Expert: Nigel Simmons - 4/24/2007

Question
My 2 year old has been having abdominal distention for about 8 months. She was just in the emergency room and they told me she has a megacolon but she will be fine. I was reading on Toxic Megacolon. when she was admitted her potassium level was very low and she was very dehydrated. she also has abdominal pain, abdominal tenderness, she gets fevers on and off for no reason. Can she have a toxic megacolon? Please help  

Answer
Xiomara

I am not a doctor and only have limited detailed knowledge of many medical problems especially the more rare, but hopefully I can help answer some of your concerns.

Firstly, I would expect that if your daughter has a toxic megacolon, she would most probably have been admitted to the hospital and given intensive treatment. According to a doctor colleague, toxic megacolon can have a high mortality if untreated, so I would suspect this is not the case for your daughter.

Megacolon, sometimes known as spastic megacolon or Hirschsprung's Disease is an inflammatory condition caused by insufficient or ineffective motility of the lower part of the digestive tract. As such, symptoms would be loss of apetite, constipation (and sometimes diarrhoea), abdominal swelling, pain and tenderness. These problems are also likely to cause fevers because of the discomfort they produce. The abnormal potassium level would be due to the dehydration which itself occurs because fluid normally absorbed in the colon is not occurring because there is no motility and digestive products are not reaching it.

If the problem continues, then surgery may become necessary to create a stoma to allow food waste to pass out of the body. However initially it may be possible to try using stimulant laxatives to see if the colon will respond. Without treatment ther problems will continue and there is a risk of infection.

If your daughter has not been referred to a paediatrician or gastro-intestinal specialist then it is advisible that she is seen by someone who can investigate the problem further and advise on appropriate treatment options.

I hope this helps.