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Faecal impaction — DGM MCQ

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HardContinenceFaecal impactionDGM

An 82-year-old man with Parkinson's disease has constipation, abdominal bloating and loose stool staining his underwear. Rectal examination reveals hard stool in the rectum. He takes co-codamol and a calcium supplement. What is the most likely diagnosis?

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Correct answer: B — Faecal impaction with overflow diarrhoea

Loose leakage around hard rectal stool is typical of overflow from faecal impaction. Infective diarrhoea is less likely with a loaded rectum and chronic constipating medicines. Constipation can present as incontinence in older adults.

Reference: NICE CKS Constipation; NICE CG49