Toxic megacolon is a condition where part or all of the colon is inflamed and bulging larger than normal size (dilated). It may bulge because of swelling because of inflammation. The colon may also fill with gas. This condition can be a complication of severe colon disease or infection. It is a rare but life-threatening condition and needs treatment right away. It can lead to inflammation all over the body (sepsis), blood loss, and death.
Toxic megacolon is a complication of these conditions:
Ulcerative colitis. This is a type of inflammatory bowel disease (IBD). It often affects the colon and rectum.
Crohn’s disease. This is also a type of IBD. It can affect any part of the digestive tract.
Colon infection. This can be caused by a bacteria (Clostridioides difficile). This germ can lead to severe diarrhea. Other infections can also cause the problem.
HIV infection or AIDS. For people with HIV, cytomegalovirus (CMV) colitis is the leading cause of toxic megacolon.
Ischemia. This is low blood flow to the colon.
Colon cancer. In rare cases, cancer growths may cause the condition.
Other risk factors include:
A transplanted organ
Weakened immune system
Chronic obstructive pulmonary disease (COPD)
You are more at risk for toxic megacolon if you have:
Low blood flow to the colon (ischemia)
Symptoms can occur a bit differently in each person. They can include:
Fast heart rate
The symptoms of toxic megacolon can seem like other health conditions. See your healthcare provider for a diagnosis.
Your healthcare provider will ask about your symptoms and health history. Your provider will give you a physical exam. You may also have tests, such as:
Blood tests. These are to check for infection and other signs of problems.
Imaging test. You may have an X-ray or CT scan of the intestine. Both of these use radiation to create images of tissues inside the body. The healthcare provider will look for abnormal dilation of the colon.
Treatment will depend on your symptoms, your age, and your general health. It will also depend on how severe the condition is. People with toxic megacolon are often very sick. Treatment can include:
Medicines. Treating the main condition or infection that caused the problem may help reduce toxic megacolon. You may be given medicines to help control inflammation. Antibiotics can help treat or prevent infection. Your healthcare provider may also prescribe other medicines.
Bowel rest and decompression. These treatments help the bowel from moving and remove gases filling the colon.
IV (intravenous) fluids. You may be given fluids and electrolytes to treat dehydration and low blood pressure.
Surgery. If other 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.
Talk with your healthcare providers about the risks, benefits, and possible side effects of all treatments.
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 include:
Nonsteroidal anti-inflammatory medicines (NSAIDs)
Medicines to stop diarrhea
If untreated, toxic megacolon can lead to severe complications such as:
Whole-body inflammation (sepsis)
Hole in the colon (perforation)
Loss of blood flow to organs and other tissues (shock)
Call your healthcare provider right away if you have:
Severe stomach pain
Call 911 if you have signs of shock, such as:
Pale, cool, moist skin
Fast or shallow breathing
A toxic megacolon is a condition where part or all of the colon is inflamed and bulging larger than normal size (dilated).
It can be a complication of severe colon disease or infection. It is a rare but life-threatening condition and needs immediate medical treatment.
It can lead to inflammation all over the body (sepsis), blood loss, and death.
Symptoms can include belly swelling, diarrhea, fever, and fast heart rate.
Treatment can include medicines, bowel rest, IV fluids, and surgery.
Tips to help you get the most from a visit to your healthcare provider:
Know the reason for your visit and what you want to happen.
Before your visit, write down questions you want answered.
Bring someone with you to help you ask questions and remember what your provider tells you.
At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
Know why a new medicine or treatment is prescribed and how it will help you. Also know what the side effects are.
Ask if your condition can be treated in other ways.
Know why a test or procedure is recommended and what the results could mean.
Know what to expect if you do not take the medicine or have the test or procedure.
If you have a follow-up appointment, write down the date, time, and purpose for that visit.
Know how you can contact your provider if you have questions.