Toxic megacolon medical therapy

Toxic Megacolon Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Toxic Megacolon from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic study of choice
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
Abdominal X Ray
CT
Ultrasound
MRI
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Toxic megacolon medical therapy On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Toxic megacolon medical therapy All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Toxic megacolon medical therapy
CDC on Toxic megacolon medical therapy
Toxic megacolon medical therapy in the news
Blogs on Toxic megacolon medical therapy
Directions to Hospitals Treating Toxic megacolon
Risk calculators and risk factors for Toxic megacolon medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

There is no treatment for [disease name]; the mainstay of therapy is supportive care.

OR

Supportive therapy for [disease name] includes [therapy 1], [therapy 2], and [therapy 3].

OR

The majority of cases of [disease name] are self-limited and require only supportive care.

OR

[Disease name] is a medical emergency and requires prompt treatment.

OR

The mainstay of treatment for [disease name] is [therapy].

OR   The optimal therapy for [malignancy name] depends on the stage at diagnosis.

OR

[Therapy] is recommended among all patients who develop [disease name].

OR

Pharmacologic medical therapy is recommended among patients with [disease subclass 1], [disease subclass 2], and [disease subclass 3].

OR

Pharmacologic medical therapies for [disease name] include (either) [therapy 1], [therapy 2], and/or [therapy 3].

OR

Empiric therapy for [disease name] depends on [disease factor 1] and [disease factor 2].

OR

Patients with [disease subclass 1] are treated with [therapy 1], whereas patients with [disease subclass 2] are treated with [therapy 2].

Medical Therapy

Medical therapy of Toxic megacolon include:

• 1.General considerations
  • 1.1.Complete bowel rest
  • 1.2.Intravenous fluid support to
  • 1.3.Electrocytes monitoring and correction of abnormalities
  • 1.4.Withdrawal of all anticholinergics, antidiarrheal and narcotics
  • 1.5.Rule out infectious etiology
• 2.Decompression
  • 2.1.Rectal tube
  • 2.2.Nasogastric or long nasointestinal tube

  Note: Long intestinal tubes are considered to be more effective than nasogastric tubes in colonic decompression but should be placed into the ileum under fluoroscopic guidance.

  • 2.3.Repositioning maneuvers

  Note: Maneuver 1: Asking patients to roll into the prone position for 10–15 minutes every 2–3 hours and encourage them to pass gas

  Note: Maneuver 2: Turning to the prone knee-elbow position, which moves the rectum to the highest point in the body

• 3.Medical management
  • 3.1.Toxic megacolon associated with inflammatory bowel disease(IBD)
    • 3.1.1.Intravenous corticosteroids
      • Preferred regimen (1): Hydrocortisone 100 mg every 6 hours
      • Preferred regimen (2) : Methylprednisolone 60 mg every 24 hours
  • 3.2.Toxic megacolon associated with Clostridium difficile
  • 3.3.Toxic megacolon associated with pseudomembranous colitis