{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T02:19:01Z","timestamp":1785464341009,"version":"3.56.0"},"reference-count":48,"publisher":"Hamad bin Khalifa University Press (HBKU Press)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Fecaloma is a mass of hardened feces impacted in the rectum and sigmoid. When the colonic mucosal wall and vasculature are compressed, stercoral colitis, a rare type of inflammatory colitis, may occur. Despite being connected to psychiatric patients and antipsychotic medications in the literature, fecaloma remains a significant, yet often overlooked, cause of morbidity and mortality in this population.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Case Presentation:<\/jats:bold>\n                    A 43-year-old patient with schizophrenia being treated with aripiprazole and benztropine lost follow-up and eventually presented to the emergency department with a giant fecaloma and associated stercoral colitis. She was managed with oral and rectal laxatives and supportive therapy. Additionally, aripiprazole was discontinued.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Discussion:<\/jats:bold>\n                    Antipsychotics have been associated with constipation, fecaloma, and stercoral colitis due to their anticholinergic properties. Benztropine, an antimuscarinic drug commonly used in psychiatric patients to alleviate extrapyramidal symptoms, may further decrease gastrointestinal mobility. Fecaloma and associated stercoral colitis are often diagnosed via imaging, typically a computed tomography scan of the abdomen. Management depends on the severity and generally ranges from conservative treatment to surgical options.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    This case describes a schizophrenic patient undergoing treatment with aripiprazole and benztropine who presented with constipation and was diagnosed with a giant fecaloma complicated by stercoral colitis. The patient was managed successfully with aggressive laxatives and discontinuation of aripiprazole. Early recognition and prompt management of fecaloma are essential to mitigate associated complications. In addition, it is important to recognize risk factors for constipation and regularly review home medications, such as antipsychotics, that may cause constipation as a side effect.\n                  <\/jats:p>","DOI":"10.5339\/qmj.2025.58","type":"journal-article","created":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T11:30:47Z","timestamp":1752579047000},"source":"Crossref","is-referenced-by-count":4,"title":["A giant fecaloma causing stercoral colitis secondary to aripiprazole and benztropine: A case report"],"prefix":"10.5339","volume":"2025","author":[{"given":"Shahem","family":"Abbarh","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mhd Kutaiba","family":"Albuni","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Trihealth Good Samaritan Hospital, Cincinnati, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Misbah","family":"Irshad","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adnan Humam","family":"Hajjar","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bisher","family":"Sawaf","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalid","family":"Al-Ejji","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hamad Medical Corporation, Doha, Qatar*Correspondence: Shahem Abbarh dr.shahem94@gmail.com"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3277","reference":[{"issue":"(4):","key":"CIT0001","series-title":"Clin Gastroenterol Hepatol","first-page":"A30","article-title":"Giant fecaloma causing anorexia and dysuria","volume":"18","author":"Yamasaki\n \nM","year":"2020;"},{"issue":"(4):","key":"CIT0002","series-title":"Clin Gastroenterol Hepatol","first-page":"e48","article-title":"A Case of a giant fecaloma","volume":"16","author":"Ghosh\n \nG","year":"2018;"},{"issue":"(1):","key":"CIT0003","series-title":"Int J Emerg Med","first-page":"46","article-title":"A fatal fecaloma","volume":"13","author":"Logre\n \nE","year":"2020;"},{"issue":"(2):","key":"CIT0004","series-title":"Forensic Sci Med Pathol","first-page":"201\u20134","article-title":"Death by fecaloma","volume":"18","author":"Usumoto\n \nY","year":"2022;"},{"key":"CIT0005","series-title":"In: StatPearls","article-title":"Stercoral colitis","author":"Morano\n \nC","year":"2024."