As the name suggests, the toxic megacolon is a serious complication that can occur in people with inflammatory intestine disease (MII). The condition is more frequent in people with ulcerative colitis (UC) than those with Crohn’s disease. The toxic megacolon is characterized by severe inflammation which makes the colon expand or stretched. The muscles of your colon can stop working, allowing food and gas to accumulate in the colon and toxins to flee in your blood circulation, according to the Cleveland Clinic. Finally, this leads to systemic toxicity, explains Amanda Mr. Johnson, MD, gastroenterologist at Mayo Clinic de Rochester, Minnesota. “Systemic toxicity causes low blood pressure, fever and high heart rate,” said Dr. Johnson. “Because of its deadly nature, the toxic megacolon requires immediate medical care and treatment.” Who is likely to develop a toxic megacolon? The toxic megacolon can be a complication of some different diseases, explains Aline Charaby Pishvian, MD, director of the Inflammatory Center for Intestinal Diseases from Sibley Memorial Hospital in Washington, DC. This includes ulcerative colitis, Crohn’s disease and certain infections. The most common infection that can lead to the toxic megacolon is caused by a bacteria called difficult clostridioides (C. Diff), explains Johnson. The infection ignites the colon, which then claims to be and becomes toxic to the body. People with CUs are more likely to contract C. Diff than people without UC, she says. A review published in August 2020 in intestinal research revealed that C. differs were tripled in people with Cu and doubled for people with Crohn’s disease. People with uncontrolled CU or who know lighting rockets can have very intense inflammation in the colon wall, which presents them a higher risk of toxic megacolon, explains Johnson. For this reason, the risk of toxic megacolon can be even greater in the early stages of a person’s disease. People who have lighting rockets and use opioids, narcotics or antidiarrheal drugs to control their symptoms can also be more at risk of toxic megacolon, explains Johnson. “If a person with colitis has an escape or is hospitalized, we try to avoid using opiates and anti-Diarrhean drugs, if possible, for this reason,” she adds. What causes the toxic megacolon? The toxic megacolon is a rare complication which affects approximately 5% of people with severe Cu, according to the clinics of colon and rectal surgery. When someone with UC has an active push, he develops intense inflammation in the wall of his colon. “It finally leads to dilation or stretching outside the colon,” explains Johnson. “As it becomes thinner and inflammation extends deeper through the colon wall, it almost seems to paralyze the colon muscles.” This causes colon dysfunction, limiting its ability to eliminate gas or excrement. What are the warning signs of the toxic megacolon? The toxic megacolon has a number of symptoms similar to other problems. But if someone has a Mii and a combination of the following symptoms described by the Cleveland Clinic, it may be useful to see a doctor. Swelling or pain in the stomach fever at a quick cardiac rhythm choca the low blood pressure How is the toxic megacolon diagnosed? If you feel symptoms and think it may be a toxic megacolon, it is important to ask for medical help right away. “A person must call their doctor or go to the emergency room if their abdominal pain becomes much more serious or if the amount of bloody diarrhea increases,” said Johnson. A fever or bloating in the abdomen are also potential warning signs of the toxic megacolon; If this happens, immediately consult medical care, she said. In addition to recording a list of your symptoms, Johnson says that your doctor could also ask for tests such as a blood test that can indicate high white blood cells or radiography or belly CT scans to show if the colon is dilated. What is the treatment of toxic megacolon? Treatment of toxic megacolon includes anti-inflammatory medicine to control inflammation and antibiotics to prevent infection. Other drugs, such as opioids and non-steroidal anti-inflammatory drugs, can be stopped due to possible complications. But if someone has a Cu, the underlying disease should also be treated. Steroids are often used in ulcerative colitis to try to calm inflammation, says Johnson. “If a person has an escape from ulcerative colitis and also has a colon infection, in particular with C. Diff, we must treat ulcerative colitis with steroids and Diff infection by very specific antibiotics.” Other non -invasive treatments include intestinal rest to remove the built gases and IV liquids to replace lost electrolytes. Extreme cases may require surgery to eliminate a part or all of the colon, according to Johns Hopkins Medicine. “If there is no response to medical therapy in the first days or concerns about viability or blood flow to the colon, or if the person has aggravated abdominal pain or any other complication due to a toxic megacolon, it is likely that they will have to have their colon removed,” said Johnson. What can happen if the toxic megacolon is not treated? If the toxic megacolon is not treated, the colon can pierce, which means that a hole can form in the colon, allowing the stools to spread in the abdominal cavity, explains Dr. Pishvaian. “It is a very dangerous situation which can considerably increase the risk of death or long-term complications,” she says. “This would require emergency surgery.” There is also a risk of developing sepsis, a deadly condition that occurs when your body releases chemicals in the blood circulation to fight an infection, explains Pishvaian. Septicemia can cause organ failure, drop in blood pressure, and even more, according to centers for Disease Control and Prevention (CDC). How to prevent toxic surveillance of megacolons and staying vigilant about your MII is the best way to prevent the toxic megacolon, according to Mount Sinai. Good treatment for diseases like UC which can cause a toxic megacolon, whatever the rarity of chance, can prevent this condition.
