Complications may include necrosis and ulcers of the rectal tissue. Polyethylene glycol can be taken daily to soften the stools without the significant risk of adverse effects that are common with other laxatives. Iron supplements or increased blood calcium levels are also potential causes. Most often manual disimpaction is performed without general anaesthesia , although sedation may be used. Many types of medications most notably opioid pain medications, such as codeine reduce motility of the colon, increasing the likelihood of fecal impactions. Increasing dietary fiber , increasing fluid intake, exercising daily, and attempting regularly to defecate every morning after eating should be promoted in all patients. In cases where enemas fail to remove the impaction, polyethylene glycol can be used to attempt to soften the mass over 24—48 hours, or if immediate removal of the mass is needed, manual disimpaction may be used. Individuals who have had one fecal impaction are at high risk of future impactions. However, for patients with chronic complications, daily medication under the direction of a physician may be needed. Medications such as opioid pain relievers suboxone , methadone , codeine , oxycodone , hydrocodone , etc. In more involved procedures, general anaesthesia may be used, although the use of general anaesthesia increases the risk of damage to the anal sphincter. Causes[ edit ] There are many possible causes; for example, physical inactivity, not eating enough particularly of fiber , and not drinking enough water. Manual disimpaction may be performed by lubricating the anus and using one gloved finger with a scoop-like motion to break up the fecal mass.
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