[citation needed] There are many possible causes; these include a long period of physical inactivity, failure to consume adequate dietary fiber, dehydration, and deliberate retention of fecal matter.

[citation needed] Opioids such as fentanyl, buprenorphine, methadone, codeine, oxycodone, hydrocodone, morphine, and hydromorphone as well as certain sedatives that reduce intestinal movement may cause fecal matter to become too large, hard and/or dry to expel.

[citation needed] Reducing or replacing opiates, adequate intake of water, dietary fiber, and exercise.

Osmotic laxatives such as magnesium citrate work within minutes to eight hours for onset of action, and even then they may not be sufficient to expel the stool.

[citation needed] Osmotic laxatives can cause cramping and even severe pain as the patient's attempts to evacuate the contents of the rectum are blocked by the fecal mass.

Manual disimpaction may be performed by lubricating the anus and using one gloved finger with a scoop-like motion to break up the fecal mass.

By using pulsating water to enter into the colon to soften and break down the dense mass, PIE treats fecal impaction.

Polyethylene glycol 3350 can be taken daily to soften the stools without the significant risk of adverse effects that are common with other laxatives.

[citation needed] A fecaloma is a more extreme form of fecal impaction, giving the accumulation an appearance of a tumor.

Surgical intervention in the form of sigmoid colectomy[12] or proctocolectomy and ileostomy[13] may be required only when all conservative measures of evacuation fail.

Attempts at removal can have severe and even lethal effects, such as the rupture of the colon wall by catheter or an acute angle of the fecaloma (stercoral perforation), followed by sepsis.