Fecal stones are not only uncomfortable for those who suffer from them, but also painful. Sometimes they can even be life-threatening. They are also not as rare as is commonly believed.

What is feces?

In the short term, fecal stones can reduce well-being and cause gastrointestinal problems. If the digestive system is completely blocked, vomiting of feces can lead to throat infections. See AbbreviationFinder for abbreviations related to Feces.

A fecal stone (coprolite) is a mostly round ball of feces about the size of a cherry stone. The fairly common sheep droppings – as they are called in the vernacular – have the same color as the rest of the droppings, but are very hard. Around the hard layer are several layers of mucus and dried-up intestinal contents.

Fecal stones settle in blind-ending sections of the intestine and curvatures in the large intestine, the diverticula (protrusions of the intestinal wall) and in the rectum. They usually go away on their own with a bowel movement. However, they become dangerous if they cause diseases such as intestinal obstruction or a breakthrough in the abdominal cavity with subsequent peritonitis.

Fecal stones usually occur in connection with chronic constipation and are then found in the rectum, where they block the intestinal passage and only allow thin stool through. This gives the impression that the patient is suffering from diarrhea (paradoxical diarrhea). If the poop balls pass by themselves, they often cause intestinal irritation and pain.

Causes

The stool thickens into a fecal stone if it is transported too slowly through the intestine due to insufficient intestinal peristalsis and then too much liquid is withdrawn. This is most common in people with intermittent and chronic constipation. Other causes of fecal stones include irritable bowel syndrome, colon cancer, and normal metabolic buildup in the convolutions of the intestine.

Patients with constipation usually do not drink enough fluids or have to take sedative medication, which of course also has a calming effect on intestinal peristalsis. In addition, they often eat a diet low in fiber, fat and high in sugar, so that not enough stool volume can be built up. Long-term abuse of laxatives and – in the case of diabetics – a disturbance in the conduction of stimuli due to diabetic polyneuropathy can also lead to the formation of faecal stones.

Symptoms, Ailments & Signs

Fecal stones can impede the transport of faeces through the intestines to such an extent that they cause stabbing, colicky pain when the contents of the intestine slide past. If they are deposited in diverticula, they sometimes cause diverticulitis : the permanent pressure of the faeces on the intestinal wall leads to ulcers in the intestinal mucosa. If the stone breaks through the intestinal wall, it can cause peritonitis. If the diverticulitis also spreads to other areas of the intestine, intestinal fistulas and abscesses are often the result.

Since many fecal stones are hidden in such a way that they hardly cause any symptoms, they are sometimes only discovered during an intestinal operation. If they are in the rectum, they can be felt manually during a normal intestinal examination. If they protrude into the cavity of the intestine, they can be detected using an endoscopy. Fecal stones are also usually clearly visible on x-rays.

An ultrasound diagnosis, on the other hand, is not so reliable: the bright areas in the image can also indicate gas in the intestine. If the faeces disturb the normal intestinal passage of the faeces, they often cause sharp pains in the abdomen. If they are not removed or if they pass off on their own, they can cause life-threatening intestinal obstruction. If they cause tears in the intestinal mucosa, it can lead to inflammation of the intestinal mucosa and – if it penetrates into the abdomen – to peritonitis (peritonitis).

Complications

Fecal stones can cause various complications. First there is the risk of an intestinal blockage, which can lead to life-threatening complications such as intestinal perforation and blood poisoning. In addition, a calculus can lead to the development of fecal abscesses, which require further treatment.

In the short term, fecal stones can reduce well-being and cause gastrointestinal problems. If the digestive system is completely blocked, vomiting of feces can lead to throat infections. In extreme cases, this can lead to pneumonia, which in turn is associated with serious complications.

Due to the severity of these complications, prompt treatment is advisable. Treating fecal stones can cause a variety of symptoms. When removing a larger ball of faeces, a tear in the anus often occurs, which can become inflamed and lead to the development of abscesses.

In the medium term, laxatives can lead to a lack of minerals or to dehydration, accompanied by exhaustion and a general reduction in performance. Irritation and other side effects can occur during an intestinal lavage due to the preparations used. The preparations used rarely cause allergic reactions and trigger diarrhea, for example.

When should you go to the doctor?

A fecal stone will only prompt a trip to the doctor in some cases, since many fecal stones are very small and very hidden. Sometimes they do not cause any symptoms, except that they can lead to pain when they leave. In addition, small specimens often go unnoticed.

However, if a coprolite is noticed by the person concerned, a visit to the doctor is advisable. Excessive or existing faecal matter of sufficient size manifests itself, for example, as colicky pain, severe pain during bowel movements, stubborn constipation or misery. Sometimes it can also be felt through the abdominal wall, as long as it is large enough and located in the appropriate place in the intestine.

If the faeces have passed, you need to go to the doctor to determine the possible causes. Metabolic diseases or diet can often be the reason. A family doctor can be a first port of call. A proctologist may be needed to remove fecal stones and examine the intestines.

