Megacolon

Dilatation of the COLON, often to alarming dimensions. There are various types of megacolon including congenital megacolon in HIRSCHSPRUNG DISEASE, idiopathic megacolon in CONSTIPATION, and TOXIC MEGACOLON.

Also Known As:

Networked: 321 relevant articles (10 outcomes, 18 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Constipation
2.	Hirschsprung Disease (Hirschsprung's Disease)
3.	Ganglion Cysts (Ganglion)
4.	Intestinal Obstruction (Obstruction, Intestinal)
5.	Muscle Spasticity (Spastic)

Experts

1.	de Oliveira, Enio C: 7 articles (01/2018 - 11/2008)
2.	da Silveira, Alexandre B M: 5 articles (08/2017 - 11/2008)
3.	Neto, Salustiano G: 5 articles (08/2012 - 11/2008)
4.	Brehmer, Axel: 4 articles (04/2019 - 04/2011)
5.	da Silveira, A B M: 4 articles (03/2017 - 10/2007)
6.	de Oliveira, E C: 4 articles (03/2017 - 10/2007)
7.	Luquetti, Alejandro O: 4 articles (04/2011 - 11/2008)
8.	Furness, John B: 3 articles (04/2021 - 11/2008)
9.	de Oliveira, Enio Chaves: 3 articles (04/2021 - 04/2018)
10.	Freitas, Michelle A R: 3 articles (04/2019 - 11/2008)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Megacolon:

