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Clozapine-induced stercoral colitis: a surgical perspective
  1. Jayan George1,2,
  2. Richard Hotham3,
  3. William Melton3 and
  4. Keith Chapple3
  1. 1 Hepatobiliary Surgery, Northern General Hospital, Sheffield, UK
  2. 2 Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
  3. 3 General Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
  1. Correspondence to Mr Jayan George,{at}


We describe a case of a 46-year-old man with schizophrenia treated with clozapine who presented as an emergency with abdominal pain on the background of a 1 month history of constipation. The initial presenting symptoms were vague and a diagnosis was difficult to establish. Initial CT of the abdomen and pelvis demonstrated only minor abnormalities. He continued to deteriorate until a further CT scan revealed worsening stercoral colitis. He subsequently underwent an emergency total colectomy and ileostomy formation and had a complicated prolonged postoperative recovery. This case highlights the risks that clozapine can have on slowing bowel transit and the dangerous consequences that can occur if not identified early.

  • gastrointestinal surgery
  • schizophrenia
  • drugs: psychiatry

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  • Contributors JG: constructing and editing the manuscript, editing images. RH: constructing and editing the manuscript. WM: editing and attaining images. KC: concept design, proofing.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.