Stool In Colon on X-ray and Fecal Impaction

Stool in the colon on X-ray can often be seen.  It is seen as speckled material along the periphery of the abdomen where the colon is located.    Excessive stool burden can be symptomatic and can cause dangerous complications.

Will X-rays show how much stool there is?

Radiologists may comment on stool burden in the colon on X-rays done of the abdomen.  A large amount of stool may not necessarily correlate with symptoms.   Often the radiologist uses his experience to determine that the amount of stool is moderate to large.

Fecal impaction

Fecal impaction is the inability to spontaneously pass stool or have a bowel movement.  This often happens in bedridden and elderly patients.  These patients will often have chronic constipation, low fiber diets, and can be on chronic opioid medicines.

In fecal impaction, stool will often accumulate in the rectum.  Stool will often have a mass like speckled appearance.  The bowel upstream will be dilated.  The large amount of stool in the rectum can lead to bowel obstruction or blockage.  This needs prompt treatment to prevent complications like perforation which can be deadly.

Complications of fecal impaction

Fecal impaction and it’s complications can better be seen on CT scan.  An inflammation of the rectum and colon can occur due to abundant mass like hard stool.    This puts pressure on the wall of the colon and rectum and can cut the blood supply off.  This is called stercoral colitis.   CT will often show a stool mass with inflamed rectum or colon.  Perforation can eventually occur which can be deadly.

Need to exclude causes of the fecal impaction

It is important to exclude anatomic and functional causes of the fecal impaction like a cancer of the colon or rectum.

Treatment of fecal impaction

Stool in the colon and Fecal impaction is treated with enemas, manual removal, and  water irrigation.  Physical activity and fiber rich diet can prevent recurrence.

Stool in the colon can be seen in X-rays and is often commented on by radiologists.  Fecal impaction is associated with chronic constipation and occurs most commonly in elderly bedridden patients.   Fecal impaction can be seen as a mass of stool in the rectum.  Complications can include a blockage, inflammation, and perforation.  Large amounts of stool need to be treated promptly to prevent complications.