Toxic megacolon is a rare complication of irritable bowel disease that causes the colon to enlarge and potentially rupture. Treatment involves medical attempts to reduce distention, but surgery may be necessary. Patients with known gastrointestinal problems should seek medical attention if they experience symptoms. Severe irritable bowel disease and failure to adhere to treatment plans increase the risk of toxic megacolon. Surgery involves removing the distended segment of the colon and may result in a colostomy or anastomosis.
Toxic megacolon is a rare complication of irritable bowel disease in which the colon becomes enlarged and is at risk of rupture. Treatment begins with medical attempts to address the distention, and if these are not enough, the patient may need surgery to remove the colon. Management of irritable bowel disease, especially during flare-ups, should reduce the risks of developing toxic megacolon. Patients with known gastrointestinal problems should contact their doctors if they experience symptoms such as bloody diarrhea, abdominal pain and tenderness, and bloating.
In toxic megacolon, inflammatory processes cause the colon to begin to distend, and the distention can be made more severe by swallowed air. The patient may have a feeling of fullness in the abdomen as well as developing bloating and discomfort. Diarrhea may develop, as can a rapid heartbeat, and the patient may become dehydrated. Failure to treat the condition can result in the colon walls rupturing, leading to serious infection, shock, and possibly death.
Medical imaging studies can be used to examine the colon. Endoscopy is usually not recommended due to the associated risks of rupture. The patient will be given short-term fluids to deal with dehydration and shock, and medical management of the toxic megacolon will be attempted to see if the swelling can be reduced. If the patient does not respond within 24 hours of treatment or the condition worsens significantly, the patient will be advised to seek colonic removal surgery.
In the surgery, the distended segment of the colon will be removed. The patient may be fitted with a colostomy, which allows stool to drain into a pouch outside the body through a hole in the abdomen, or the surgeon may attempt an anastomosis, in which the severed end of the intestine is reconnected to the anal canal to allow the patient to defecate. The option your surgeon chooses will vary depending on what is inside your abdomen during surgery.
Patients with severe irritable bowel disease are more likely to develop this complication, as are patients who don’t manage their condition effectively. Failure to adhere to treatment regimens can increase inflammation, putting patients at greater risk. A patient who is having trouble with a treatment plan should discuss options with a doctor to develop a more effective plan that the patient can stick to in order to reduce the risk of complications such as toxic megacolon.
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