Skip main navigation

Faecal impaction with overflow

Read this article to find out more about the common bowel condition of faecal impaction or faecal loading which can occur with overflow.
© Association for Continence Advice. CC BY-NC 4.0

Faecal impaction or faecal loading occurs when the rectum, and often the lower colon, is full with hard or soft stool and the individual is unable to evacuate their bowel unaided.

It usually happens when there has been no adequate bowel movement for days, or weeks, and a large compacted mass of faeces builds up in the large bowel which cannot be passed.

Liquid, Bristol stool chart type 6-7 stool, can leak around the mass. This happens between bowel movements, causing soiling of loose stool on clothing called faecal overflow incontinence/spurious diarrhoea.

The leakage occurs with no awareness as the urge to defaecate has been lost as a result of the distended rectum. The loose stool is often very offensive and the smell lingers.

The large stool can be very painful and distressing to pass.

If the constipation is not treated effectively and the bowel is completely emptied, the problem is likely to reoccur.

The majority (98%) of faecal impaction occurs on the rectum but it can also occur in the colon (1.6%) and in the ileum (0.4%)

Clinical practice point. On examination of the abdomen it can be felt as hard lumps and, in severe cases, when the individual is supine.

Sites and frequency of faecal impaction

Figure 4.8: Sites and frequency of faecal impaction in the colon and rectum.

The top illustration in Figure 4.9 below shows normal bowel function with the stool in the rectum and no constipation and the lower illustration shows impacted faecal mass pressing on the urethra and bladder stretching the pelvic floor (rectal loading).

Comparison of normal bowel function with faecal impaction

Figure 4.9: Comparison of normal bowel function with faecal impaction.

Your task

Consider what the term constipation means to you.

Use a search engine to investigate the definition and diagnosis of constipation. Share your thoughts with fellow learners.

© Association for Continence Advice. CC BY-NC 4.0
This article is from the free online

Understanding Continence Promotion: Effective Management of Bladder and Bowel Dysfunction in Adults

Created by
FutureLearn - Learning For Life

Our purpose is to transform access to education.

We offer a diverse selection of courses from leading universities and cultural institutions from around the world. These are delivered one step at a time, and are accessible on mobile, tablet and desktop, so you can fit learning around your life.

We believe learning should be an enjoyable, social experience, so our courses offer the opportunity to discuss what you’re learning with others as you go, helping you make fresh discoveries and form new ideas.
You can unlock new opportunities with unlimited access to hundreds of online short courses for a year by subscribing to our Unlimited package. Build your knowledge with top universities and organisations.

Learn more about how FutureLearn is transforming access to education