From the Research
Management of stercoral colitis requires prompt intervention to prevent serious complications like perforation and sepsis, with initial treatment focusing on fecal disimpaction through manual disimpaction, enemas, or water-soluble contrast enemas in severe cases, as supported by the most recent study 1. The treatment approach should be tailored to the severity of the condition, with aggressive bowel cleansing using polyethylene glycol solutions (GoLYTELY or MiraLAX) at doses of 1-2 liters orally or via nasogastric tube, as well as pain management with appropriate analgesics and intravenous fluid resuscitation, being essential supportive measures 2.
- Key considerations in the management of stercoral colitis include:
- Fecal disimpaction through manual disimpaction, enemas, or water-soluble contrast enemas
- Aggressive bowel cleansing using polyethylene glycol solutions
- Pain management with appropriate analgesics and intravenous fluid resuscitation
- Broad-spectrum antibiotics for signs of infection or perforation, such as piperacillin-tazobactam or ceftriaxone plus metronidazole 3
- Surgical consultation for cases with perforation, peritonitis, or failure of conservative management
- Prevention of recurrence is crucial and can be achieved through a high-fiber diet, adequate hydration, regular physical activity, and maintenance laxative regimens as needed, with underlying causes of constipation being identified and addressed 4. The most recent and highest quality study 1 provides the best guidance for the management of stercoral colitis, emphasizing the importance of prompt intervention and a tailored treatment approach to prevent serious complications and improve patient outcomes.