Toxic megacolon – Causes, Symptoms, Complications and Treatment

Toxic Megacolon

is a condition which is characterized by the abnormal distension and dilation of the colon. The colon is a part of the large intestine and is the last organ involved in the digestion process. The colon plays a very crucial role in solidifying digestive wastes by absorbing salts and water from them and also helps in defecating the wastes from the body.

The colon is considered dilated and enlarged when the diameter is more than 12 cm. The term “toxic” refers to the accompanying infection and inflammation with the condition.

Micrograph of Pseudomembraneous colitis which is a cause of Toxic Megacolon

Causes of Toxic Megacolon

  • This condition is often a symptom of a serious condition known as Inflammatory Bowel Disease (IBD). Ulcerative colitis, Crohn’s disease and some of the infections of the colon are known to cause it. Pseudomembraneous colitis caused by the bacteria clostridium difficile also increases the risk of the discussed condition.
  • It can be present as a congenital defect as in Hirschsprung’s disease.
  • It can be caused by the prolonged use of certain drugs like painkillers, anticholinergics, narcotics, anti-psychotic drugs and antidiarrheals such as loperamide.

Symptoms of the condition

  • Abdominal pain.
  • Abdominal distension.
  • Abdominal tenderness.
  • Bloating.
  • High Fever.
  • Dehydration.
  • Decreased blood pressure.
  • Tachycardia or rapid heart rate.
  • Increase in leukocytes or high white blood cell count.

Complications from the condition

  • If the condition is left untreated then it might lead to a condition called sepsis where the infection remains unarrested and spreads in the body bringing about multiple organ failure and death.
  • The leukocyte or white blood cell count goes down making the body more susceptible to infection.
    Perforations and tears in the colon wall is also another complication of the condition.

Treatment of Toxic Megacolon

  • Elecrtolytes and fluids are administered intravenously if the patient is dehydrated or in shock.
  • Bowel decompression and preventing swallowed air from causing further distension or dilation.
  • If the above therapy does not yield results a colectomy or surgical removal of the colon is essential.
  • To prevent infections from tears and perforations antibiotics are prescribed.
  • Corticosteroids are used to reduce inflammation especially when IBD has resulted in the condition.

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