[stercoral colitis American Journal of EM 2025](https://www.sciencedirect.com/science/article/pii/S0735675725000634) > Admission to the hospital should be considered for all patients with stercoral colitis. - Stercoral colitis is an inflammatory condition of the large bowel caused by **substantial stool burden**. - Stercoral colitis is a rare but serious diagnosis which is associated with a high rate of morbidity. - This condition most commonly occurs in *elderly patients* with multiple comorbidities. - Stercoral colitis is associated with high intraluminal pressures in the rectosigmoid and/or distal colon due to the presence of large volumes of impacted stool, which results in inflammation of the bowel wall. - Left untreated, stercoral colitis can progress to bowel ulceration, focal bowel ischemia, bowel wall perforation, peritonitis, sepsis, and **death**. Common risk factors for stercoral colitis include older age and chronic constipation. Chronic constipation affects over one third of patients over 60 years, with females more commonly affected. Though most commonly present with abdominal pain and constipation, many patients present without typical symptoms requiring emergency clinicians to maintain high clinical suspicion, especially in patients at high risk for developing severe constipation. **Diagnosis:** with CT abdo. **Management:** IVF, multimodal bowel disimpaction, +/- abx. Likely admit to hospital under surgery.