in the intestine or modulating their distribution within the fecal mass. It is recommended to start the treatment with a low dosage (15 ml of 62-74% solution), twice a day. The dose should be adjusted according to the severity of the condition. Abuse of osmotic laxatives can induce abdominal cramps and abdominal distension.
Here are some precautions to be put into practice to prevent fecal impaction and its possible reappearance:
- follow a balanced, healthy diet rich in fruit and vegetables
- drink plenty of fluids
- avoid introducing too many fibers
- do not ingest excessive quantities of food (delay food intake in many small snacks)
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