Disease: Pseudomembranous colitis

Overview

Pseudomembranous (SOO-doe-mem-bruh-nus) colitis, also called antibiotic-associated colitis or C. difficile colitis, is inflammation of the colon associated with an overgrowth of the bacterium Clostridium difficile (C. diff). This overgrowth of C. difficile is most often related to recent antibiotic use.

Source: http://www.mayoclinic.com

Symptoms

Signs and symptoms of pseudomembranous colitis may include:

  • Diarrhea that can be watery or even bloody
  • Abdominal cramps, pain or tenderness
  • Fever
  • Pus or mucus in your stool
  • Nausea
  • Dehydration

Symptoms of pseudomembranous colitis can begin as soon as one to two days after you start taking an antibiotic, or as long as several weeks after you finish taking the antibiotic.

When to see a doctor

If you are currently taking or have recently taken antibiotics and you develop diarrhea, contact your doctor, even if the diarrhea is relatively mild. Also, see your doctor any time you have severe diarrhea, with fever, painful abdominal cramps, or blood or pus in your stool.

Source: http://www.mayoclinic.com

Causes

Usually, your body keeps the many bacteria in your colon in a naturally healthy balance. However, antibiotics and other medications can upset this balance. Pseudomembranous colitis occurs when certain bacteria — usually C. difficile — rapidly outgrow other bacteria that normally keep them in check. Certain toxins produced by C. difficile, which are usually present in only tiny amounts, rise to levels high enough to damage the colon.

While almost any antibiotic can cause pseudomembranous colitis, some antibiotics are more likely to cause pseudomembranous colitis than others:

  • Fluoroquinolones, such as ciprofloxacin (Cipro) and levofloxacin (Levaquin)
  • Penicillins, such as amoxicillin and ampicillin
  • Clindamycin (Cleocin)
  • Cephalosporins, such as cefixime (Suprax)

Other causes

Other medications besides antibiotics can sometimes cause pseudomembranous colitis. Chemotherapy drugs that are used to treat cancer may disrupt the normal balance of bacteria in the colon.

Certain diseases that affect the colon, such as ulcerative colitis or Crohn's disease, may also predispose people to pseudomembranous colitis.

C. difficile spores are resistant to many common disinfectants and can be transmitted from the hands of health care professionals to patients. Increasingly, C. difficile has been reported in people with no known risk factors, including people with no recent health care contact or use of antibiotics. This is called community-acquired C. difficile.

Source: http://www.mayoclinic.com

Diagnosis

Tests and procedures used to diagnose pseudomembranous colitis and to search for complications include:

  • Stool sample. There are a number of different stool sample tests used to detect C. difficile infection of the colon.
  • Blood tests. These may reveal an abnormally high white blood cell count (leukocytosis), which may indicate pseudomembranous colitis.
  • Colonoscopy or sigmoidoscopy. In both of these tests, your doctor uses a tube with a miniature camera at its tip to examine the inside of your colon for signs of pseudomembranous colitis — raised, yellow plaques (lesions), as well as swelling.
  • Imaging tests. If you have severe symptoms, your doctor may obtain an abdominal X-ray or an abdominal CT scan to look for complications such as toxic megacolon or colon rupture.

Source: http://www.mayoclinic.com

Complications

Treatment of pseudomembranous colitis is usually successful. However, even with prompt diagnosis and treatment, pseudomembranous colitis can be life-threatening. Possible complications include:

  • Abnormally low levels of potassium in your blood (hypokalemia), due to the loss of potassium during excessive diarrhea
  • Dehydration leading to abnormally low blood pressure (hypotension), related to significant loss of fluids and electrolytes due to diarrhea
  • Kidney failure, due to severe dehydration resulting from diarrhea
  • A hole in your bowel (perforated colon), which can lead to an infection of your abdominal cavity
  • Toxic megacolon, a rare but serious swelling of the colon, leaving it incapable of expelling gas and stool, which could cause your colon to rupture

In addition, pseudomembranous colitis may sometimes return, days or even weeks after apparently successful treatment.

Source: http://www.mayoclinic.com

Lifestyle and home remedies

Some research suggests that concentrated supplements of good bacteria and yeasts (probiotics) can help prevent C. difficile infection, but more studies are needed for their use in treating recurrences. They are safe to use and available in capsule or liquid form without a prescription.

To cope with the diarrhea and dehydration that can occur with pseudomembranous colitis, try to:

  • Drink plenty of fluids. Water is best, but fluids with added sodium and potassium (electrolytes) also may be beneficial. Avoid beverages that are high in sugar or contain alcohol or caffeine, such as coffee, tea and colas, which can aggravate your symptoms.
  • Choose soft, easy-to-digest foods. These include applesauce, bananas and rice. Avoid high-fiber foods, such as beans, nuts and vegetables. If you feel your symptoms are improving, slowly add high-fiber foods back to your diet.
  • Eat several small meals, rather than a few large meals. Space the smaller meals throughout the day.
  • Avoid irritating foods. Stay away from spicy, fatty or fried foods, and any other foods that make your symptoms worse.

Source: http://www.mayoclinic.com

Risk factors

Factors that may increase your risk of pseudomembranous colitis include:

  • Taking antibiotics
  • Staying in the hospital or a nursing home
  • Increasing age, especially over 65 years
  • Having a weakened immune system
  • Having a colon disease, such as inflammatory bowel disease or colorectal cancer
  • Undergoing intestinal surgery
  • Receiving chemotherapy treatment for cancer

Source: http://www.mayoclinic.com

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