[Effect of combined drug treatment on megacolon with severe constipation].
OBJECTIVE
To assess the effectiveness of combined drug treatment on megacolon complicated by severe constipation.


METHODS
Ten patients with megacolon confirmed by barium enema examination, 4 males and 6 females, aged 38 (15 - 66), with a mean course of 10 years (2 weeks - 23 years), all complicated by severe constipation and 5 cases with colonic obstruction confirmed by X-ray examination, 1 being diagnosed as with Hirschsprung' disease, 3 secondary to chronic constipation, 1 with diabetes mellitus, 1 with a history of anorectal malformation, 4 with colonic pseudo-obstruction, and 4 with colonic pseudo-obstruction, were treated with combined conservative therapy including tegaserod (6 mg 2/d), polyethylene glycol (PEG) 4000 (20 - 40 g/d), and liuweianxiao (traditional Chinese medicine, 5 # 3/d). Colon enema was used in the first week if necessary. Follow-up was conducted for 1 - 7 months. The major clinical data included bowel symptoms, complications and adverse effects.


RESULTS
After 1 - 2 weeks of treatment, properties of feces, defecation times, defecation difficulty, and abdominal symptoms, and X-ray findings were all notably improved. No relapse of colonic obstruction was found. The 5 patients with colonic obstruction all showed release. Regarding adverse effect, mild diarrhea was found in 2 cases and was relieved when the dosage was decreased.


CONCLUSIONS
Combined drug treatment including tegaserod, PEG 4000 and traditional Chinese medicine is effective in treating megacolon with severe constipation and may help avoid surgical treatment.
Ding
Zhao-Lu
ZL
Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
Ke
Mei-Yun
MY
Sun
Xiao-Hong
XH
Wang
Zhi-Feng
ZF
D000293:Adolescent; D000328:Adult; D000368:Aged; D003248:Constipation / Q000188:drug therapy* / Q000209:etiology; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007211:Indoles / Q000627:therapeutic use; D008297:Male; D008516:Medicine, Chinese Traditional; D008531:Megacolon / Q000150:complications / Q000188:drug therapy*; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000627:therapeutic use; D012189:Retrospective Studies; D016896:Treatment Outcome
D007211:Indoles; D011092:Polyethylene Glycols; C105050:tegaserod