Characteristics and outcomes among patients with stercoral colitis - a retrospective cohort study

Stercoral colitis is a rare, but potentially serious, complication of chronic constipation. Limited literature exists, pertaining to stercoral colitis-related management and outcomes. We aim to study characteristics and outcomes of stercoral colitis patients presenting to emergency department.

We compiled a cohort of patients who presented to one of 21 EDs between 1 January 2024 and 31 January 2025 and had a radiological finding of stercoral colitis on CT imaging. We manually extracted details regarding their ED presentation and disposition, hospital course, and any acute adverse outcomes defined as inpatient endoscopy, inpatient surgery, and death within 90 days of the ED visit related to stercoral colitis. Additional chart review was performed in patients who experienced adverse outcomes to study the clinical circumstances.

Three hundred and eighty-one patient encounters (358, unique patients) were identified with stercoral colitis. Only seven patients (2.0%) experienced acute adverse outcomes, though four of these were not attributed to stercoral colitis. Two hundred and seventy-two patient encounters (71.4%) were admitted to the hospital, among which 114 encounters (29.9%) had primary admitting diagnoses related to stercoral colitis. Of the 109 (28.6%) encounters discharged from ED, 2 patients returned to ED within 72 hours. Management of hospitalized stercoral colitis patients mostly included disimpaction and bowel regimen medications.

Stercoral colitis is an uncommon diagnosis, and adverse outcomes are rare. The decision to hospitalize should be based on the overall clinical picture, considering need for hospital-based interventions, or assistance with bowel regimen. The Age-Friendly Health System framework can facilitate an optimal management approach.