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Pseudomembranous colitis is caused by an overgrowth of Clostridium difficile bacteria in the large intestine, often due to antibiotic use. Symptoms include bloody diarrhea, stomach cramps, and fever. Treatment involves stopping antibiotics, providing fluids, and using specialized antibiotics. Surgery may be necessary in severe cases.
Pseudomembranous colitis is a potentially serious infection of the large intestine. It is caused by excessive levels of a very common bacterium called Clostridium difficile (C. difficile) in the intestines. In most cases, people acquire pseudomembranous colitis after taking antibiotics for other conditions, which leads to an imbalance of bacteria in the body. Doctors can usually treat the infection by stopping the use of antibiotics and providing fluids to prevent dehydration.
C. difficile is normally a class of harmless bacteria that lives in the large intestine of nearly all people. However, if other bacteria are destroyed with antibiotics, C. difficile can overgrow and cause a toxic response. The result is usually severe inflammation of the intestinal lining that causes it to bleed and ooze pus. Any antibiotic has the potential to trigger pseudomembranous colitis, but penicillin and other drugs for Staphylococcus aureus infections are the most common causes. Active infections are highly contagious, and outbreaks are common in hospitals.
Symptoms of pseudomembranous colitis can begin shortly after the first dose of an antibiotic is taken, but it usually takes a few days for a person to experience any physical discomfort. A person who has an active infection is likely to experience frequent bloody diarrhea, stomach cramps, fever, and nausea. Dehydration due to fluid loss in diarrhea is a common complication. If left untreated, irritation of the lining of the intestines can cause it to tear. A perforated colon is potentially life-threatening, as bacteria can migrate throughout the body through the hole in the intestines.
Most people who get pseudomembranous colitis are already hospitalized for another condition that required antibiotic treatment. If a person taking prescription antibiotics at home has gastrointestinal problems, they should seek help as soon as possible. A doctor can diagnose pseudomembranous colitis by analyzing the contents of stool samples and examining the intestines via colonoscopy. If your doctor suspects a lesion in your colon, he may also take x-rays.
Treatment for pseudomembranous colitis depends on the severity of the symptoms. Most patients have to be admitted to hospital rooms and given intravenous fluids to treat the symptoms of dehydration. Antibiotic use for other ailments is stopped immediately to prevent the condition from worsening. Specialized antibiotic drugs containing metronidazole or vancomycin may be given to reduce C. difficile toxicity. With prompt treatment, the condition tends to improve over the course of about 10 days.
Surgery may be needed if there is severe damage to the colon. A surgeon may try to repair the tissue and possibly remove a section of the intestine. The prognosis after surgery is generally good when most of the colon can be repaired. Patients usually need to take medications and schedule regular checkups to prevent recurring infections.
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