management

Last reviewed 01/2018

The principles of management of toxic megacolon include:

  • supportive care in the intensive care unit
  • nil by mouth and nasogastic tube insertion
  • antimotility agents should be stopped
  • intravenous fluids, corticosteroids and antibiotics
  • serial abdominal radiographs
  • daily full blood counts and electrolytes
  • blood transfusion for anaemia
  • total parenteral feeding if required
  • infectious causes of colitis should be treated:
    • CMV
    • C. difficile
    • E. histolytica
  • surgery should be considered for:
    • progressive dilatation
    • worsening toxicity
    • haemorrhage
    • perforation