[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-403762-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-403762-en":131},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","guidelines-for-treating-adult-faecal-loading-impaction","Guidelines for Treating Adult Faecal Loading - Impaction","","This document provides comprehensive clinical guidelines for the management of faecal impaction in adult patients, formulated by the Shropshire Community Health NHS Trust. It outlines a systematic approach for clinicians, starting from initial assessment through to first and second-line treatment protocols. The guidelines emphasize the necessity of a digital rectal examination by a competent nurse, the identification of red flag symptoms that mandate urgent colorectal referral, and evidence-based pharmaceutical interventions involving macrogols and various enemas. It is designed to assist community nurses and hospital staff in delivering effective patient care while ensuring adherence to safety standards and updated NICE guidelines. The document serves as a critical reference for addressing constipation-related complications, providing clear instructions on medication administration and the exclusion criteria regarding specific patient demographics like pregnant women and children.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/guidelines-for-treating-adult-faecal-loading-impaction/403762/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/guidelines-for-treating-adult-faecal-loading-impaction/403762.png","ImageObject",300,407,{"name":42,"@type":43},"Đào","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-06","2026-09-27",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",17,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What are the red flag symptoms for faecal impaction?","Question",{"text":63,"@type":64},"Red flag symptoms include the presence of a rectal or abdominal mass, unexplained weight loss, iron deficiency anaemia, a change in bowel habit, and abdominal pain. Patients exhibiting these symptoms require an urgent colorectal referral.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"Who is authorized to perform a digital rectal examination for faecal impaction?",{"text":68,"@type":64},"A digital rectal examination (DRE) must be undertaken by a nurse who is specifically competent in performing DRE and possesses a full understanding of the patient's history, including any previous cases of bowel obstruction.",{"name":70,"@type":61,"acceptedAnswer":71},"What is the recommended approach for treating hard versus soft stools?",{"text":72,"@type":64},"For hard stools, clinicians should consider an impaction dose of oral Macrogol. If the stools are soft, or if hard stools persist after initial treatment, starting or adding an oral stimulant laxative is advised.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},403762,1790820641,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":124,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":124,"slug":126},10,"Lifestyle","lifestyle",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":97,"slug":130},19,"General","general",{"code":4,"msg":82,"data":132},{"doc_id":79,"user_id":133,"nickname":42,"user_avatar":134,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":26,"language":140,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":12,"update_tm":144,"read_time":97,"preview_page_count":4},1374402968488,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","| Document Details |  |  |\n| --- | --- | --- |\n| Title |  | Guidelines for Treating Adult Faecal Loading / Impaction |\n| Trust Ref No |  | 1871-88749 |\n| Main points the document covers |  | Guidance on how to treat faecal impaction. This excludes children, and pregnant women |\n| Who is the document aimed at? |  | Clinicians who manage patients in any location who present with faecal impaction |\n| Author |  | Continence Team |\n| Approval process |  |  |\n| Approved by\u003Cbr>(Committee/Director) |  | Patient Safety Committee |\n| Approval Date |  | 15th April 2024 |\n| Initial Equality Impact Screening |  | Yes |\n| Full Equality Impact Assessment |  | Yes |\n| Lead Director |  | Director of Nursing and Clinical Delivery |\n| Category |  | Clinical |\n| Subcategory |  | Continence |\n| Review date |  | 30th April 2027 |\n| Distribution |  |  |\n| Who the policy will be distributed to |  | Community Nurses, Community Hospitals |\n| Method |  | Electronically via managers / Datix, available to all staff via Trust Website and Key clinicians , Continence Link Nurses |\n| Document Links |  |  |\n| Required by CQC |  | No |\n| Required by NHLSA |  | No |\n| Amendments History |  |  |\n| No | Date | Amendment |\n| 1 | 2013 | New Guideline approved by the Area Prescribing Committee (APC) in October 2012 |\n| 2 | 2016 | Updated guideline with colorectal services and medicines management approved by APC in September |\n| 3 | 2019 | Scheduled Review, link for constipation amended. |\n| 4 | 2024 | Scheduled Review:\u003Cbr>Amended to follow NICE Guidance: Constipation in Adults, Jan 2024 |","cbCaissOBHmrteUN","https://ap.wps.com/l/cbCaissOBHmrteUN","pdf",183071,"English","# Clinical Definition and Assessment\n## Red Flag Symptoms and Referral\n# Treatment Protocols\n## First Line Treatment\n## Second Line Treatment\n## Advanced Interventions","[{\"question\":\"What are the red flag symptoms for faecal impaction?\",\"answer\":\"Red flag symptoms include the presence of a rectal or abdominal mass, unexplained weight loss, iron deficiency anaemia, a change in bowel habit, and abdominal pain. Patients exhibiting these symptoms require an urgent colorectal referral.\"},{\"question\":\"Who is authorized to perform a digital rectal examination for faecal impaction?\",\"answer\":\"A digital rectal examination (DRE) must be undertaken by a nurse who is specifically competent in performing DRE and possesses a full understanding of the patient's history, including any previous cases of bowel obstruction.\"},{\"question\":\"What is the recommended approach for treating hard versus soft stools?\",\"answer\":\"For hard stools, clinicians should consider an impaction dose of oral Macrogol. If the stools are soft, or if hard stools persist after initial treatment, starting or adding an oral stimulant laxative is advised.\"}]","Guidelines for Treating Adult Faecal Loading - Impaction | PDF",1790543144]