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Toxic Megacolon

Toxic megacolon is a serious condition of the large intestine. The large intestine consists of the colon, rectum and appendix.

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It is the last section of the digestive tract and tends to absorb water and helps pass waste through the anus from the body. There are many conditions that affect the large intestine. One such condition that leads to serious and even fatal consequences is called as toxic megacolon.

What is Toxic Megacolon?

Toxic megacolon is a rare, but potentially fatal complication of pseudomembranous colitis. The term megacolon is used to describe the severe dilation (>6cm) of the colon. This extreme widening of the large intestine can occur within a few days as a complication of inflammatory bowel disease.

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What Causes Toxic Megacolon?

Toxic megacoln is often seen in association with infectious colitis or inflammatory bowel disease. In some cases, it occurs as a complication of Clostridium difficileinfections. In case of children, it is often seen as a congenital condition in cases of Hirschsprung’s disease. In rare cases, it can also occur as a complication of Crohn’s disease.

Signs and Symptoms of Toxic Megacolon

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In toxic megacolon, severe inflammation of the mucosa occurs that extends into the smooth muscle layer. It may lead to paralysis of the colonic smooth muscles with marked dilation. There is infiltration by neutrophils, lymphocytes, histocytes and plasma cells. Necrosis and myocyte degeneration occurs, followed by granulation tissue formation.

The symptoms of toxic megacolon include:

  • Acute illness after one suffers from ulcerative colitis or Chron’s disease. It includes symptoms such as abdominal pain, diarrhea, blood in stool and dehydration
  • Abdominal distention
  • Pain and tenderness in abdomen
  • Paleness
  • Rapid heart rate
  • Shock
  • Absence of bowel sounds
  • Signs of septic shock

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Toxic megacolon can turn fatal. If any of the above signs are noticed, seek immediate medical treatment.

Diagnosis of Toxic Megacolon

The patient’s medical history is taken into consideration, especially in case of inflammatory bowel disease. A physical examination shows abdominal tenderness and loss of bowel sounds.

Other diagnostic tests carried out for confirmation of toxic megacolon includes:

  • Blood tests to check for anemia and white blood cell count, CBC
  • Abdominal x-ray to see colonic dilation
  • Stool culture to check for infection
  • Colonoscopy

Treatment for Toxic Megacolon

The treatment aims at decompressing the bowel and preventing more swallowed air from further distention of the bowel. A small tube is passed through the mouth or nose into the intestine to help remove the gas and fluids. The patient is given intravenous solutions and nutrients to prevent dehydration and shock. If required, blood transfusion is carried out. In case of infection or blood poisoning due to septic shock, antibiotics are prescribed.

If within 24 hours no improvement is observed, the patient is taken in for surgery. A colectomy, that is, surgical removal of all or part of the colon, is carried out.

Prognosis of Toxic Megacolon

In case the condition does not show improvement, it can lead to death. Thus, prompt medical attention is very important.

Toxic megacolon is an emergency condition that requires hospitalization. It can lead to colon perforation, sepsis and shock. Seek immediate medical care in case of blooddiarrhea, fever, painful bowel movements.

sandya

Written by: healthplus24.com team

Date last updated: January 22, 2015