Stercoral colitis is an inflammatory condition in which feces collect and cause pressure to build up within the colon. It can lead to complications such as rupture without treatment. Chronic constipation may cause stercoral colitis.

Stercoral colitis is one of several types of colitis. Colitis refers to a group of inflammatory conditions that affect the lining of the colon.

The condition is rare, but it can be severe and sometimes fatal.

This article takes a closer look at stercoral colitis along with its symptoms, causes, diagnosis, treatment, outlook, and complications.

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Stercoral colitis is a condition in which fecal matter collects and causes swelling within the colon, eventually leading to a fecaloma mass. This mass causes a blockage, usually in the last part of the colon, known as the rectosigmoid colon.

The blockage creates pressure increases that can cause ulcers to develop. These ulcers may lead to focal ischemic necrosis, which reduces blood flow to tissues, and colonic perforation, where a hole forms in the colon.

These complications can be fatal, particularly if the colon perforates.

People with chronic constipation are more likely to develop stercoral colitis. Additionally, stercoral colitis is more likely to affect older people and people with dementia.

The main symptoms of stercoral colitis are:

  • abdominal discomfort
  • cramps
  • fever
  • anorectal pain

People with stercoral colitis may experience abdominal distension, where the belly swells noticeably. The abdomen may feel tender when the person tenses their stomach muscles.

Unlike people with an intestinal blockage, people with stercoral colitis are likely to have stool in the rectum but may only be able to pass small amounts of stool.

Stercoral colitis results from increased pressure in the colon due to fecal impaction.

Fecal impaction is the inability to pass large, hard, thickened stool from the lower gastrointestinal tract.

If people with chronic constipation are physically inactive, it may be harder to pass stool. This can lead to a cycle where constipation causes fecal impaction, and the fecal impaction makes it harder to pass stool.

It is not possible to diagnose stercoral colitis on the basis of a physical examination and lab results alone. Imaging is necessary to make a diagnosis.

Doctors diagnose stercoral colitis if a person has:

  • fecal impaction
  • colonic dilation, where the colon widens due to the buildup of stool
  • a colon wall thickness of over 3 centimeters (cm) at the site of fecal impaction
  • an increase in fat around the colon
  • air moving from the opening of the bowels into or beyond the colon wall

It is essential to diagnose stercoral colitis as soon as possible because it may lead to complications such as colonic perforation.

Treatment for stercoral colitis involves removing the blockage and an aggressive bowel regimen to avoid constipation.

Removing the fecal blockage may involve:

  • using enemas
  • manually dis-impacting the blockage
  • placing a rectal tube

Surgery is another option for those who are risk of complications, such as bowel perforation.

Outlook can vary greatly depending on the speed of diagnosis and the management plan.

Factors that may increase a person’s risk of death include:

  • colon perforation, which has a 32–59% chance of mortality
  • blockages over 40 cm long
  • ischemic bowel, which can cause septic shock

The most common stercoral colitis complications are intestinal perforation and solitary stercoral ulcers.

Other possible complications include:

  • sepsis, or septic shock
  • ischemic colitis
  • urinary retention if the bowel causes compression
  • renal failure from compression and blockage of ureters

Here we answer some common questions about the condition.

What is the treatment for stercoral colitis?

Treatment involves fecal dis-impaction to break down the blockage and management of constipation.

Is stercoral colitis fatal?

Stercoral colitis can be fatal. The outlook depends on how soon a person receives a diagnosis and begins treatment.

Is stercoral colitis painful?

Stercoral colitis can cause severe abdominal pain.

What does stercoral mean?

Stercoral comes from the word stercoraceous, meaning “relating to, being, or containing feces.”

In this context, stercoral refers to a mass that forms from retaining feces in the colon.

What is the difference between stercoral and ulcerative colitis?

There are many different types of colitis. They vary in cause and severity.

Ulcerative colitis is chronic autoimmune-mediated colitis, whereas stercoral colitis is acute.

Stercoral colitis affects the area inside the colon, whereas ulcerative colitis causes symptoms outside the colon. Ulcerative colitis is more common and less severe.

Stercoral colitis is a rare and severe condition where feces cause blockages within the colon. It usually begins with chronic constipation.

As feces collect and create a mass, pressure increases in the colon. Without diagnosis and treatment, the condition causes severe complications, such as perforation of the bowel.

Treating stercoral colitis involves removing the fecal impaction by breaking it down or physically removing it and treatment for chronic constipation. It is possible to remove the mass surgically, but the procedure comes with high risk.