Spinal cord injury is a common cause of constipation, due to ileus. Manual removal of a fecal impaction is often required with obese patients in traction, after a barium enema, and in poorly hydrated older adults. Prevention
Reducing opiate-based medication (when possible, tolerable, and safe; prescription medication changes should be done under the supervision of a physician), and adequate intake of liquids (water) and dietary fiber and daily exercise. Treatment
The treatment of fecal impaction requires both the remedy of the impaction and treatment to prevent recurrences. Decreased motility of the colon results in dry, hard stools that in the case of fecal impaction become compacted into a large, hard mass of stool that cannot be expelled from the rectum. Various methods of treatment attempt to remove the impaction by softening the stool, lubricating the stool, or breaking it into pieces small enough for removal. Enemas and osmotic laxatives can be used to soften the stool by increasing the water content until it is soft enough to be expelled. Osmotic laxatives such as magnesium citrate work within minutes - eight hours for onset of action, and even then they may not be sufficient to expel the stool. Osmotic laxatives can cause cramping and even severe pain as the patients attempts to evacuate the contents of the rectum are blocked by the fecal mass. Polyethylene glycol (PEG 3350) may be used to increase the water content of the stool without cramping.
Velopharyngeal incompetency occurs when the soft palate and the lateral/posterior pharyngeal walls fail to separate the oral cavity from the nasal cavity during speech. Although the definitions are similar, the etiologies correlated with each term differ slightly. However, in the field of medical professionals these terms are typically used interchangeably. References
Conley SF, Gosain AK, Marks SM, Larson DL (1997). "Identification and assessment of velopharyngeal inadequacy". Am J Otolaryngol. 18 (1): 38–46. doi:10.1016/S0196-0709(97)90047-8. PMID 9006676. Johns DF, Rohrich RJ, Awada M (2003). "Velopharyngeal incompetence: a guide for clinical evaluation". Plast. Reconstr. Surg. 112 (7): 1890–7, quiz 1898, 1982. doi:10.1097/01.PRS.0000091245.32905.D5. PMID 14663236. McWilliams, Betty Jane; Peterson-Falzone, Sally J.; Hardin-Jones, Mary A.; Karnell, Michael P. (2001). Cleft palate speech. St. Louis: Mosby. ISBN 0-8151-3153-4. Hardin-Jones, Mary A.; Peterson-Falzone, Sally J.; Judith Trost-Cardamone; Karnell, Michael P. (2005). The Clinicians Guide to Treating Cleft Palate Speech. St. Louis: Mosby-Year Book. ISBN 0-323-02526-9. Willging JP (1999). "Velopharyngeal insufficiency". Int. J. Pediatr. Otorhinolaryngol. 49 Suppl 1: S307–9. doi:10.1016/S0165-5876(99)00182-2. PMID 10577827. == External links ==