Epidemiology
Toxic megacolon is a highly morbid complication of colitis of various etiologies, and affects males and females of all ages. The overall incidence of toxic megacolon is difficult to determine because it depends on the etiology of colitis and colonic dilation. Toxic megacolon has a reported lifetime incidence of less than 5% in patients with inflammatory bowel disease (IBD) and 0.4% to 3% in patients with pseudomembranous or Clostridium difficile colitis.[2][3][4][5] The incidence of toxic megacolon associated with IBD is gradually decreasing as a result of earlier diagnosis of severe exacerbations and better medical management. IBD patients remain at greatest risk of developing toxic colitis/toxic megacolon early in their disease course, and this may be the initial presentation. In the USA the incidence of toxic megacolon in patients with C difficile-associated colitis is increasing due to increasing prevalence of pseudomembranous colitis and other infectious colitides.[4][6][7]
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