Clostridium Difficile Colitis (C. Diff) – A Normal Bactria Gone Bad.

Medically reviewed by: Gary H. Hoffman, MD

What Is C. Diff. Colitis?

With the advent and increased usage of antibiotics, especially broad spectrum antibiotics, we have seen a rise in the number of cases of Clostridium Difficile (C. Diff.) colitis.  Clostridium Difficile colitis is responsible for up to 14,000 deaths per year in the United States.

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In times past, colon and rectal surgeons, also known as proctologists, rarely saw a case of this debilitating illness.  However, with the sometimes indiscriminate use of antibiotics, there has been a strong uptick in the case volume.  Clostridium Difficile colitis is treatable, but often, is fatal.

How Do I contract Clostridium Difficile Colitis and How Do I know If I have it?

C. Diff. colitis is caused by the spores of a bacteria known as clostridium difficile.  These spores are hardy and difficult to kill with normal hand washing techniques.  Dilute bleach solution is the only reliable sporicidal agent, although soap may also kill spores.  But, why is the disease more common in patients who recently were treated with antibiotics?  Why are hospitalized patients even more susceptible?  Clostridium difficile is normally present in small amounts in our gastrointestinal tracts.  When antibiotics alter or deplete our normal bacteria, c. diff. is allowed to overgrow the colon lining and cause symptoms.  Even more specialized antibiotics are required to treat a c. diff. infection.

Symptoms include diarrhea, abdominal bloating, fever, loss of appetite and nausea.  In hospitalized patients on antibiotics, the diagnosis should be considered.  Patients may have foul smelling bowel movements or watery diarrhea.  Many of the symptoms are due to a toxin produced by the bacteria.  It is this toxin that enables physicians to test the diarrheal stool for the presence of the toxin.  When your proctologist examines your rectum or colon, there will be pseudo membranes seen lining the wall.

Prevention.  The Best Treatment.

Frequent hand washing with dilute bleach solutions is excellent prevention, especially around hospitalized patients or around known carriers of clostridium difficile.  Soap is also helpful in reducing spore counts.  Obviously, the wearing of protective gloves is a must.  Isolation of patients known to be infected with c. diff. is very important.

When C. Diff. is Active.

The two most commonly used drugs in the treatment of colitis are oral metronidazole (Flagyl®) and intravenous vancomycin.  The diarrhea must run its course during treatment.  Drugs to slow or stop the diarrhea may actually worsen the illness.

Recently the use of fecal bacteria from healthy donors has shown great promise in eradicating resistant disease.  The technique is known as F.M.T., or fecal microbial transplantation.  The bacteria is inserted into the colon using a colonoscope.  The results have been excellent, eradicating the disease in up to 90% of those who did not respond to standard antibiotic therapy.

In those with fulminant disease, known as toxic megacolon, an emergency colon resection may be required.  Although this may sound extreme, it may be life saving.

Los Angeles Colon And Rectal Surgical Associates.

Your board certified surgeons of Los Angeles Colon And Rectal Surgical Associates are often asked to see and treat hospitalized patients with clostridium difficile colitis.  In the outpatient setting, the surgeons frequently perform fecal microbial transplantation.  Results to date have been excellent.  While FMT sounds extreme, it may be life changing, and patients are happy to have had the transplantation.  Call (310)273-2310 to schedule a confidential and in-depth consultation.

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