If the symptoms point to a coprolite still lying inside, a quick medical examination is advisable. After all, such a condition harbors the possibility of life-threatening complications and sometimes severely restricts the person concerned because the entire digestion can be disturbed.

Treatment & Therapy

If there is an intestinal obstruction (ileus), there is a risk of death. He must be eliminated as soon as possible. Diverticulitis and the break-through of feces into the lower abdominal area must also be treated as quickly as possible. The ball of feces is often surgically removed. Surgical intervention is also necessary for faecal deposits in the upper intestinal area.

Stones deposited in the rectum can be removed manually by a doctor or a specially trained nurse or dissolved using several enemas. Removal is usually carried out after two unsuccessful attempts to soften the faeces.

Even if the patient feels great relief afterwards, the evacuation is usually very painful and is perceived as uncomfortable. Fecal stones can also be flushed out with the help of colon hydrotherapy (intestinal irrigation). Since significantly more water (about 35 liters) is introduced into the intestine with it than with an enema, additional incrustations caused by deposited indigestible food components and metabolic waste products can also be removed.

As a rule, three colonic irrigations are necessary to clean the convolutions of the colon in otherwise inaccessible places. Since several different water temperatures are used (up to 41 degrees and up to 21 degrees), intestinal peristalsis is also stimulated. In the case of fecal stones that occur in connection with intestinal diseases, the underlying disease is treated first. The constipation is eliminated by administration of more or less strong laxatives, a change in diet.

Outlook & Forecast

In principle, one can assume that a faecal stone can be removed with and without medical help. This results in a favorable prognosis. However, the scope of treatment differs significantly. If there is no severe pain or bleeding, those affected can usually alleviate symptoms through self-help measures. Adequate fluid intake and a high-fiber diet counteract the problem.

The situation is different in the case of complications such as an intestinal obstruction. In this case there is danger to life. A doctor should be consulted immediately. First, the medical professional tries to fix the problem manually. If this fails, an operation will be necessary. The last procedure is always given in the case of a breakthrough in the lower abdomen. Patients should never ignore the typical symptoms. In the case of severe symptoms, consultation with a doctor is essential. If you delay the start of treatment for several days, you risk further inflammation. As a result, regular bowel movements are impossible.

Sufferers with chronic constipation are considered prone to the feces. You are advised to exercise caution. Doctors recommend regular colonic irrigation if you are susceptible. Diet and lifestyle changes are permanent.

Prevention

Since faecal stones often occur in combination with (chronic) constipation and constipation, a high-fiber, low-sugar and low-fat diet is recommended. In addition, the affected person should drink at least 2.5 liters of liquid throughout the day and pay attention to daily bowel movements.

From time to time, intestinal cleansing with certain herbs, psyllium or chlorella is recommended. Probiotic foods also help to rebuild the damaged intestinal flora. Colonic massage (necessary for those confined to bed!) and certain exercises to stimulate peristalsis are also useful.

Aftercare

A fecal stone can be successfully removed. This often does not even require medical treatment. If there are no more complaints, there are no reasons for scheduled follow-up examinations. Because unlike tumors, where follow-up care always takes place, there is no potentially life-threatening situation that requires early treatment.

There is no spread of the disease in the form of metastases. Patients are told the causes of the first fecal stone treated. At the same time, if they are likely to be vulnerable, they also receive tips on how to behave in their everyday lives. However, the implementation of these instructions is the responsibility of those affected.

There is no medical check-up. Appropriate preventive measures include a high-fiber, low-fat diet. Fluid intake should be at least two liters per day. People with chronic constipation and intestinal irritation are considered a risk group. For them, the long-term use of certain sedative medications can be useful.

This will break up the faeces. If the typical symptoms reappear in patients after an initial diagnosis, they should consult a doctor immediately. Depending on the extent of the blockage, there is a risk of death. X-rays and endoscopy are suitable acute methods for determining feces.

You can do that yourself

Those affected can only treat faecal stones themselves if they have not yet led to complications (intestinal obstruction, misery, etc.). In such cases, operations or manual clearing are unavoidable.

For example, small feces and those that have formed in uncomplicated places can possibly be brought to defecation by those affected by stimulating peristalsis. Exercise, a balanced diet, and drinking enough fluids can help. In addition, the relevant area – insofar as it is known – can be massaged from the outside with a little emphasis. This can cause the feces to break down or move on.

An enema also helps. It is not necessary to add substances to the water. However, water enemas (several hundred milliliters) only help if the feces are in the last section of the intestine. Several enemas with changing temperatures should be performed. Excessive use of (herbal) laxatives is discouraged, as diarrhea can occur, but this will not be dissolved feces. This only risks dehydration and demineralization.

If pain, discomfort, bleeding or other symptoms occur, stop all self-help measures and consult a doctor.