A toxic megacolon is rare, but life-threatening. It is a complication of severe colon disease or infection.
Toxic megacolon can be deadly because it puts you at risk for infection throughout the body, shock, and dehydration. Toxic megacolon is a life-threatening condition that needs immediate treatment.
These are signs and symptoms related to toxic megacolon:
Swelling of the belly
Pain in the belly
Rapid heart rate
Toxic megacolon is a complication of these conditions:
Ulcerative colitis. This is an inflammatory bowel disease. It usually affects the colon and rectum.
Crohn’s disease. This is an inflammatory bowel disease. It can affect any part of the digestive tract.
Infections of the colon. These can be caused by C difficile. This is a germ that can lead to symptoms ranging from diarrhea to a possibly deadly colon inflammation. Other infections can also cause the problem.
Ischemia. Low blood flow to the colon.
In rare situation, colon cancer.
Other risk factors include diabetes, organ transplants, kidney failure, suppressed immunity, and chronic obstructive pulmonary disease.
To make a diagnosis, your healthcare provider will do these things:
Take your medical history
Do a physical exam
Order blood tests, such as a complete blood count
Order an X-ray of the intestine or a CT scan
Treatment of toxic megacolon includes:
Medicines. Treating the original condition or infection may help reduce toxic megacolon. Anti-inflammatory medicines can help control inflammation. Antibiotics can help treat or prevent infection. Your healthcare provider may prescribe other medicines.
Bowel rest and bowel decompression. These treatments remove gas and substances filling the colon.
IV fluids. You may be given an IV of fluids and electrolytes to help nourish your body and prevent dehydration.
Surgery. If less invasive treatments don’t reduce the size of the toxic megacolon within 2 to 3 days, you may need surgery to remove part or all of the colon.
Your healthcare provider may have you stop taking certain medicines while you're being treated for toxic megacolon. Some medicines that can make the condition worse are opioids, nonsteroidal anti-inflammatory medicines, medicines to stop diarrhea, antidepressants, and anticholinergic medicines.
If untreated, a toxic megacolon can result in severe complications, such as:
Bleeding and blood loss
Whole-body infection (sepsis)
Abnormal hole in the colon (perforation)
Toxic megacolon can be deadly if not treated.
When to call the healthcare provider
Seek immediate medical help or have someone call 911 if you have severe stomach pain and these symptoms:
Swelling in your belly
Rapid heart rate
Signs of shock, such as a weak pulse, cool or clammy skin, dilated eyes, confusion, and rapid or shallow breathing
March 22, 2017
Management of Acute Colitis and Toxic Megacolon. Strong S. Clinics in Colon and Rectal Surgery. Dec 2010;23(4):274–84., Toxic megacolon associated Clostridium difficile colitis. Sayedy L. World Journal of Gastrointestinal Endoscopy. 2010;2(8):293–97., Toxic Megacolon, UpToDate, Toxic Megacolon: A review for Emergency Department Clinicians. Woodhouse, E. Journal of Emergency Nursing. 2016.
Freeborn, Donna, PhD, CNM, FNP,Lehrer, Jenifer, MD