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Intake of Antibiotics Can be a Risk Factor for Toxic Megacolon


Antibiotic is one of the treatment methods used to treat various infectious diseases by inhibiting the growth of bacteria in our body.  But did you know that taking antibiotic even just once can cause colon infection and potentially lead to Toxic Megacolon.

Dr. Chanyawat Sangsomwong, colorectal surgeon specializes in colon and rectum at Vejthani Hospital, explains that Toxic Megacolon is a complication of an inflammation or severe infection in the colon that leads to an abnormal dilation. Common bacteria that cause swelling and inflammation into the deeper layers of the colon that results in Toxic Megacolon is known as Clostridium difficile.

Our body naturally has a germ called Clostridium difficile contain in the colon (normal flora) and it works as a crucial mechanism that controls the abnormal growth of other types of bacteria. When the body receives antibacterial medicine, these natural bacteria die. The body then loses its natural bacterial balance and causes C. difficile to be the reason for colon infection. Reports suggest that an intake of antibiotic even once can result in colon inflammation from this type of bacteria. The group of antibiotics that increases the risk of colon inflammation from C. Difficile are Clindamcyn, Ampicillin, Cephalosporin and etc.

Patients with mild infection of colon inflammation from C. Difficile may show no symptoms or have acute diarrhea with mucus. For patients with serious condition may have fever, abdominal pain, severe diarrhea that leads to shock from dehydration. Worsen of the illness may result in Toxic Megacolon or perforated colon. If signs start to arise, and patients have a history of taking antibiotics, they must seek immediate medical advice for an investigation. A stool analysis in conjunction with colonoscopy will facilitate in diagnosing the condition of colon inflammation from C. Difficile. As for those who have severe bloating, CT scan will distinguish the condition of Toxic Megacolon from other diseases. CT scan images will display swollen colon from the infection and inflammation in the abdomen.  

Toxic Megacolon is considered as an urgent medical condition that requires immediate treatment to prevent complications, such as multiorgan failure or perforation or rupture of the colon. The treatment options range from antibiotics directed to C. Difficile or intravenous fluid. However, if the body does not respond to medications, the entire part of infected colon needs to be surgically removed then undergo colostomy. For patients with severe conditions that require surgical treatment has a high death rate of 60 percent.

“Risk factors of Toxic Megacolon do not include smoking or drinking alcohol. It predominantly happens to elderlies who have records of receiving antibiotics in the past three months, have impaired immunity, critically ill and admitted to ICU or is diagnosed with inflammatory bowel disease (IBD). Colon infection from C. Difficile bacteria will be reduced if the use of unnecessary antibiotics is diminished,” said Dr. Chanyawat.

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