Fluid resuscitation
IV corticosteroids
Hydrocortisone IV 100mg q6h
Triple Antibiotic Therapy
Ampicillin 2 g IV q6h PLUS Metronidazole 500mg IV q6h PLUS Gentamicin 7mg/kg q24h or Ciprofloxacin 400mg IV q12h OR
Imipenem 500mg IV q6h
Electrolyte repletion
Aggressively treat hypokalemia and hypomagnesemia because these can exacerbate dilation
Emergent Surgical Consultation
Hydrocortisone IV 100mg q6h
Ampicillin 2 g IV q6h PLUS Metronidazole 500mg IV q6h PLUS Gentamicin 7mg/kg q24h or Ciprofloxacin 400mg IV q12h OR
Imipenem 500mg IV q6h
Aggressively treat hypokalemia and hypomagnesemia because these can exacerbate dilation
Obtain blood cultures, stool cultures, C. Diff<unk> 
If known cause is C. Diff treat with Vancomycin or Metronidazole
If known cause is CMV can add Ganciclovir
Avoid
Anticholinergics, anti-motility agents, opioids which can worsen dilation
Sulfasalazine or 5-aminosalicylate (5-ASA) unhelpful
Nasogastric (NG) Tube NOT effective in reducing colonic distention
Anticholinergics, anti-motility agents, opioids which can worsen dilation
Sulfasalazine or 5-aminosalicylate (5-ASA) unhelpful
Nasogastric (NG) Tube NOT effective in reducing colonic distention
Toxic megacolon
Small bowel obstruction
Mesenteric ischemia
Large bowel obstruction
Neutropenic enterocolitis 
Volvulus, Neoplastic Disease, Paralytic ileus, Pseudo-obstruction
Short bowel syndrome
Colitis