Antibiotics are used for bacterial infections such as oral vancomycin for Clostridium difficile Disimpaction of feces and decompression using anorectal and nasogastric tubes. When megacolon worsens and the conservative measures fail to restore transit, surgery may be necessary. Bethanechol can also be used to treat megacolon by means of its direct cholinergic action and its stimulation of muscarinic receptors which bring about a parasympathetic like effect.