Colon distension is an enlargement of the bottom of the large bowel. The intestines can have difficulty contracting because of the enlargement, making it difficult or impossible to defecate. Patients who do not receive treatment can be at risk of a perforation, where the wall of the colon thins and cracks open, spilling the contents into the abdominal cavity. Treatment options can depend on the cause and the patient’s general level of health, but may include a range of choices from medications to surgery.
One reason this condition develops is from a congenital disorder, in which case it will be apparent shortly after birth. Other patients develop distension in the colon later in life. Chronic forms may be the result of medications, inflammatory disease, and ongoing medical issues like poor blood supply. Acute forms onset quickly and can be rapidly fatal because the colon swells so quickly. Medical evaluation can determine the nature and cause of colon distension to allow care providers to develop a treatment plan.
Patients with colon distension can experience symptoms like constipation, abdominal pain, nausea, and lack of appetite. The abdomen may feel tender when palpated and medical imaging studies will reveal swelling in the colon, which may be filled with air or impacted feces. One option for conservative treatment is rest and high fiber foods. Feces can also be extracted to clear the colon and determine if it can contract normally.
More aggressive treatment is needed in cases of perforation, or when there are signs of ischemia, where the blood supply is inadequate. If parts of the colon are cut off from fresh blood due to colon distension, they may die, creating an increased risk of infection and severe complications. Surgery may involve repairs to the colon, removal of some segments, or a complete removal of the colon in extreme cases. These options are considered after medical imaging studies and careful examination to determine which option would be best for the patient.
After treatment for colon distension, patients may need to exercise caution. A doctor could make diet recommendations to promote healthy and efficient digestion, such as boosting fiber consumption and staying hydrated. Patients might need to switch medications if drugs contributed to the episode, or could need a new course of treatment for an underlying condition like inflammatory bowel disease to control it more effectively. During recovery, it can be important to remain alert for signs of problems like constipation or cramping which might indicate that the colon is becoming distended again.