The geriatric implications of fecal impaction

Fecal impactions are a common problem in debilitated elderly people and may present as a life-threatening event. The atypical presentations of fecal impactions are not well-recognized, and the incidence, morbidity and mortality of fecal impactions in the elderly are largely unknown. Elderly debilitated people have reduced organ system reserve. An acute illness may worsen underlying chronic diseases. Fecal impactions may upset the fragile homeostasis of an elderly debilitated person. The signs and symptoms of fecal impaction may not be manifested in the gastrointestinal system; rather, the patient may present with circulatory, cardiac or respiratory symptoms. If the diagnosis of fecal impaction is unrecognized and untreated, signs and symptoms may progress, leading to death. The causes, mechanisms, appropriate history, physical examination, diagnostic techniques, therapy and prevention of fecal impactions in elderly people are presented.