Clostridium difficile colitis involves inflammation of the large intestine that triggers episodes of diarrhea. This inflammation can be caused by growth of unusual bacteria that results from antibiotic use.
Various antibiotics are capable of altering the equilibrium among the types and number of bacteria present in the intestine, thus allowing some bacteria to grow and replace other bacteria. The form of bacteria that overgrows and triggers infection is Clostridium difficile. It is important to note that this infection releases 2 toxins that results to the swelling of the protective coating of the large intestine.
The antibiotics known to cause the disorder include penicillin, clindamycin, fluoroquinolones and cephalosporin. Clostridium difficile colitis can also occur after using certain cancer chemotherapy medications.
What are the indications of clostridium difficile colitis?
The indications of clostridium difficile colitis usually start 5-10 days after antibiotics were started and can manifest on the first day. Nevertheless, some who have this condition will not have any symptoms until 1-10 days after treatment has been stopped. In some, the symptoms do not manifest for 2 months.
The symptoms vary based on the degree of inflammation triggered by the bacteria that ranges from slightly loose stools or even blood-streaked diarrhea, fever and abdominal pain. Vomiting and nausea are considered rare. In severe cases, it can involve life-threatening dehydration, toxic megacolon, low blood pressure and even perforation of the large intestines.
How is it diagnosed
The doctor will suspect clostridium difficile colitis if the individual has diarrhea within 2 months of using an antibiotic or within 72 hours of being admitted to a healthcare facility.
A diagnosis is confirmed if one of the toxins released produced by clostridium difficile is identified in the stool sample. In some cases, 2-3 stool samples might be required before the toxin is detected.
Treatment for clostridium difficile colitis
In case an individual with clostridium difficile colitis ends up with diarrhea while using antibiotics, the drugs are discontinued right away unless they are needed. The drugs that slow down the movement of the intestine are avoided since they prolong the condition by keeping the toxin in contact with the large intestine.
In most cases of clostridium difficile colitis, the antibiotic metronidazole is effective. If the episodes of diarrhea recurs repeatedly, an extended therapy under antibiotics is needed.
As for severe cases, an individual with clostridium difficile colitis might require hospitalization so that intravenous fluids, electrolytes and blood transfusions can be given. In rare circumstances, surgery is required.