Constipation is prevalent in the elderly. Rarely, severe constipation leads to stercoral colitis, a condition which results from fecal impaction in the colon causing increased intraluminal pressure, ulcer formation, and perforation of the colonic tissue. This condition can be fatal if it is not recognized early and promptly treated. Early detection is often difficult as this disease primarily affects elderly patients with history of dementia, stroke, or other neurologic disorders, and can cause ...

A 57-year-old male presented with a four week history of shortness of breath on exertion, fatigue and melaena with no underlying medical or family history. Recent blood tests with his primary care physician demonstrated an iron deficiency anaemia with a haemoglobin of 7 g/dL and MCV of 68 fl. Oesophagogastroduodenoscopy (OGD) was performed in the first instance which did not show any evidence of recent bleeding or cause of the melaena. Of note, a CEA level was normal at 1.2 ng/ml. A colonoscopy ...