1.	Nitric Oxide (Nitrogen Monoxide)FDA Link 01/01/2019 - "Finally, local inhibition of nitric oxide signaling improved motility and prevented death by megacolon. " 11/01/1998 - "This study was designed to examine the alterations of the nitric oxide-containing neurons in the enteric nervous system of the colon of patients who underwent resections for advanced megacolon and to compare these specimens with small-bowel specimens from the same patients and with specimens from control subjects. " 06/01/2000 - "Nitric oxide production is diminished in colonic circular muscle from acquired megacolon." 06/01/2000 - "The results support the concept that nitric oxide production modulates cholinergic nerve-mediated contractions in normal colonic circular muscle, whereas acquired megacolon is associated with altered release of this inhibitory neurochemical. " 06/01/2000 - "To determine whether nitric oxide production is altered in colon from acquired megacolon, we measured cholinergic nerve-mediated contractions in vitro before and after inhibition of nitric oxide synthase. "
2.	Cisapride (Propulsid)FDA Link 11/01/1997 - "Thus, cisapride may be useful in the treatment of cats with idiopathic megacolon." 04/01/1999 - "[Cisapride in idiopathic megacolon-megarectum]." 11/01/1997 - "In cats with idiopathic megacolon, cisapride stimulated contractions of longitudinal smooth muscle from both the ascending and the descending colon. "
3.	Mixed Function Oxygenases (Monooxygenases)IBA 08/26/2011 - "The congenital hearing loss involving neurodegeneration of SGNs as well as megacolon disease in Ednrb(-/-) mice were markedly improved by introducing an Ednrb transgene under control of the dopamine β-hydroxylase promoter (Ednrb(-/-);DBH-Ednrb mice) on P19. "
4.	Dopamine (Intropin)FDA LinkGeneric 08/26/2011 - "The congenital hearing loss involving neurodegeneration of SGNs as well as megacolon disease in Ednrb(-/-) mice were markedly improved by introducing an Ednrb transgene under control of the dopamine β-hydroxylase promoter (Ednrb(-/-);DBH-Ednrb mice) on P19. "
5.	tegaserod (Zelnorm)FDA Link 03/13/2007 - "Combined drug treatment including tegaserod, PEG 4000 and traditional Chinese medicine is effective in treating megacolon with severe constipation and may help avoid surgical treatment." 03/13/2007 - "Ten patients with megacolon confirmed by barium enema examination, 4 males and 6 females, aged 38 (15 - 66), with a mean course of 10 years (2 weeks - 23 years), all complicated by severe constipation and 5 cases with colonic obstruction confirmed by X-ray examination, 1 being diagnosed as with Hirschsprung' disease, 3 secondary to chronic constipation, 1 with diabetes mellitus, 1 with a history of anorectal malformation, 4 with colonic pseudo-obstruction, and 4 with colonic pseudo-obstruction, were treated with combined conservative therapy including tegaserod (6 mg 2/d), polyethylene glycol (PEG) 4000 (20 - 40 g/d), and liuweianxiao (traditional Chinese medicine, 5 # 3/d). "
6.	Infliximab (Remicade)FDA Link 02/01/2020 - "We present a series of 12 patients with megacolon treated with infliximab, five with signs of systemic toxicity. " 02/01/2020 - "Seventy-five percent of the patients avoided a colectomy during their acute episode after early infliximab treatment, 2.45 days after the megacolon diagnosis. " 02/01/2020 - "Megacolon in inflammatory bowel disease: response to infliximab." 12/01/2013 - "Is really megacolon a contraindication to infliximab in Crohn's disease?" 05/06/2021 - "The aim of the study was to present a case of a patient with ASUC and megacolon, treated with hydrocortisone and accelerated scheme of infliximab that was monitored by drug trough level. "
7.	Serotonin (5 Hydroxytryptamine)IBA 03/01/2017 - "The aim at this study was to characterize the presence of mast cells and expression of serotonin in chagasic patients with and without megacolon and evaluate the relation between mast cells, serotonin and megacolon development. " 04/01/2021 - "However, it was noticeable that EEC in which 5-HT and PYY were co-expressed were common in control colon, but were rare in the non-dilated and absent in the dilated portion of chagasic megacolon. " 03/01/2017 - "We believe that serotonin may be involved in the inflammatory process control, triggered by mast cells, and the presence of this substance in large quantities of the intestine could represent a mechanism of megacolon prevention." 03/01/2017 - "Our results demonstrated that patients without megacolon feature a large amount of serotonin and few mast cells, while patients with megacolon feature low serotonin expression and a lot of mast cells. " 03/01/2017 - "Previous data suggested that mast cells and serotonin (5-hydroxytryptamine [5-HT]) expression could be involved in intestinal homeostasis control, avoiding the chagasic megacolon development. "
8.	DNA (Deoxyribonucleic Acid)IBA 01/01/2019 - "We aimed to assess the genetic cause of chronic megacolon through clinical and DNA studies. " 01/01/2019 - "Exome DNA sequencing of colon tissue or blood DNA from seven family members with colon or duodenal dilatation, or no megacolon (n = 1) was carried out. " 01/01/2009 - "We further identified a functional missense mutation (R1292Q) in the PDS5B DNA-binding domain in a familial case of CdLS, in which affected individuals also develop megacolon. " 08/01/2008 - "We evaluated the presence and distribution of Trypanosoma cruzi DNA in a mummy presenting with megacolon that was dated as approximately 560 +/- 40 years old. " 01/01/2019 - "Information was available in all except five members alive at time of study; among 30 members who provided DNA, six had definite megacolon, one megaduodenum, seven significant constipation without bowel dilatation, and 16 normal bowel function by questionnaire. "
9.	CreatinineIBA 07/01/2019 - "All patients presenting confirmed chagasic cardiomyopathy, megacolon or both underwent a urologic symptom questionnaire, uroflowmetry, urinary tract ultrasonography and a creatinine assay. " 09/01/2016 - "This was a retrospective study from a single institution, thereby limiting generalizability, with a lack of information regarding premorbid creatinine levels, ileus, or megacolon. " 02/01/2016 - "The objective of this study was to identify factors associated with severe CDI defined according to four different severity definitions (Def): the 2010 SHEA/IDSA guidelines (Def1), the 2014 ESCMID guidelines (Def2), complicated CDI at the end of diarrhea (Def3), and our hospital-specific guidelines (white blood cell (WBC) count ≥15 × 10(9)/L, serum creatinine concentration >50% above baseline, pseudomembranous colitis, megacolon, intestinal perforation, or septic shock requiring intensive care unit admission. "
10.	Pentagastrin (Peptavlon)FDA Link 01/01/1983 - "Pentagastrin had a stimulating effect on the sigmoid and rectum in control subjects as well as in chagasic patients without megacolon. " 02/01/1980 - "Lower oesophageal sphincter response to pentagastrin in chagasic patients with megaoesophagus and megacolon." 01/01/1983 - "In chagasic patients with megacolon, pentagastrin had no effect on sigmoid or rectum motility, probably as a result of the intrinsic denervation known to occur in this disease. " 01/01/1983 - "In order to evaluate the effect of pentagastrin on the motor activity of the sigmoid and rectum in patients with Chagas' disease, manometric studies were performed on 22 chagasic patients, 11 without and 11 with megacolon, and 11 control subjects. "

