Megacolon

A gross distension (enlargement) of the colon, usually accompanied by severe, chronic constipation. In children, the main causes of megacolon are anal fissures, Hirschsprung’s disease, and psychological factors that may have arisen during toilet-training. In elderly people, causes include the long-term use of strong laxative drugs. People suffering from chronic depression or schizophrenia often have megacolon. Other, rarer causes include hypothyroidism, spinal injury, and drugs such as morphine and codeine. Megacolon causes constipation and abdominal bloating. Associated loss of appetite may lead to weight loss. Diarrhoea may result if semi-liquid faeces leak around the obstructing hard faeces. Diagnosis is made by proctoscopy, barium X-ray examination, and tests of bowel muscle function. If Hirschsprung’s disease is suspected, biopsy of the large intestine may be performed. Impacted faeces are often removed using enemas. In severe cases, the faeces must be removed manually.