Overview
Pseudomembranous colitis is a condition characterized by inflammation of the colon, associated with an overgrowth of the bacterium Clostridioides difficile (formerly Clostridium difficile). It is also known as antibiotic-associated colitis or C. difficile colitis. The overgrowth of C. difficile often occurs due to recent hospital stays, antibiotic treatment, or other medications that disrupt the normal balance of bacteria in the colon. Symptoms may include watery diarrhea, stomach cramps, fever, pus or mucus in the stool, nausea, and dehydration. Pseudomembranous colitis can be a complication of antibiotic use or other factors, such as certain diseases affecting the colon or exposure to healthcare settings.
Understanding the disease
Symptoms
Symptoms of pseudomembranous colitis may include watery diarrhea, stomach cramps, pain or tenderness, fever, pus or mucus in the stool, nausea, and dehydration. These symptoms can start within 1 to 2 days of taking antibiotics or sometimes even several months or longer after finishing the antibiotic treatment. If you experience any of these symptoms, it is important to contact your healthcare provider.
Risk Factors
The risk factors for developing pseudomembranous colitis include:
- Recent hospital stay or antibiotic treatment.
- Advanced age, particularly over 65 years.
- Weakened immune system.
- Having a colon disease, such as inflammatory bowel disease or colorectal cancer.
- Undergoing intestinal surgery.
- Receiving chemotherapy treatment for cancer.
- Use of certain antibiotics, especially those that disrupt the normal gut microbiome.
- Community-acquired C. difficile (infections from sources outside of healthcare settings). A new aggressive strain of C. difficile has emerged, which may be more resistant to certain medicines and has been reported in people with no known risk factors.
Development
Pseudomembranous colitis can develop due to an overgrowth of the bacterium Clostridioides difficile (formerly Clostridium difficile), often called C. diff. This overgrowth is often related to a recent hospital stay, antibiotic treatment, or other factors that disrupt the normal balance of bacteria in the colon. Other medicines besides antibiotics, such as chemotherapy drugs, and certain diseases affecting the colon, like ulcerative colitis or Crohn's disease, can also contribute to the development of pseudomembranous colitis. An aggressive strain of C. difficile has emerged, which may be more resistant to certain medicines and has been reported in people without known risk factors or recent healthcare contact.
Assessment and Diagnosis
Triage
If you are currently taking or have recently taken antibiotics and you develop diarrhea, contact your health care provider, even if the diarrhea is relatively mild. Also, see your provider anytime you have severe diarrhea, with a fever, painful stomach cramps, or blood or pus in your stool.
Diagnosis
To diagnose pseudomembranous colitis, medical professionals typically perform the following tests and procedures:
- Stool sample: This test detects Clostridioides difficile (C. difficile) infection in the colon.
- Blood tests: They may indicate an infection like C. difficile if you have diarrhea and an unusually high white blood cell count.
- Colonoscopy or sigmoidoscopy: These tests involve examining the colon for raised, yellow plaques called lesions and swelling.
- Imaging tests: If you have severe symptoms, your healthcare provider may use X-rays or CT scans to look for complications like toxic megacolon or colon rupture.
Management and Treatment
Complications
Potential complications of pseudomembranous colitis include dehydration and kidney failure. Severe diarrhea can lead to a significant loss of fluids and electrolytes, making it difficult for the body to function and causing blood pressure to drop to dangerously low levels. In some cases, dehydration can occur so quickly that kidney function rapidly deteriorates, causing kidney failure. Prompt diagnosis and treatment are essential to manage these complications.
Home Remedies
It is important to consult with a healthcare provider for proper diagnosis and treatment of pseudomembranous colitis, as it can be a serious and potentially life-threatening condition.
Treatment
Treatment for pseudomembranous colitis typically involves addressing the overgrowth of Clostridioides difficile (C. difficile) bacteria and restoring the normal balance of gut bacteria. The following treatment options may be considered:
- Stopping the offending antibiotic: If the pseudomembranous colitis is linked to antibiotic use, your healthcare provider may recommend stopping the antibiotic or switching to a different one that is less likely to cause gut imbalances.
- Metronidazole or vancomycin: These antibiotics are commonly used to treat C. difficile infections. They target the bacteria responsible for the overgrowth and help to reduce the inflammation and symptoms associated with the condition.
- Probiotics: Probiotic supplements or foods containing live bacteria, such as yogurt, kefir, or fermented foods, can help restore the normal balance of gut bacteria.
- Oral rehydration: If dehydration is present, your healthcare provider may recommend oral rehydration solutions to replace lost fluids and electrolytes.
- Fecal microbiota transplant (FMT): In severe cases or when antibiotics fail to work, fecal microbiota transplant involves transferring fecal matter from a healthy donor to the affected individual to introduce healthy gut bacteria and restore the balance. It is important to consult with a healthcare professional for an accurate diagnosis and appropriate treatment plan tailored to your specific situation.
Preparing for medical consultation
To prepare for an appointment for pseudomembranous colitis, you should:
- Make an appointment with your primary healthcare provider or a gastroenterologist.
- Ask if there are any tests or preparations required before the appointment, such as fasting before specific tests.
- Create a list of your symptoms, including those that may seem unrelated to pseudomembranous colitis.
- Gather information about your personal and family medical history, recent life changes, and any major stresses.
- Compile a list of all medications, vitamins, or supplements you are currently taking, including doses.
- Bring someone with you to the appointment to help remember important information and provide support. During the appointment, be prepared to answer questions about the onset and severity of your symptoms, any improvements or worsening of symptoms, and any other medical conditions you may have. Remember to ask any questions you may have about your condition, diagnosis, treatment options, and how to manage your symptoms.