From the Research
Stercoral colitis is a serious condition related to severe constipation where hardened fecal matter causes pressure on the walls of the colon, potentially leading to stercoral colitis or stercoral ulceration, and it is crucial to prioritize immediate treatment to prevent perforation and peritonitis, as highlighted in a recent study 1.
Definition and Pathophysiology
Stercoral colitis is a rare inflammatory process involving the colonic wall secondary to fecal impaction, with high morbidity and mortality, especially if complicated with ischemic colitis, stercoral ulcer formation, and subsequent perforation 1. The condition occurs when hardened fecal matter (fecaloma) causes pressure on the walls of the colon, compromising blood flow to the bowel wall, potentially leading to ischemia, necrosis, and perforation if left untreated.
Treatment and Prevention
Treatment typically involves immediate bowel decompression through enemas, manual disimpaction, or colonoscopic removal of the impacted stool, as recommended in a study published in 2023 2. For prevention, maintaining adequate hydration, consuming a high-fiber diet, regular physical activity, and using stool softeners like docusate sodium or osmotic laxatives such as polyethylene glycol are recommended 3. In severe cases requiring hospitalization, intravenous fluids and more aggressive bowel management may be necessary.
Risk Factors and Complications
The condition occurs most commonly in elderly, bedridden patients, those with chronic constipation, or individuals taking medications that slow bowel motility such as opioids or anticholinergics 4. Complications may include bowel obstruction leading to aspiration, stercoral ulcers, perforation, and peritonitis, with a mortality rate exceeding 50% in cases of perforated stercoral ulceration 5.
Key Points
- Stercoral colitis is a serious condition related to severe constipation
- Immediate treatment is crucial to prevent perforation and peritonitis
- Treatment involves bowel decompression, manual disimpaction, or colonoscopic removal of impacted stool
- Prevention includes maintaining hydration, consuming a high-fiber diet, and using stool softeners
- The condition is more common in elderly, bedridden patients, and those with chronic constipation or taking certain medications.