| Clostridium
difficile colitis (commonly known as "c diff" for short)
is a potentially serious and life-threatening infection of the intestine.
The C diff bacteria is naturally occurring and is present in the
intestines in a small percentage of patients. In small numbers it
does not cause disease. The bacteria can be acquired from other
persons with the bacteria; so it is potentially contagious. It can
also proliferate in patients taking certain antibiotics, namely
Ampicillin, Clindamycin and Cephalosporins. Antibiotics have been
found to disrupt the normal digestive tract flora and can cause
the C diff bacteria to multiply. This can result in active C difficile
infection.
Infectious C difficile colitis results in the production of toxins
in the bowel, which can cause numerous symptoms, including diarrhea,
cramps, fever, high white blood cell counts, dehydration and potentially…sepsis
and toxic megacolon. Once the diagnosis of C diff has been confirmed
by laboratory testing of the stool, the patient requires prompt
treatment. Here are some recognized do's and don'ts in patients
who are being treated for c diff. DO: discontinue
the implicated antibiotic; institute oral vancomycin or metronidazole
therapy for severe cases; isolate the patient from others if the
patient is hospitalized. DON'T: Use antiperistaltic
agents, which will slow function of the colon and keep the toxins
present in the intestine, increasing the likelihood of recurrence
and/or toxic megacolon. Examples of drugs that will effect peristalsis
(sometimes referred to as motility) are Lomotil, Imodium, and
opiate medications.
While a potentially
serious condition, c diff, if promptly and correctly
treated usually results in a favorable outcome. Even in patients
with the more recent and serious strain of c difficile colitis,
which carries with it a slightly increased risk of mortality,
approximately 80-83% of patients survive. Patients with increased
risk factors for a less favorable outcome include: patients who
are 65 or older, patients who acquire the infection in the hospital,
and, patients who are immunosupressed. Contrarily, those patients
without the foregoing risk factors tend to have better short and
long-term outcomes.
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