Pseudomembranous colitis is inflammation (swelling, irritation) of the large intestine. In many cases, it occurs after taking antibiotics. The use of antibiotics can cause the bacteria to overgrow and infect the lining of the intestine, leading to inflammation. Certain antibiotics, such as penicillin, clindamycin, cephalosporins, and fluoroquinolones, make the overgrowth of Clostridium difficile more likely.
Who is at risk for pseudomembranous colitis?
Individuals at the highest risk for developing pseudomembranous colitis include:
- Residents of nursing homes
- People who are hospitalized for long periods
- Individuals with serious medical conditions
What causes pseudomembranous colitis?
For some people, Clostridium difficile is part of the normal bacterial flora or collection of bacteria in the gastrointestinal tract. Pseudomembranous colitis arises from changes in the bacterial flora following antibiotic use.
In some cases, the use of antibiotics can cause the uncontrolled growth of Clostridium difficile, which releases toxins (poisons) into the intestinal tissues. These toxins damage the lining of the intestine and cause symptoms of pseudomembranous colitis.
What are the symptoms of pseudomembranous colitis?
Symptoms of pseudomembranous colitis include:
- Frequent watery diarrhea, which may be bloody
- Abdominal pain and tenderness
- Cramping
- Nausea
- Fever
- Loss of appetite
In more severe cases, sepsis (a potentially dangerous overreaction of the body to infection) may occur.
Most people with pseudomembranous colitis notice symptoms 5 to 10 days after starting antibiotic treatment.
How is pseudomembranous colitis diagnosed?
Pseudomembranous colitis is diagnosed by examining a stool sample in a laboratory to identify toxins produced by Clostridium difficile. Doctors can also diagnose pseudomembranous colitis through sigmoidoscopy, a procedure that uses a thin, flexible tube (sigmoidoscope) allowing your doctor to view the inside of your large intestine.
How is pseudomembranous colitis treated?
The first thing your doctor may recommend is to stop taking the antibiotic that led to pseudomembranous colitis. Treatment typically involves antibiotics that target this infection. In most cases, doctors prescribe metronidazole, vancomycin, or fidaxomicin for up to 14 days.
Pseudomembranous colitis can recur in up to 20% of individuals who have been treated. If this happens, your doctor will prescribe another course of antibiotics.
A newer treatment known as fecal microbiota transplantation uses stool from a healthy donor to help restore normal bacterial flora in your intestine, especially if the infection has returned after the first treatment.
What complications are associated with pseudomembranous colitis?
Complications of pseudomembranous colitis include:
- Some people suffer from recurrent Clostridium difficile infections, leading to repeated episodes of pseudomembranous colitis.
- If the Clostridium difficile infection worsens, you may become dehydrated from frequent diarrhea. In rare cases, pseudomembranous colitis can cause toxic megacolon (severe intestinal dilation or swelling), intestinal perforation, or sepsis. These conditions are medical emergencies that require immediate attention.
Contact a doctor immediately if you experience signs of these complications, such as:
- Severe abdominal distension (bloating) and pain
- Rapid heart rate (tachycardia)
- Abdominal tenderness
Can pseudomembranous colitis be prevented?
Pseudomembranous colitis from uncontrolled growth of Clostridium difficile can be prevented by following basic hygiene practices:
- Wash your hands frequently with soap and water.
- Wash your hands after visiting someone in a nursing home or hospital.
- Disinfect surfaces with bleach-based cleaning products.
- Do not use antibiotics unless prescribed by your doctor.
- If you care for someone with Clostridium difficile, wear disposable gloves and wash your hands after each contact.
- If your clothes become soiled with feces from someone infected with Clostridium difficile, wash them with soap and bleach.
What are the prospects for individuals with pseudomembranous colitis?
With treatment, most people fully recover from pseudomembranous colitis. For a small number of individuals, the recurrence of Clostridium difficile can lead to repeated episodes of the disease.
When should I call my doctor about pseudomembranous colitis?
If you experience symptoms of pseudomembranous colitis, especially if you have recently taken antibiotics, contact your doctor for evaluation and treatment.
Source: https://my.clevelandclinic.org/health/diseases/17718-pseudomembranous-colitis