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Nursing Homes Abuse Blog By Jonathan Rosenfeld

Impacted Bowel

bowel impactedEven though nursing home staff members need to monitor the liquid and food intake of nursing home patients carefully, it is also important to pay attention to waste elimination. If the patient does not produce feces and urine regularly, it is important that staff members are aware of the situation and address it with the patient’s physician. The reason that this is important is because elderly patients may be prone to issues such as an impacted bowel.

What is an impacted bowel?

This describes a situation where fecal matter is locked in in the lower part of the large intestine. This leads to an obstruction of waste. As the stool sits in the bowel, the body does not excrete it and in turn, it becomes hardened. This remaining stool may lead to irritation of the rectum, which can lead to fecal incontinence because it results in the production of fluid and mucus that may possibly leak.

What are signs of an impacted bowel?

There are a number of symptoms associated with an impacted bowel. One of the main reasons it may be difficult to determine when a patient is struggling with an impacted bowel is because A) it is a personal subject for many patients and B) the symptoms are similar to a number of other medical complications.

Perhaps the most common symptom is a lack of appetite, this is because the abdomen consistently have pressure on them. Other issues include hemorrhoids, bloating, bad breath, constipation, vomiting, cramping, pain, hardened feces that are painful to excrete, diarrhea, and a constant feeling of fullness.

What are some of the complications?

Unfortunately, an impacted bowel can lead to a number of serious health problems. Some of the most common and serious ones include:

  • Tissue damage – It is possible that rectal bleeding results because of damage done to the tissue that lines the bowel (mucosa). Necrosis or ulceration (death of the bowel tissue) may also occur after long-term problems, this may need surgical removal.
  • Megacolon – Because of the fecal impaction, it is possible that the colon becomes massively dilated and swollen. This makes it difficult to move stool through the colon because the bowel is unable to contract. This is a serious issue and often requires surgery.
  • Cardiac complications – An impacted bowel may lead to vagal nerve stimulation. This can result in fainting, weakness, and irregular heart rhythms. In rare cases, it may lead to the development of cardiac tamponade. This means that the ventricles are unable to expand completely and cannot pump out adequate amounts of blood because of compression of the heart
  • Perforation – It is possible that long-term bowel obstruction leads to perforation and possibly even prove fatal. This means that stool spills from the bowel into the peritonitis and abdominal cavity. If not promptly treated, this infection could be deadly.

When identified in time, it is possible to treat an impacted bowel with suppositories, enemas, laxatives, exercise, increased hydration, or a high fiber diet. Unfortunately, an unhealthy lifestyle and inattentive staff place nursing home patients at a higher risk of developing impacted bowels. If you feel as though someone you care about is not receiving adequate attention to ensure the prevention of an impacted bowel, it is important that you make your voice heard with a formal complaint.


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