Patient presents with symptoms consistent with stool burden, also referred to as fecal impaction or fecal loading.  Presenting complaints include chronic constipation, infrequent bowel movements, abdominal pain and distension, rectal pressure, and sensation of incomplete evacuation.  Digital rectal examination revealed a palpable fecal mass in the rectum.  The patient reports decreased frequency of bowel movements, straining during defecation, and passage of small, hard stools.  Symptoms have been ongoing for [duration] and impact the patient's quality of life, interfering with daily activities and causing significant discomfort.  Assessment suggests a diagnosis of stool burden secondary to [possible etiologies e.g., chronic constipation, low fiber diet, inadequate fluid intake, medication side effects, decreased mobility, neurological conditions].  Plan includes disimpaction with [specify method e.g., manual disimpaction, enema administration] followed by a bowel management program consisting of increased dietary fiber intake, adequate hydration, and prescribed stool softeners such as [medication name and dosage].  Patient education provided on the importance of regular bowel habits, proper toileting techniques, and potential complications of untreated stool burden.  Follow-up scheduled to monitor treatment efficacy and adjust the bowel management plan as needed.  Differential diagnoses considered include fecal incontinence, obstipation, and bowel obstruction.  ICD-10 code K59.0 (Constipation) and CPT codes for disimpaction procedures (e.g., 45300, 45305) may be applicable depending on the specific treatment provided.