Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Jan 11;16:4.
doi: 10.1186/s12877-015-0162-5.

Fecal Impaction: A Systematic Review of Its Medical Complications

Free PMC article

Fecal Impaction: A Systematic Review of Its Medical Complications

Blanca Serrano Falcón et al. BMC Geriatr. .
Free PMC article


Background: Fecal impaction (FI) is a common problem in the elderly and other at-risk groups, such as patients with a neuro-psychiatric disease. It has been associated with medical problems and high morbi-mortality. A systematic review of this topic might be useful to improve the knowledge in this area and helpful to make an appropriate and early diagnosis.

Methods: A PubMed systematic search was performed using relevant keywords. Case reports published in English, Spanish or French till June 2014 were included if they had a diagnosis of FI and a medical complication secondary to it. Each case was classified based on its principal complication. The main objective is to create a classification of FI complications based on published clinical cases.

Results: 188 articles met inclusion criteria, comprising 280 clinical cases. Out of the total, 43,5% were over 65 years old, 49% suffered from chronic constipation, 29% had an underlying neuropsychiatric disease and 15% were hospitalised or institutionalised. A total of 346 medical complications secondary to FI were collected. They were divided according to gastrointestinal tract involvement and then classified based on their anatomical and pathophysiological mechanism into three groups: Complications secondary to fecaloma effect on the intestinal wall (73.4%), on the intestinal lumen (14%) and on adjacent structures (12.6%).

Conclusions: FI causes complications that might be fatal. The elderly, underlying neuropsychiatric disease and hospitalised or institutionalised patients integrate the high-risk group in which FI must be suspected. The first FI complications classification is presented to improve the knowledge about this entity.


Fig. 1
Fig. 1
Study selection process. Breakdown of study selection process
Fig. 2
Fig. 2
Classification of fecal impaction complications. Schematic display of the classification of faecal impaction complications

Similar articles

See all similar articles

Cited by 7 articles

See all "Cited by" articles


    1. Zhao W, Ke M. Report of an unusual case with severe fecal impaction responding to medication therapy. J Neurogastroenterol Motil. 2010;16(2):199–202. doi: 10.5056/jnm.2010.16.2.199. - DOI - PMC - PubMed
    1. Barcelo M, Jimenez-Cebrian MJ, Diaz-Rubio M, Rocha AL, Rey E. Validation of a questionnaire for assessing fecal impaction in the elderly: impact of cognitive impairment and using a proxy. BMC Geriatr 2013; 1324: doi 10.1186/1471-2318-13-24. - PMC - PubMed
    1. Araghizadeh F. Fecal impaction. Clin Colon Rectal Surg. 2005;18(2):116–9. doi: 10.1055/s-2005-870893. - DOI - PMC - PubMed
    1. Wald A. Management and prevention of fecal impaction. Curr Gastroenterol Rep. 2008;10(5):499–501. doi: 10.1007/s11894-008-0091-y. - DOI - PubMed
    1. Grinvalsky HT, Bowerman CI. Stercoraceous ulcers of the colon: relatively neglected medical and surgical problem. J Am Med Assoc. 1959;171:1941–6. doi: 10.1001/jama.1959.03010320031008. - DOI - PubMed

LinkOut - more resources