Stercoral colitis

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Stercoral colitis
CT of a 30-year-old with stercoral colitis showing rectal dilatation (star) due to fecal impaction; and rectal wall thickening (arrow) and perirectal fat stranding (arrowheads) due to inflammation.[1]
SpecialtyGeneral surgery, gastroenterology
SymptomsNone, abdominal distension, nausea, abdominal pain[1]
ComplicationsIschemic colitis, colonic perforation[1][2]
Usual onsetElderly[3]
Risk factorsConstipation, dementia, opioids, mental health problems, unable to walk[3][2]
Diagnostic methodCT scan[3]
Differential diagnosisDiverticulitis, appendicitis, bowel obstruction, mesenteric ischemia, infectious colitis[1]
TreatmentLaxatives, digital disimpaction, surgery[3]

Stercoral colitis is when severe constipation results in inflammation of the colon.[1] Symptoms vary from none to, abdominal distension, nausea, and abdominal pain.[1] Complications can include ischemic colitis, resulting in crampy pain or colonic perforation resulting in severe pain of sudden onset.[1][2]

Risk factors include long-term constipation, dementia, long-term opioid use, mental health problems, and being unable to walk.[3][2] The underlying mechanism involves increased pressure in the colon which may include a fecaloma (dehydrated stool).[2] Diagnosis may be supported by CT scan.[3]

Management may involve the use of laxatives or digital disimpaction, which may require admission to hospital.[3] If this does not work, or perforation is present, surgery is required.[3] Stercoral colitis is rare.[1] Less than 150 cases resulting in perforation have been described as of 2019.[4] Most of those who are affected are old.[3] It was first described in 1894.[4][5]


  1. 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 Bae, E; Tran, J; Shah, K (2 January 2024). "Stercoral colitis in the emergency department: a review of the literature". International journal of emergency medicine. 17 (1): 3. doi:10.1186/s12245-023-00578-x. PMID 38166616.
  2. 2.0 2.1 2.2 2.3 2.4 Morano, C; Sharman, T (January 2024). "Stercoral Colitis". StatPearls. PMID 32809443. Archived from the original on 16 June 2022. Retrieved 17 March 2024.
  3. 3.0 3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8 "Stercoral Colitis". Core EM. Archived from the original on 4 December 2023. Retrieved 17 March 2024.
  4. 4.0 4.1 Ahuja, Vanita (29 April 2019). "A Clinical Case Study and Review of the Literature on Stercoral Ulcer Perforation: An Uncommon but Deadly Culprit". doi:10.31487/j.SCR.2018.03.024. {{cite journal}}: Cite journal requires |journal= (help)
  5. Sahani, Dushyant V.; Samir, Anthony E. (29 October 2010). Abdominal Imaging E-Book: Expert Radiology Series. Elsevier Health Sciences. ISBN 978-1-4557-4033-8. Archived from the original on 18 March 2024. Retrieved 18 March 2024.