List clinical features.
Inability to defecate for days or weeks
Normal bowel sounds
Distended, tympanitic abdomen
DRE: hard, impacted stools distending the rectum
Describe diagnostic tests.
Abdominal x-ray (to rule out bowel perforation)
Dilated bowel loops
Fecal shadows in the colon and rectum
Air-fluid levels may be visible.
Describe the treatment.
Rule out bowel perforation.
Administer osmotic enema (e.g., warm water enema or mineral oil enema).
Consider the addition of stimulatory suppositories
Prevention of recurrence
Start maintenance bowel regimen with osmotic laxative.
Stop contributing medications.
For severe cases, consult surgery.