BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuToxic megacolonToxic dilation of the colon; Megarectum; Inflammatory bowel disease - toxic megacolon; Crohn disease - toxic megacolon; Ulcerative colitis - toxic megacolonToxic megacolon occurs when swelling and inflammation spread into the deeper layers of your colon. As a result, the colon stops working and widens. In severe cases, the colon may rupture. Causes The term "toxic" means that this problem is very dangerous. Toxic megacolon may occur in people with an inflamed colon due to: Ulcerative colitis, or Crohn disease that is not well controlled Ulcerative colitisUlcerative colitis is a condition in which the lining of the large intestine (colon) and rectum become inflamed. It is a form of inflammatory bowel ...ImageRead Article Now Book Mark Article Crohn diseaseCrohn disease is a disease where parts of the digestive tract become inflamed. It most often involves the lower end of the small intestine and the be...ImageRead Article Now Book Mark Article Infections of the colon such as Clostridioides difficile Ischemic bowel diseaseOther forms of megacolon include pseudo-obstruction, acute colonic ileus, or congenital colonic dilation. These conditions do not involve an infected or inflamed colon. Symptoms The rapid widening of the colon may cause the following symptoms to occur over a short period of time:Painful, distended abdomen Distended abdomenA swollen abdomen is when your belly area is bigger than usual.Read Article Now Book Mark Article Fever (sepsis) Diarrhea (usually bloody) Exams and Tests The health care provider will perform a physical exam. Findings may include:Tenderness in the abdomen Reduced or absent bowel soundsBowel soundsAbdominal sounds are the noises made by the intestines.ImageRead Article Now Book Mark Article The exam may reveal signs of septic shock, such as:Septic shockSeptic shock is a serious condition that occurs when a body-wide infection leads to dangerously low blood pressure.Read Article Now Book Mark Article Increased heart rate Mental status changes Rapid heart rate Low blood pressureThe provider may order any of the following tests:Abdominal x-ray, ultrasound, CT scan, or MRI scan Abdominal x-rayAn abdominal x-ray is an imaging test to look at organs and structures in the abdomen. Organs include the liver, spleen, stomach, and intestines. Wh...ImageRead Article Now Book Mark Article Blood electrolytes Complete blood countComplete blood countA complete blood count (CBC) test measures the following:The number of white blood cells (WBC count)The number of red blood cells (RBC count)The numb...ImageRead Article Now Book Mark Article Treatment Treatment of the disorder that led to toxic megacolon includes:Steroids and other medicines that suppress the immune system AntibioticsIf you have septic shock, you will be admitted to the intensive care unit (ICU) of the hospital. Treatment may include:Breathing machine (mechanical ventilation) Dialysis for kidney failure Drugs to treat low blood pressure, infection, or poor blood clotting Fluids given directly into a vein OxygenIf rapid widening is not treated, an opening or rupture can form in the colon. If the condition doesn't improve with medical treatment, surgery will be needed to remove part or all of the colon.You may receive antibiotics to prevent sepsis (a severe infection).SepsisSepsis is an illness in which the body has a severe, inflammatory response to bacteria or other germs.ImageRead Article Now Book Mark Article Outlook (Prognosis) If the condition does not improve, it can be fatal. Colon surgery is usually needed in such cases. Possible Complications Complications may include:Perforation of the colon Sepsis Shock Death When to Contact a Medical Professional Go to the emergency room or call the local emergency number (such as 911) if you develop severe abdominal pain, especially if you also have:Bloody diarrhea Fever Frequent diarrhea Rapid heart rate Tenderness when the abdomen is pressed Abdominal distention Prevention Treating diseases that cause toxic megacolon, such as ulcerative colitis or Crohn disease, can prevent this condition.Open ReferencesReferencesLichtenstein GR. Inflammatory bowel disease. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 132.Nishtala MV, Benlice C, Steele SR. Management of toxic megacolon. In: Cameron AM, Cameron JL, eds. Current Surgical Therapy. 13th ed. Philadelphia, PA: Elsevier; 2020:180-185.Peterson MA, Wu AW. Disorders of the large intestine. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 85.AllVideoImagesTogDigestive system - illustration The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.Digestive systemillustrationToxic megacolon - illustration Toxic megacolon is characterized by extreme inflammation and distention of the colon. Common symptoms are pain, distention of the abdomen, fever, rapid heart rate, and dehydration. This is a life-threatening complication that requires immediate medical treatment.Toxic megacolonillustrationCrohn disease - affected areas - illustration The inflammation of Crohn disease is nearly always found in the ileocecal region. The ileocecal region consists of the last few inches of the small intestine (the ileum), which moves digesting food to the beginning portion of the large intestine (the cecum). However, Crohn disease can occur anywhere along the digestive tract.Crohn disease - affected areasillustrationUlcerative colitis - illustration Ulcerative colitis is categorized according to location. Proctitis involves only the rectum. Proctosigmoiditis affects the rectum and sigmoid colon. Left-sided colitis encompasses the entire left side of the large intestine. Pancolitis inflames the entire colon.Ulcerative colitisillustrationDigestive system organs - illustration The digestive system organs in the abdominal cavity include the liver, gallbladder, stomach, small intestine and large intestine.Digestive system organsillustrationDigestive system - illustration The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.Digestive