},{"issue":"(1):","key":"CIT0006","series-title":"Int J Emerg Med","first-page":"3","article-title":"Stercoral colitis in the emergency department: a review of the literature","volume":"17","author":"Bae\n \nE","year":"2024;"},{"issue":"(3):","key":"CIT0007","series-title":"Eur J Case Rep Intern Med","first-page":"004328","article-title":"Stercoral colitis-induced ischemia mimicking acute mesenteric ischemia: a case report and literature review","volume":"11","author":"Kloub\n \nMN","year":"2024;"},{"issue":"(1):","key":"CIT0008","series-title":"Int J Emerg Med","first-page":"7","article-title":"Stercoral colitis mimicking appendicitis","volume":"10","author":"Elkoundi\n \nA","year":"2017;"},{"issue":"(12):","key":"CIT0009","series-title":"CNS Drugs","first-page":"1265\u201374","article-title":"Antipsychotic-induced constipation: a review of the pathogenesis, clinical diagnosis, and treatment","volume":"35","author":"Xu\n \nY","year":"2021;"},{"key":"CIT0010","series-title":"In: StatPearls","article-title":"Benztropine","author":"Ahuja\n \nA","year":"2024."},{"issue":"(5):","key":"CIT0011","series-title":"J Clin Psychiatry","first-page":"759\u201368","article-title":"Life-threatening clozapine-induced gastrointestinal hypomotility: an analysis of 102 cases","volume":"69","author":"Palmer\n \nSE","year":"2008;"},{"issue":"(1):","key":"CIT0012","series-title":"Eur Psychiatry","first-page":"34\u201344","article-title":"Second-generation antipsychotics and constipation: a review of the literature","volume":"26","author":"De Hert\n \nM","year":"2011;"},{"issue":"(3):","key":"CIT0013","series-title":"Am J Gastroenterol","first-page":"934\u20135","article-title":"Haloperidol and benztropine interaction presenting as acute intestinal pseudo-obstruction","volume":"96","author":"Sheikh\n \nRA","year":"2001;"},{"issue":"(6):","key":"CIT0014","series-title":"J Clin 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Med","first-page":"004328","article-title":"Stercoral colitis-induced ischemia mimicking acute mesenteric ischemia: a case report and literature review","volume":"11","author":"Kloub\n \nMN","year":"2024;"},{"issue":"(1):","key":"CIT0008","series-title":"Int J Emerg Med","first-page":"7","article-title":"Stercoral colitis mimicking appendicitis","volume":"10","author":"Elkoundi\n \nA","year":"2017;"},{"issue":"(12):","key":"CIT0009","series-title":"CNS Drugs","first-page":"1265\u201374","article-title":"Antipsychotic-induced constipation: a review of the pathogenesis, clinical diagnosis, and treatment","volume":"35","author":"Xu\n \nY","year":"2021;"},{"key":"CIT0010","series-title":"In: StatPearls","article-title":"Benztropine","author":"Ahuja\n \nA","year":"2024."},{"issue":"(5):","key":"CIT0011","series-title":"J Clin Psychiatry","first-page":"759\u201368","article-title":"Life-threatening clozapine-induced gastrointestinal hypomotility: an analysis of 102 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\nNA","year":"2023;"},{"issue":"(2):","key":"CIT0020","series-title":"Clin Endosc","first-page":"174\u20136","article-title":"Cecal fecaloma due to intestinal tuberculosis: endoscopic treatment","volume":"45","author":"Kim\n \nSM","year":"2012;"},{"issue":"(4):","key":"CIT0021","series-title":"Rev Esp Enferm Dig","first-page":"306\u20138","article-title":"Colonic obstruction secondary to sigmoid fecaloma endoscopically resolved with Coca-Cola\u00ae","volume":"109","author":"Ontanilla Clavijo\n \nG","year":"2017;"},{"issue":"(2):","key":"CIT0022","series-title":"World J Gastrointest Endosc","first-page":"91\u20134","article-title":"Successful endoscopic fragmentation of large hardened fecaloma using jumbo forceps","volume":"9","author":"Matsuo\n \nY","year":"2017;"},{"issue":"(2):","key":"CIT0023","series-title":"World J Gastrointest Endosc","first-page":"83\u201390","article-title":"Coca-Cola consumption vs fragmentation in the management of patients with phytobezoars: a prospective 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