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Toxic Megacolon and Its Treatment: Here's What You Need to Know

Medically reviewed by Jezreel Esguerra, MD · General Practitioner

Written by Ruby Anne Hornillos · Updated Oct 27, 2022

Toxic Megacolon and Its Treatment: Here's What You Need to Know

Having a toxic megacolon is dangerous and potentially fatal. What are the symptoms of toxic megacolon, and what is toxic megacolon treatment? Learn more here.

The colon is part of the large intestine, together with the rectum and anus. The large intestine is a tube-like organ which serves as the final pathway for waste before it is released by the body. It is where water absorption happens.

Toxic Megacolon and Its Treatment: What is a Toxic Megacolon?

Toxic megacolon is rare yet life-threatening dilatation of the colon either due to irritation or infection. It can develop over the course of a few days. Its most common cause is what we call inflammatory bowel disease or IBD. It is a collective term for the two (2) disease that causes chronic inflammation to the bowels namely Crohn’s disease and ulcerative colitis. However, many other conditions can cause this disease. Written below are the other etiologies of toxic megacolon:

  • Colon infections (commonly caused by C. difficile)
  • Colon cancer
  • Ischemia, or loss of blood flow hence loss of oxygen to the organ
  • Diabetes
  • Organ transplants
  • Kidney failure
  • Chronic obstructive pulmonary disease
  • Suppressed immunity

Toxic megacolon happens when IBD or any of the other etiologies causes abnormal dilatation of the colon. When this happens, the colon experiences difficulty in fulfilling its function such as allowing the movement of the digested food out of the body, and water absorption. If left unmanaged, the feces build up in your colon, and it may eventually cause the large intestine to rupture. The rupturing of the colon is a life-threatening scenario. Your GI tract houses millions to billions of bacteria. When it ruptures, you become at risk that those bacteria will spread in your system.

While toxic megacolon is usually caused by inflammation or infection, other types of megacolons that are not caused by inflammation or infection also exist.

Toxic Megacolon: Signs and symptoms

The symptoms of a toxic megacolon include:

  • Abdominal pain
  • Tenderness in the abdomen
  • Bloating
  • Increased heart rate
  • Fever
  • Shock
  • Bloody diarrhea
  • Painful bowel movement

When you experience any combination of these symptoms, it is imperative that you seek immediate medical attention for further assessment.

Toxic Megacolon: Diagnosis

The diagnostic basis is the patient’s symptoms and the dilation of the colon seen on radiographic images. Your doctor may order you to undergo X-ray or CT scan to see the dilatations of your colon.

A criteria is usually used to diagnose this disease. Below are the most commonly used diagnostic criteria for toxic megacolon:

  • Radiographic evidence of the dilation of the colon AND:
  • At least three of the following:
  • Fever over 38 degrees C
  • Heart rate greater than 120 beats/min
  • Increased white blood cell count (seen in complete blood count or CBC)
  • Anemia
  • At least one of the following:
    • Dehydration
    • Altered sensorium (dizziness, or even lethargy)
    • Electrolyte disturbances (seen in blood chemistry)
    • Hypotension or low blood pressure
  • Please seek medical attention once you experience these symptoms. Toxic megacolon cannot diagnosed at home.

    Toxic Megacolon and Its Treatment

    The treatment for toxic megacolon usually involves surgery. Once admitted to the hospital, you will given intravenous fluids so as to prevent dehydration. It will also stabilize your blood pressure. Once it is done, you will now then undergo surgery. Surgeons will treat any tears in the colon. This is so that the bacteria that are present inside the colon does not spread to the rest of your system.

    Should your surgeon find that your colon does not have a tear, tissues that are present in the colon can still be damaged thus may need removal. In some cases, depending on the damage to your colon, colectomy or the removal part or all of your colon might be needed.

    You will be given antibiotics for the procedure in order to prevent sepsis, which is a body’s extreme response to infection that may prove fatal by itself.

    Key takeaway

    Toxic megacolon is rare yet life-threatening condition where colon dilates due to irritation or inflammation. Its most common cause is inflammatory bowel disease.

    To help you mitigate the symptoms of IBD, you may need to include changes to your lifestyle, as well as maintenance medications. This helps you void infections, and minimizes the chances that you will develop a toxic megacolon.

    Learn more about Inflammatory Bowel Disease here.


    Hello Health Group does not provide medical advice, diagnosis or treatment.

    Medically reviewed by

    Jezreel Esguerra, MD

    General Practitioner

    Written by Ruby Anne Hornillos · Updated Oct 27, 2022

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