From the Research
The treatment for stercoral colitis involves a multi-faceted approach focusing on relieving fecal impaction and preventing complications, as supported by the most recent study 1 from 2023.
Key Components of Treatment
- Initial management includes bowel decompression through stool softeners, laxatives, and enemas to remove the impacted fecal material. Polyethylene glycol (such as MiraLAX, 17g in 8oz water daily) or lactulose (15-30ml orally twice daily) are commonly used, as noted in 2.
- Manual disimpaction may be necessary in severe cases, highlighting the need for careful patient assessment and timely intervention 3.
- Intravenous fluids are administered to correct dehydration and electrolyte imbalances, a critical step in managing patients with stercoral colitis, especially given the high risk of complications 4.
- Broad-spectrum antibiotics (such as piperacillin-tazobactam 3.375g IV every 6 hours or ciprofloxacin 400mg IV every 12 hours plus metronidazole 500mg IV every 8 hours) are given if infection is present or suspected, underscoring the importance of monitoring for signs of infection 5.
Prevention of Recurrence
- After resolution, prevention strategies include increased dietary fiber (25-30g daily), adequate hydration (at least 2 liters of water daily), regular physical activity, and a bowel regimen to prevent recurrent constipation, as emphasized by the need to address the underlying causes of fecal impaction 1.