systemillustrationToxic megacolon - illustration Toxic megacolon is characterized by extreme inflammation and distention of the colon. Common symptoms are pain, distention of the abdomen, fever, rapid heart rate, and dehydration. This is a life-threatening complication that requires immediate medical treatment.Toxic megacolonillustrationCrohn disease - affected areas - illustration The inflammation of Crohn disease is nearly always found in the ileocecal region. The ileocecal region consists of the last few inches of the small intestine (the ileum), which moves digesting food to the beginning portion of the large intestine (the cecum). However, Crohn disease can occur anywhere along the digestive tract.Crohn disease - affected areasillustrationUlcerative colitis - illustration Ulcerative colitis is categorized according to location. Proctitis involves only the rectum. Proctosigmoiditis affects the rectum and sigmoid colon. Left-sided colitis encompasses the entire left side of the large intestine. Pancolitis inflames the entire colon.Ulcerative colitisillustrationDigestive system organs - illustration The digestive system organs in the abdominal cavity include the liver, gallbladder, stomach, small intestine and large intestine.Digestive system organsillustrationRelated Information Ulcerative colitis(Condition)Crohn disease(Condition)Ulcerative colitis - InDepth(In-Depth)Crohn disease - InDepth(In-Depth) Review Date: 10/26/2021 Reviewed By: Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. 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Toxic megacolonToxic dilation of the colon; Megarectum; Inflammatory bowel disease - toxic megacolon; Crohn disease - toxic megacolon; Ulcerative colitis - toxic megacolonToxic megacolon occurs when swelling and inflammation spread into the deeper layers of your colon. As a result, the colon stops working and widens. In severe cases, the colon may rupture. Causes The term "toxic" means that this problem is very dangerous. Toxic megacolon may occur in people with an inflamed colon due to: Ulcerative colitis, or Crohn disease that is not well controlled Ulcerative colitisUlcerative colitis is a condition in which the lining of the large intestine (colon) and rectum become inflamed. It is a form of inflammatory bowel ...ImageRead Article Now Book Mark Article Crohn diseaseCrohn disease is a disease where parts of the digestive tract become inflamed. It most often involves the lower end of the small intestine and the be...ImageRead Article Now Book Mark Article Infections of the colon such as Clostridioides difficile Ischemic bowel diseaseOther forms of megacolon include pseudo-obstruction, acute colonic ileus, or congenital colonic dilation. These conditions do not involve an infected or inflamed colon. Symptoms The rapid widening of the colon may cause the following symptoms to occur over a short period of time:Painful, distended abdomen Distended abdomenA swollen abdomen is when your belly area is bigger than usual.Read Article Now Book Mark Article Fever (sepsis) Diarrhea (usually bloody) Exams and Tests The health care provider will perform a physical exam. Findings may include:Tenderness in the abdomen Reduced or absent bowel soundsBowel soundsAbdominal sounds are the noises made by the intestines.ImageRead Article Now Book Mark Article The exam may reveal signs of septic shock, such as:Septic shockSeptic shock is a serious condition that occurs when a body-wide infection leads to dangerously low blood pressure.Read Article Now Book Mark Article Increased heart rate Mental status changes Rapid heart rate Low blood pressureThe provider may order any of the following tests:Abdominal x-ray, ultrasound, CT scan, or MRI scan Abdominal x-rayAn abdominal x-ray is an imaging test to look at organs and structures in the abdomen. Organs include the liver, spleen, stomach, and intestines. Wh...ImageRead Article Now Book Mark Article Blood electrolytes Complete blood countComplete blood countA complete blood count (CBC) test measures the following:The number of white blood cells (WBC count)The number of red blood cells (RBC count)The numb...ImageRead Article Now Book Mark Article Treatment Treatment of the disorder that led to toxic megacolon includes:Steroids and other medicines that suppress the immune system AntibioticsIf you have septic shock, you will be admitted to the intensive care unit (ICU) of the hospital. Treatment may include:Breathing machine (mechanical ventilation) Dialysis for kidney failure Drugs to treat low blood pressure, infection, or poor blood clotting Fluids given directly into a vein OxygenIf rapid widening is not treated, an opening or rupture can form in the colon. If the condition doesn't improve with medical treatment, surgery will be needed to remove part or all of the colon.You may receive antibiotics to prevent sepsis (a severe infection).SepsisSepsis is an illness in which the body has a severe, inflammatory response to bacteria or other germs.ImageRead Article Now Book Mark Article Outlook (Prognosis) If the condition does not improve, it can be fatal. Colon surgery is usually needed in such cases. Possible Complications Complications may include:Perforation of the colon Sepsis Shock Death When to Contact a Medical Professional Go to the emergency room or call the local emergency number (such as 911) if you develop severe abdominal pain, especially if you also have:Bloody diarrhea Fever Frequent diarrhea Rapid heart rate Tenderness when the abdomen is pressed Abdominal distention Prevention Treating diseases that cause toxic megacolon, such as ulcerative colitis or Crohn disease, can prevent this condition.Open ReferencesReferencesLichtenstein GR. Inflammatory bowel disease. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 132.Nishtala MV, Benlice C, Steele SR. Management of toxic megacolon. In: Cameron AM, Cameron JL, eds. Current Surgical Therapy. 13th ed. Philadelphia, PA: Elsevier; 2020:180-185.Peterson MA, Wu AW. Disorders of the large intestine. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 85.