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How to Treat Faecal Impaction?


Things to note:
  • Dietary advice preferably by dietician.
  • Dietary measures i.e. balanced diet with unprocessed foods, e.g. cereals, legumes, fruit and vegetables.
  • Correct dehydration. Ensure adequate fluid intake.
  • Wheat bran: introduce slowly and take with sufficient fluid.
  • Side-effects include: bloating, cramps and flatulence.
  • Manual removal of impacted stools.
  • Encourage regular bowel habits.
  • Physical exercise.

Medical Treatment:
Osmotic laxatives
  • Lactulose, oral, 10-20 mL daily.
    • Titrate to effect i.e. up to 60 mL daily.
Stimulant laxatives
For short term use only, except in the elderly where long-term treatment may be indicated:
  • Sennosides A and B, oral, 7.5-15 mg at night 2-3 times a week for up to 4 weeks.
Polyethylene glycol-based purges
For acute bowel preparation or for chronic constipation on specialist advice.
Saline or phosphate enemas
  • May occasionally be indicated in acute constipation.


When to refer:
  • For investigation for organic disease.