What symptom may manifest with impaction and why?

• A. Diarrhea with intermittent passage of small volumes of liquid stool and abdominal distention and cramping
• B. Constipation and abdominal fullness
• C. Nausea and vomiting
• D. Fever and tachycardia

Answer: (A)

Fecal impaction can lead to overflow diarrhea. When a hard stool mass blocks the rectum, stool from higher up keeps being produced and is forced around the blockage, causing intermittent passage of small volumes of liquid stool. The buildup of stool and gas proximal to the impaction produces abdominal distention and cramping as the bowel tries to move contents past the blockage. This overflow leakage is a classic sign that the obstruction is present, even though it may look like diarrhea.

Constipation and abdominal fullness can occur with impaction, but they don’t capture the distinctive overflow pattern. Fever and tachycardia suggest infection or dehydration rather than impaction alone, and nausea or vomiting are less specifically tied to the impaction mechanism.