Toxic dilation of the colon; Megarectum; Inflammatory bowel disease - toxic megacolon; Crohn disease - toxic megacolon; Ulcerative colitis - toxic megacolon
Toxic 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.
The term "toxic" means that this problem is very dangerous. Toxic megacolon may occur in people with an inflamed colon due to:
Other forms of megacolon include pseudo-obstruction, acute colonic ileus, or congenital colonic dilation. These conditions do not involve an infected or inflamed colon.
The rapid widening of the colon may cause the following symptoms to occur over a short period of time:
The health care provider will perform a physical exam. Findings may include:
The exam may reveal signs of septic shock, such as:
The provider may order any of the following tests:
Treatment of the disorder that led to toxic megacolon includes:
If you have septic shock, you will be admitted to the intensive care unit (ICU) of the hospital. Treatment may include:
If 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).
If the condition does not improve, it can be fatal. Colon surgery is usually needed in such cases.
Complications may include:
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:
Treating diseases that cause toxic megacolon, such as ulcerative colitis or Crohn disease, can prevent this condition.
Lichtenstein 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.BACK TO TOP
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.
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