Therapies and Procedures

1.	Colectomy 12/01/1991 - "Colectomy offers good results with few complications in the treatment of idiopathic megacolon, and an ileorectal anastomosis is the preferred operation." 07/01/1993 - "Seven of the eight (87.5%), including three with megacolon, went into remission and started the chronic phase of treatment; the eighth patient underwent colectomy. " 07/01/1969 - "[Preliminary study of delayed follow-up of patients with subtotal colectomy and cecorectal anastomosis for the treatment of megacolon in the adult]." 05/01/1949 - "Of 20 patients under 15 years of age with proven diagnoses of megacolon, ten were treated surgically with either partial colectomy or resection of the entire colon down to the rectosigmoid junction after thorough trial of medical management. " 10/25/2023 - "Bowel resection is the treatment of choice, and if a megacolon is present a subtotal colectomy is recommended. "
2.	Decompression 01/01/2021 - "This is the first report to suggest the benefit of intermittent rectal tube decompression in the community for the long-term management of chronic megacolon. " 01/01/1988 - "This study demonstrates that colonoscopic decompression followed by tube placement is the preferred treatment modality for acute nontoxic megacolon." 01/01/1988 - "Treatment of acute nontoxic megacolon during colonoscopy: tube placement versus simple decompression." 02/01/2014 - "Colonic decompression and direct intraluminal medical therapy for Clostridium difficile-associated megacolon using a tube placed endoscopically in the proximal colon." 12/12/2012 - "Sigmoid volvulus associated with megacolon was diagnosed and emergence endoscopic decompression was performed. "
3.	Aftercare (After-Treatment) 01/01/2022 - "Thus, the main objective of this study was to determine whether the duration of clinical signs of idiopathic megacolon in cats affected their diagnosis and prognosis after treatment. " 10/01/2003 - "We evaluated the neurotrophic effect of the neurokinin SP in the induced megacolon and the cell proliferation of the colonic epithelium after treatment. " 01/29/2018 - "Treatment with SLAB51™ in cats with chronic constipation and idiopathic megacolon showed significant clinical improvement after treatment, and histological parameters suggest a potential anti-inflammatory effect of SLAB51™, associated with a reduction of mucosal infiltration, and restoration of the number of interstitial cells of Cajal."
4.	Colostomy 10/01/2004 - "Eight were found not to fall into any of the above groups and were treated medically for presumed functional megacolon; 2 of these ultimately had a colostomy. " 06/01/1996 - "The megacolon detected intraoperatively has seven different causes necessitating a colostomy and further diagnostic procedures in special hospitals. " 11/01/1969 - "Treatment of acquired megacolon by retrorectal lowering of the colon with a perineal colostomy: modified Duhamel operation." 09/01/1968 - "[Treatment fo acquired megacolon with rectro-rectal lowering of the colon with perineal colostomy (modified Duhamel operation)]." 03/01/1965 - "[Colonic retro-rectal depression by perineal colostomy in the treatment of acquired megacolon. "
5.	Conservative Treatment 09/01/2016 - "The purpose of this case series is to describe the long-term outcome for 3 cats with obstipation treated with internal hemipelvectomy because of megacolon secondary to pelvic canal narrowing after conservative management. " 01/01/2017 - "To evaluate the results of Rehbein procedure with extraperitoneal colorectal anastomosis combined with complex conservative treatment in children with secondary megacolon due to chronic constipation. " 09/01/1996 - "Unlike the vast majority of patients with low anorectal anomalies, all of these patients had a huge megacolon, with consequent constipation that was refractory to conservative treatment. " 01/01/2022 - "Some patients admitted for emergency intestinal obstruction received conservative treatment first or underwent elective surgery after colonoscopic decompression was improved; two patients with ganglion cell deficiency subtotal colectomy were performed to remove the dilated proximal bowel segment and the narrow distal bowel segment; three patients with toxic Hirschsprung's disease underwent colostomy in mild cases, while subtotal colorectal resection was required in severe cases; Iatrogenic megacolon was diagnosed in eight cases and the optimum operation should be selected according to the specific conditions of patients. " 01/01/2020 - "We recommend that continuous intravenous infusion of cyclosporine be considered as an effective option for the conservative management of severe, fulminating ulcerative colitis with megacolon."