Toxic megacolon medical therapy: Difference between revisions

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****Preferred regimen(1): Hydrocortisone 100 mg IV q6h
****Preferred regimen(1): Hydrocortisone 100 mg IV q6h
****Preferred regimen(2): Methylprednisolone 60 mg IV q24h
****Preferred regimen(2): Methylprednisolone 60 mg IV q24h
***3.1.2.Broad-spectrum antibiotics
****Preferred regimen(1): ampicillin-gentamicin-etronidazole
****Preferred regimen(2):
**3.2.Toxic megacolon associated with Clostridium difficile
**3.2.Toxic megacolon associated with Clostridium difficile
**3.3.Toxic megacolon associated with pseudomembranous colitis
**3.3.Toxic megacolon associated with pseudomembranous colitis

Revision as of 18:56, 7 November 2017

Toxic Megacolon Microchapters

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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.Corticosteroids
        • Preferred regimen(1): Hydrocortisone 100 mg IV q6h
        • Preferred regimen(2): Methylprednisolone 60 mg IV q24h
      • 3.1.2.Broad-spectrum antibiotics
        • Preferred regimen(1): ampicillin-gentamicin-etronidazole
        • Preferred regimen(2):
    • 3.2.Toxic megacolon associated with Clostridium difficile
    • 3.3.Toxic megacolon associated with pseudomembranous colitis

References

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