Which of the following is a primary cause of oozing stools in a tube fed patient?

• A. Fecal impaction
• B. Fluid restriction
• C. Physical inactivity
• D. Narcotic usage

Answer: (A)

Overflow incontinence from fecal impaction is the main idea here. When a hard mass of stool builds up in the colon or rectum, the distal portion can’t hold stool, but liquid stool from higher up continues to be formed and leaks around the blockage. That leakage appears as oozing stools in a tube-fed patient. Tube feeds increase constipation risk, especially with immobility, dehydration, and opioids, making impaction more likely. Fluid restriction or inactivity alone doesn’t produce this overflow pattern, and while narcotics contribute to constipation, the distinguishing feature is the leakage around an impaction. Managing this involves relieving the impaction and addressing contributing factors to prevent recurrence.