What is the treatment for toxic megacolon?

Toxic megacolon is a severe complication often associated with inflammatory bowel diseases, particularly ulcerative colitis, and can also occur in infections or other conditions affecting the colon. The primary concern with toxic megacolon is the risk of colonic perforation, which poses a life-threatening situation.

The definitive treatment for toxic megacolon typically involves surgical intervention, especially if there is no response to medical management. A subtotal abdominal colectomy, which involves the surgical removal of the majority of the colon, effectively addresses the underlying pathophysiology by eliminating the dilated, dysfunctional segment of the bowel. An end ileostomy, which creates an opening from the small intestine to the abdominal wall, is often performed at the same time to allow for waste elimination without the use of the affected colon. This surgical approach not only alleviates the dangerous condition but also prevents future complications related to the megacolon.

Other treatment options, such as medications and dietary changes or antibiotics and hydration, may play roles in the management of inflammatory bowel disease or infections, but they are not definitive cures for toxic megacolon. Non-operative treatments may fail or worsen the condition, particularly when the risk of perforation is high. Colonoscopy and observation are generally not suitable