Grant and Dozois used criteria to define toxic megacolon in patients with ulcerative colitis or Crohn's disease. These are based on the criteria of Truelove and Witts for severe ulcerative colitis. The authors are from the Mayo Clinic.


Criteria of Truelove and Witts for severe ulcerative colitis:

(1) ESR > 30 mm per hour (normal < 30 mm per hour)

(2) diarrhea, with loose stools >= 6 times per day

(3) bloody stools (hematochezia)

(4) fever (mean evening temperature > 37.5°C, or higher than 37.8°C on >= 2 days out of 4)

(5) tachycardia, with mean pulse more than 90 beats per minute

(6) anemia (less than 75% of normal, taking into account any recent transfusions)


Additional feature:

(7) colonic diameter > 9 cm on abdominal X-rays


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