Toxic Megacolon: Causes, Symptoms, Diagnosis, Treatment, Prognosis

The last segment of the digestive tract is the large intestine. The large intestine consists of appendix, colon, and rectum. The large intestine finishes off the digestion process of the food by absorbing water and eliminating the waste products through the anus. At times, due to some medical conditions, the large intestine starts to malfunction. One condition which causes the large intestine to malfunction is called as Toxic Megacolon, in which the colon gets dilated. This condition is a significantly rare but potentially life threatening condition. This condition is also a form of complication of inflammatory bowel diseases.

Inflammatory bowel condition is the root cause of Toxic Megacolon. This medical condition causes swelling and irritation in sections of the digestive tract. Inflammatory bowel conditions can be extremely painful and can permanently damage large and small intestines. Some of Inflammatory bowel conditions include ulcerative colitis and Crohn’s disease. Toxic Megacolon develops when inflammatory bowel diseases cause the colon to become dilated as a result of which the colon is unable to dispense body waste causing buildup of feces in the colon causing a rupture of the intestine. Colonic rupture is a potentially serious condition as when the intestines rupture the bacteria present in the intestines get released into the abdomen causing serious infections and at times even death.

The symptoms onset in Toxic megacolon is sudden and may include:

• Pain in the abdomen
• Abdominal distention
• Tenderness in the abdomen
• Fever
• Tachycardia
• Shock
• Bloody and frequent diarrhea
• Pain with passing bowels

In order to diagnose Toxic Megacolon, the treating physician will take a detailed history of the symptoms and perform a physical examination to look at the abdomen for signs or any tenderness and also listen to the bowel sounds to find out if they are normoactive or not. The physician will also perform tests in order to confirm the diagnosis of Toxic Megacolon. Some of the tests done to confirm the diagnosis of Toxic Megacolon are:

• Abdominal X-rays
• Blood tests to look at the CBC and electrolyte count

The usual treatment for Toxic Megacolon is through surgery. If an individual has this condition, he/she will be administered IV fluids so as to prevent shock from occurring as the presence of infection may cause the blood pressure to drop significantly resulting in shock. Once the blood pressure is stabilized, surgical procedure will be done to repair Toxic Megacolon. In some instances there may be a tear in the colon which will also be repaired. If there is irreparable damage to the colon then the surgeon may remove the entire colon. This procedure is called colectomy. Postsurgery, antibiotics will be given to prevent further infections or development of sepsis.

If prompt treatment is given, the overall prognosis of Toxic Megacolon is pretty good, some of the complications of Toxic Megacolon are:

• Colon perforation
• Sepsis
• Shock

The above mentioned complications are very serious and affect the overall prognosis significantly. In case if an individual undergoes colectomy then that individual will require devices like anal anastomosis to remove the feces after the entire colon is removed.

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