Megacolon - Causes and Signs of Megacolon

Specialists distinguish the following types of the disease:

• congenital megacolon (Hirschsprung's disease), the area of the rectum and sigmoid colon;
• acquired functional megacolon, the cause of which is psychogenic constipation;
• symptomatic megacolon, the cause of which is diseases that lead to narrowing of the anus (tumors, inflammatory processes and various types of lesions).

Causes

Congenital appearance of megalocolon is due to the absence or deficiency of receptors on the periphery, deterioration of patency along the nerve endings, which appears due to a violation of the distribution of nerve cells in the embryonic period.

The causes and provoking factors of the appearance of acquired megacolon can be toxic lesions of the interweaving of nerves in the thickness of the intestinal wall of the large intestine, dysfunction of the central nervous system, trauma, tumors, delayed bowel movements for more than four days.

The above factors and causes provoke deterioration of the motor function of the large intestine in its different parts and a gradual decrease in the lumen of the intestine. Mechanical obstacles disrupt the passage of feces through narrow sections of the intestine, which contributes to its sharp expansion or increase.

The activity of peristaltic waves and thickening of the walls of the upper intestine manifests itself compensatorily and develops for better and faster movement of food masses through the intestine into the aganglionic or stenotic zones. Further, in the enlarged and stretched sections of the intestine, hypertrophied muscle fibers constantly die, connective tissue is formed, or scarring.

The movement of intestinal contents slows down, prolonged constipation occurs, absence of bowel movements for up to a week, sometimes with an absence of up to a month. The urge to defecate disappears, intoxication of the body with the absorption of toxins begins, dysbacteriosis develops.

Symptoms

The severity of the disease and the manifestations of clinical symptoms of megacolon are directly related to the volume of the process in the affected parts of the intestine, as well as the adaptive capabilities of the body. If children have congenital megacolon, even from the first minutes of life there is no defecation and no feces, increased gas formation (flatulence) appears, the size of the abdomen increases, fecal intoxication of the child's body occurs.

Sometimes nausea and vomiting with an admixture of bile appear. Emptying of the intestines occurs after the introduction of a special tube, cleansing or siphon enemas are used to remove gases. The feces acquire a putrid odor, mucus appears, sometimes with blood and particles of undigested food. Such children begin to lag behind in physical development, accompanied by exhaustion and anemia.

With megacolon, chronic constipation and increased gas formation in the intestines progress, which leads to flaccidity of the abdominal wall, the formation of a "frog belly".

During an external examination, it is possible to visually detect increased peristaltic waves that are visible through the abdominal wall with the naked eye.

With megacolon, an increase and distension of the large intestine is manifested by typical signs that are revealed during examination and diagnostics: a high position of the dome of the diaphragm, a decrease in the volume of the lungs, a shift in the organs of the mediastinum, changes in the size, shape and configuration of the chest (the chest becomes like a barrel). With these symptoms, tachycardia, dyspnea develop, and changes occur in the electrocardiographic study.

Megacolon is often accompanied by complications in the form of dysbacteriosis, and acute intestinal obstruction appears. With bacteriosis, ulcers form on the intestinal mucosa, which leads to diarrhea. The appearance of obstructive obstruction is characterized by frequent vomiting, severe pain in the abdomen, and in severe cases, perforation of the colon or the development of peritonitis. If a volvulus or formation of nodes between intestinal loops occurs, strangulation intestinal obstruction develops.

Diagnostics

When the correct diagnosis is established, it is necessary to prescribe the patient to undergo an objective examination by a therapist and a surgeon.

The specialist prescribes:

• X-ray examination of the intestine;
• endoscopic examination, biopsy;
• laboratory examination (stool for dysbacteriosis, clinical analysis of feces);
• histology tests;
• clinical blood test;
• colonoscopy;
• rectoscopy;
• anorectal manometry.

Treatment

Several types of treatment are prescribed to improve the patient's quality of life. In the treatment of acquired megacolon, pharmacological treatment is prescribed: a consultation with a psychotherapist, treatment of constipation with medications, and the appointment of diets with a high fiber content are prescribed. Cleansing enemas and abdominal massage are used. Antibacterial drugs are used in the treatment to normalize intestinal microflora, modulators for colon motility. Therapeutic physical prevention is carried out. In severe cases of the disease, surgical treatment is used.

Prevention

For preventive measures, it is necessary to:

• avoid stress and nervous experiences;
• follow the rules of a balanced diet;
• monitor the stool of adults and small children;
• regularly undergo preventive examination by a proctologist in the presence of chronic inflammatory diseases.