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Firm, immobile mass of stool, most often in the rectum but may also occur in sigmoid or descending part of the large intestine (colon). This condition is most commonly seen in those who are inactive or on prolonged bed rest due to surgery, accident, or illness (e.g., Dementia, Multiple Sclerosis). The elderly in nursing homes and those with chronic Constipation are
especially at risk. Differential diagnosis is similar to that for Constipation.
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Impaction may present with involuntary leakage of stool around the impaction, which may be mistaken for Diarrhea or fecal incontinence. There may be low-grade fever, abdominal pain and tenderness, Bloating, inability to pass gas, Dehydration, and mental status changes (confusion, especially in the elderly).
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To prevent this problem it is best to encourage exercise and activity, a high fiber diet, and adequate hydration (fluids and juices). Avoid medications that have the side effects of decreased intestinal motility and Constipation.
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