Symptoms of a toxic megacolon

The main symptom with which the affected persons present themselves in the emergency room is very severe abdominal pain and a defensive tension in the abdominal area, which presents itself to the examiner as a stomach as hard as a board. The pain is accompanied by high fever and a significantly worsened general condition of the person concerned. Listening to the abdomen reveals a paralyzed closure of the intestine, which is called paralytic ileus.

This means that further transport of intestinal contents is no longer possible. This accumulation of intestinal contents causes, among other things, the severe pain. The high fever also leads to an accelerated pulse and rapid breathing.

The combination of high pulse and low blood pressure in high fever is attributed to sepsis, better known as blood poisoning. The damaged intestinal wall also causes a shift in the body’s water and salt balance, as the intestinal cells are closely involved in the control of this system under normal conditions. This often leads to a loss of water and thus to dehydration of the patient, which in turn lowers blood pressure.

Furthermore, patients often show anemia and also tend to bleed. The number of white blood cells, the leukocytes, can be significantly increased, which is a typical sign of inflammation. All in all, the affected person makes a very sick and weak impression and is in severe pain.

Therapy of a toxic megacolon

Toxic megacolon is always an acute emergency that requires immediate treatment. The therapy of Toxic Megacolon usually starts with a conservative treatment. The shifted salt and water balance must be corrected.

This is done by means of syringe pumps during close, intensive medical care. In addition, the toxins that caused the condition must be removed during conservative therapy. Here it is important to know the cause of the disease.

Furthermore, it has been shown that it has a positive effect to perform a leukocyte apheresis.This is a type of blood washing in which the leukocytes, which are highly increased, are collected from the blood, which can reduce inflammation. The administration of antibiotics and antibody therapy is also possible with medication. If the condition of the affected person does not improve within 48-72 hours, surgery is necessary.

The affected bowel segment is completely removed and an artificial bowel outlet is created. If the colon has to be removed completely, the artificial bowel outlet must be kept for life. In patients where only part of the colon needs to be removed, the artificial bowel outlet can be removed after the bowel has healed.