Megacolon is the dilation of the large intestine, accompanied by difficulty removing faeces and gases, caused by damage to nerve endings in the intestine.It may be the result of a congenital baby disease, known as Hirschsprung’s disease, or it can be acquired throughout life, due to Chagas disease, for example.
Another form of megacolon is due to acute and severe intestinal inflammation, called toxic megacolon, which is usually developed by people with inflammatory bowel disease, causing severe intestinal dilation, fever, tachycardia and risk of death.
- With the loss of contractions and faeces in this disease.
- Signs and symptoms appear such as constipation that worsens over time.
- Vomiting.
- Bloating and abdominal pain.
- Although it has no cure.
- Megacolon can be treated according to its cause and consists of the relief of symptoms.
- With the use of laxatives and intestinal washes.
- Or by performing surgery to remove the affected part of the intestine.
- Correcting in a more definitive way the changes.
Due to reduced defecation capacity, signs and symptoms of megacolon include:
The intensity of these symptoms varies depending on the severity of the disease, so symptoms can be noticed from the first few days of life, as in the case of congenital megacolon, or after months or years of onset, as in the case of acquired megacolon, as the disease progresses slowly.
Megacolon can occur for a number of reasons, which can occur from birth or acquired throughout life. The most common causes are:
This alteration, known as Hirschsprung’s disease, is a disease born with the baby, due to a deficiency or lack of nerve fibers in the intestine, which prevents its proper functioning for the elimination of faeces, which accumulate and cause symptoms.
This disease is rare, caused by genetic changes and symptoms can already occur from the first hours or days after birth; However, if changes and symptoms are mild, it may take weeks or months to correctly identify the disease, and in these cases, it is common for the baby to have atrophy growth due to a lower ability to absorb nutrients from food.
How to confirm: The diagnosis of congenital megacolon is done by observing the child’s symptoms by the doctor, performing a physical exam, as well as requesting tests such as abdomen x-ray, opaque enema, anorectal manometry and rectal biopsy., confirming the disease..
How to treat: Initially, a temporary colostomy may be performed to allow the baby to pass the stool through a small bag attached to the belly.Final surgery is then planned, around 10-11 months, with removal of the altered intestinal part and restructuring of intestinal transit.
The main cause and megacolon acquired is Chagas disease, a situation known as a chagas megacolon, which occurs due to damage to intestinal nerve endings caused by an infection with the protozoa Trypanosoma cruzi, transmitted by the bite of the barber insect.
Other lifetime causes of dilation and cessation of bowel function include:
Megacolon can also be functional, the exact cause of which is unknown, but which probably comes from chronic and severe intestinal constipation that is not treated properly and worsens over time.
How to confirm: to diagnose the acquired megacolon, a assessment by the gastroenterologist or coloproctor is necessary, which will analyze the medical history and physical examination, and order tests such as abdomen x-ray, opaque enema and, in case of doubt, the cause of the intestinal biopsy, allowing its confirmation.
How to treat: treatment is performed to allow the removal of faeces and gases through the intestine, and can initially be performed with laxatives, such as lactulose or bisacody, for example, and intestinal washes, however, when symptoms are severe and with little improvement, surgery to remove the affected part of the intestine is programmed by the coloproctologist.
Toxic megacolon is an acute and serious complication of certain types of intestinal inflammation, mainly due to Crohn’s disease or ulcerative colitis, although it can be associated with any type of colitis, whether from intestinal torsion, diverticulitis, intestinal ischemia or colon obstruction.Cancer.
During a toxic megacolon condition, intense dilation of the intestine occurs that has a rapid and severe evolution and carries a risk of death, due to the intense inflammation that occurs in the body, in addition signs and symptoms appear, such as fever.above 38.5 degrees Celsius, heart rate greater than 120 beats per minute, excess white blood cells in the blood, anemia, dehydration, mental confusion, alteration of blood electrolytes and lower blood pressure.
How to confirm: Confirmation of the toxic megacolon is done by a medical evaluation using an X-ray test of the abdomen, showing a bowel dilation greater than 6 cm wide, a physical examination, and clinical signs and symptoms.
How to treat: Treatment aims to control symptoms, replenish blood electrolytes, use antibiotics and other medications to reduce intestinal inflammation, such as corticosteroids and anti-inflammatory drugs; However, if the disease continues to worsen, surgery should be performed for the total removal of the large intestines may be indicated as a way to eliminate ignition and allow the affected person to recover.