From the Research
Treatment for stercoral colitis involves addressing the fecal impaction that causes the condition, along with managing complications, with the most recent and highest quality study 1 guiding the approach to prioritize bowel decompression and prevention of recurrence. The treatment approach for stercoral colitis is multifaceted, focusing on both immediate relief and long-term prevention. Initial treatment involves bowel decompression through methods such as manual disimpaction, enemas, or high-volume polyethylene glycol solutions to clear the impacted stool, as highlighted in the study 2. Patients typically require intravenous fluids for rehydration and electrolyte correction.
- Broad-spectrum antibiotics such as piperacillin-tazobactam, ceftriaxone plus metronidazole, or ciprofloxacin plus metronidazole are administered if infection is suspected or confirmed.
- Pain management with appropriate analgesics is important.
- For severe cases with perforation or peritonitis, emergency surgery may be necessary, including colonic resection with or without colostomy, as discussed in 1. After resolving the acute episode, prevention of recurrence is crucial through:
- Increased dietary fiber (25-30g daily)
- Adequate hydration (at least 2 liters of fluid daily)
- Regular physical activity
- Scheduled bowel regimens using stool softeners like docusate sodium or osmotic laxatives Patients with mobility issues or chronic constipation may benefit from maintenance laxative therapy, as suggested by the comprehensive approach outlined in 3. This approach addresses both the immediate condition and helps prevent future episodes by targeting the underlying constipation that leads to stercoral colitis. The most recent study 1 emphasizes the importance of prompt diagnosis and appropriate management to reduce morbidity and mortality associated with stercoral colitis.