From the Research
Stercoral proctitis is a serious condition characterized by inflammation of the rectum caused by prolonged pressure from hard, impacted stool against the rectal wall, and it requires prompt treatment to prevent severe complications, as highlighted in a recent study 1.
Definition and Causes
Stercoral proctitis typically occurs in people with chronic constipation who have hardened fecal matter that remains in the rectum for extended periods. The pressure from the impacted stool reduces blood flow to the rectal tissue, leading to inflammation, ulceration, and in severe cases, perforation of the rectal wall.
Symptoms and Diagnosis
Symptoms of stercoral proctitis include rectal pain, bleeding, mucus discharge, and difficulty with bowel movements. Diagnosis is often made through physical examination, medical history, and imaging studies such as computed tomography (CT) scans, which can show fecal impaction, bowel wall inflammation, and fat stranding, as noted in a study published in the Annals of Emergency Medicine 1.
Treatment and Prevention
Treatment focuses on relieving the fecal impaction through:
- Manual disimpaction
- Enemas
- Oral laxatives such as polyethylene glycol (17g dissolved in 8oz water daily), bisacodyl (5-10mg orally), or docusate sodium (100mg twice daily), as recommended in a study on the use of polyethylene glycol in functional constipation and fecal impaction 2 After the impaction is resolved, patients should:
- Increase dietary fiber (25-30g daily)
- Maintain adequate hydration (at least 8 glasses of water daily)
- Establish regular bowel habits to prevent recurrence In severe cases with ulceration or perforation, antibiotics and surgical intervention may be necessary, as reported in a case study on stercoral sigmoid perforation 3.
High-Risk Populations
The condition is particularly common in:
- Elderly, bedridden patients
- Those with neurological disorders affecting bowel function Preventive measures are especially important in these populations, including aggressive treatment of fecal impaction and monitoring of treatment adequacy with abdominal radiography, as suggested in a study on megacolon and stercoral proctitis after frequent fecal impactions 4.