R11.13 Vomiting of fecal matter

Name of the Condition

• Common Name: Vomiting of fecal matter
• Medical Term: Feculent vomiting

Summary

Vomiting of fecal matter, also known as feculent vomiting, is the forceful expulsion of stomach contents that have a fecal odor or appearance. This symptom indicates a severe underlying condition, typically involving intestinal obstruction or dysfunction, and requires prompt medical evaluation.

Causes

Feculent vomiting is most commonly caused by complete or near-complete intestinal obstruction, which prevents normal passage of intestinal contents. Other potential causes include severe gastrointestinal motility disorders, volvulus (twisting of the intestine), or advanced bowel ischemia (reduced blood flow to the intestine).

Risk Factors

Factors that may increase the risk of feculent vomiting include:

• History of abdominal surgery or adhesions
• Inflammatory bowel disease (e.g., Crohn’s disease)
• Hernias (especially incarcerated or strangulated)
• Malignancies affecting the gastrointestinal tract
• Severe constipation or fecal impaction

Symptoms

Typical symptoms associated with feculent vomiting include:

• Forceful expulsion of material with a fecal odor or appearance
• Abdominal pain or distension
• Nausea
• Inability to pass gas or stool
• Dehydration or electrolyte imbalances

Diagnosis

Diagnosis of feculent vomiting involves a combination of clinical assessment and diagnostic testing. A detailed medical history and physical examination are performed to evaluate for signs of obstruction or abdominal pathology. Imaging studies, such as X-rays, CT scans, or abdominal ultrasound, may be used to identify structural abnormalities. Laboratory tests, including blood work to assess for dehydration or metabolic disturbances, are also commonly ordered.

Treatment Options

Treatment for feculent vomiting depends on the underlying cause and severity. Immediate interventions may include intravenous fluids to correct dehydration and electrolyte imbalances. If an obstruction is present, surgical or endoscopic intervention may be necessary to relieve the blockage. Supportive care, such as bowel rest and nutritional support, is often required during recovery.

Prognosis and Follow-Up

The prognosis for feculent vomiting varies based on the underlying condition and timeliness of treatment. Early intervention for intestinal obstruction or other treatable causes can improve outcomes. Follow-up care typically involves monitoring for recurrence of symptoms and addressing any underlying gastrointestinal disorders. Long-term management may include dietary modifications or medications to prevent future episodes.

Complications

Complications of feculent vomiting can be severe and include:

• Severe dehydration and electrolyte imbalances
• Bowel perforation or ischemia
• Sepsis (infection spreading through the bloodstream)
• Malnutrition or weight loss
• Respiratory issues from aspiration of vomitus

Lifestyle & Prevention

Preventive measures focus on addressing underlying gastrointestinal conditions. Maintaining a high-fiber diet and adequate hydration can help prevent constipation and reduce the risk of obstruction. For individuals with a history of abdominal surgery or hernias, prompt medical attention for abdominal pain or bloating is critical. Avoiding known triggers, such as certain foods or medications, may also be recommended based on individual risk factors.

When to Seek Professional Help

Seek immediate medical attention if you experience vomiting of fecal matter, as it is a sign of a serious condition requiring urgent evaluation. Other warning signs include severe abdominal pain, inability to pass gas or stool, fever, or signs of dehydration (e.g., dizziness, reduced urination).

Tips for Medical Coders

When coding for vomiting of fecal matter, use ICD-10-CM code R11.13. Documentation should clearly describe the presence of feculent material in vomitus, as well as any associated symptoms (e.g., abdominal pain, obstruction) or underlying conditions. Ensure the medical record supports the specificity of this code, as it reflects a distinct clinical presentation requiring detailed clinical correlation.