Pseudomembranous colitis (patient information)

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Aarti Narayan, M.B.B.S [2]

Overview

Pseudomembranous colitis is infection of the large intestine (colon) with an overgrowth of Clostridium difficile bacteria.

What are the symptoms of Pseudomembranous colitis?

• Abdominal cramps (mild to severe)
• Bloody stools
• Fever
• Urge to have a bowel movement
• Watery diarrhea (often five to 10 times per day)

What are the causes of Pseudomembranous colitis?

The Clostridium difficile bacteria is normally seen in the intestine. However, it may overgrow when you take antibiotics. The bacteria release a powerful toxin that causes the lining of the colon to become inflammed and bleed.

The most common antibiotics associated with this condition are ampicillin, clindamycin, fluoroquinolones, and cephalosporins.

Pseudomembranous colitis is rare in infants younger than 12 months old and uncommon in children. It is most often seen in people who are in the hospital. However, it is becoming more common in people who take antibiotics and who are not in the hospital.

Who is at risk for Pseudomembranous colitis?

Risk factors include

• Older age

• Antibiotic use

• Use of medicines that weaken the immune system, including chemotherapy

• Recent surgery

• Personal history of pseudomembranous colitis

How to know you have Pseudomembranous colitis(Diagnosis)?

Either or both of the following tests will confirm the disorder

• Colonoscopy or flexible sigmoidoscopy
• Immunoassay for C. difficile toxin in the stool

When to seek urgent medical care?

Call your health care provider if the following symptoms occur:

• Bloody stools after taking antibiotics
• Five or more episodes of diarrhea per day for more than 1-2 days
• Severe abdominal pain
• Signs of dehydration (dry skin, dry mouth, glassy appearance of the eyes, sunken soft spots on top of head in infants, rapid pulse, confusion, excessive tiredness)

Treatment options

The antibiotic or other medicine causing the condition should be stopped. Metronidazole is usually used to treat the disorder, but other medicines may also be used.

Electrolyte solutions or fluids given through a vein may be needed to treat dehydration due to diarrhea. In rare cases, surgery is needed to treat infections that get worse or do not respond to antibiotics.

Prevention of Pseudomembranous colitis

People who have had pseudomembranous colitis should inform their doctors before taking antibiotics again.

What to expect (outlook/Prognosis)?

If there are no complications, the outlook is generally good. However, up to 20% of infections may return, requiring additional treatment.

Possible Complications

• Dehydration with electrolyte imbalance
• Perforation of (hole through) the colon
• Toxic megacolon

Sources

• http://www.nlm.nih.gov/medlineplus/ency/article/000259.htm

References

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