Toxic Megacolon, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

This book describes Toxic Megacolon, Diagnosis and Treatment and Related Diseases

One of my patients who has Crohn Disease had sudden abdominal pain and swelling of his abdomen together with fever and blood in his stools. It was an emergency and he was sent to the hospital where he was diagnosed as Toxic Megacolon.
Luckily he was treated rapidly and recovered after an operation to remove part of his inflamed colon.

Toxic megacolon happens when swelling and inflammation extend into the deeper layers of the colon.
As a result, the colon ceases working and widens.
In severe instances, the colon may burst or rupture.
It begins when irritation or infection inflames the colon, the last segment of the digestive tract.
This alone does not mean the patient has toxic megacolon, but it is the initial step.
It is only when all or part of the colon extends to wider than normal (dilated) and begins to push toxic substances throughout the body (systemic toxicity), that the patient has the disorder.
It needs treatment right away since it could cause tears in the digestive tract, blood loss, and a possibly deadly disorder called sepsis in which the whole body becomes inflamed as a response to the toxins in it.
Toxic megacolon can be a fatal result of ulcerative colitis and Crohn's Disease.
It induces widening (dilation) of the large intestine within 1 to a few days.
It happens with infection or inflammation and is very hazardous.
Causes
Toxic megacolon may happen in people with an inflamed colon due to:
1. Ulcerative colitis or Crohn disease that is not well regulated
2. Infections of the colon such as Clostridium difficile
One of the causes of toxic megacolon is an inflammatory bowel disease (IBD).
Inflammatory bowel diseases produce swelling and irritation in parts of the digestive tract.
These diseases may be painful and produce permanent injury to the large and small intestines.
Some IBDs are ulcerative colitis and Crohn's disease.
Toxic megacolon can also be produced by infections such as Clostridium difficile colitis.
Toxic megacolon happens when inflammatory bowel diseases produce the colon to expand, dilate, and distend.
When this occurs, the colon is not able to eliminate gas or feces from the body.
If gas and feces collect in the colon, the large intestine may ultimately rupture.
Any rupture of the colon is life-threatening.
Symptoms
Symptoms of the disorder may come on suddenly and are:
1. Abdominal pain
2. Bloating of the abdomen (distention)
3. Abdominal tenderness
4. Fever
5. Rapid heart rate (tachycardia)
6. Shock
7. Bloody or profuse diarrhea
8. Painful bowel movements
Diagnosis
A swollen abdomen along with other symptoms like fever over 100 degrees F, heart rate over 120, low red blood cell count, low blood pressure, and dehydration might indicate a toxic megacolon diagnosis.
Additional tests to confirm this diagnosis are:
1. Abdominal X-rays
2. CT scan of the abdomen
Treatment
The treatment of the disorder that cause toxic megacolon involves:
1. Steroids and other medicines that suppress the immune system
2. Antibiotics
If the patient has septic shock, the patient will be admitted to the intensive care unit.
Treatment may be:
1. Breathing machine
2. Dialysis for kidney failure
3. Drugs to treat low blood pressure, infection, or poor blood clotting
4. Bowel rest with fluids and nutrition given directly into a vein
5. Oxygen
If rapid distension is not treated, an opening or rupture can occur in the colon.
A suction tube may be needed to remove gas from the distended megacolon
If non-surgical treatments do not ease the condition in 2 or 3 days, the patient will likely need surgery to remove all or section of the colon.

TABLE OF CONTENT
Introduction
Chapter 1 Toxic Megacolon
Ch...