[An increased incidence of megacolon in psychiatric and neurologic patients]

The incidence of megacolon is elevated in neuropsychiatric patients. Siegmund was the first, in 1935, to report on the development of megacolon and megasigmoid as the result of chronic atropine therapy of patients with postencephalitic parkinsonism and the associated risk of stercoraceous ulcers and ileus or even sudden death. The etiology of increased frequency of megacolon among neuropsychiatric patients is assumed to be nonuniform, and to include organic defects of centers of the autonomous nervous system in the diencephalon and/or hypothalamous, pharmacodynamic, psychogenic and neurogenic influences on the autonomic nervous system, akinesia and increased obstipation among psychiatric patients, insufficient pressure in the abdominal wall especially in the mentally retarded, with frequently associated weakness of the connective tissue. In cases of long-term therapy with psychotropic drugs the anticholinergic side effects with the risk of megacolon and resulting ileus, sometimes with fatal outcome should be borne into mind.