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Pseudomembranous colitis

21:53 - 4 May , 2021

Disease

What is Pseudomembranous colitis?

It is an inflammatory condition of the colon due to an infection caused by an excessive increase in the bacteria Clostridioides difficile (C. difficile), which is naturally present in the intestine, but it can multiply after taking antibiotics or hospitalization, releasing a toxin that inflames the colon and causes severe diarrhea, among other symptoms.

This condition is also known as antibiotic-associated colitis and can affect people of any age, but it has a higher incidence in older adults.

The severity of pseudomembranous colitis is high, since despite being diagnosed and treated promptly, it can lead to a series of complications with fatal consequences. Potential complications include:

  • Extreme diarrhea: can cause severe dehydration and affect organ physiology until severely decreasing blood pressure.
  • Accelerated dehydration: with a high risk of causing kidney failure.
  • Toxic megacolon: it is an exaggerated inflammation of the colon that can cause a wall to break, spreading the infection to the abdomen, causing a reserved prognosis.
  • Intestinal perforation: causes an infection called peritonitis, which can lead to death.

It is a difficult infection to cure because the bacteria that causes it has become resistant to various antibiotics, so even after receiving treatment, it may reappear after a short time. Therefore, it is important not to take antibiotics unnecessarily and avoid self-medication.

Symptoms

Symptoms can manifest a few days after concluding an antibiotic treatment or they can appear months later:

  • Nausea.
  • Liquid diarrhea.
  • More than eight bowel movements a day.
  • Moderate to severe abdominal pain.
  • High fever.
  • Blood, pus, or mucus in the stool.
  • Dehydration.

Diagnosis and treatment

Once your doctor analyzes your symptoms and clinical history, they will perform a physical examination and request the following tests to confirm the diagnosis and identify possible complications: 

  • Blood tests.
  • Stool culture.
  • Colonoscopy.
  • X-rays.
  • Ultrasound.
  • Computed tomography.

The treatment to be followed will depend on the severity of the case and the type of complications caused by the infection, but in most cases it begins with the suspension of the antibiotic that caused it (if you are still taking the drugs that caused it), and the prescription of a specific antibiotic for the bacteria C. difficile.

If your condition is severe, you will have a fecal transplant to implant healthy intestinal microbiota and restore the bacterial balance.

When there is a ruptured colon or serious intestinal insufficiency, the only option is surgery to repair the damage.

At ABC Medical Center’s Internal Medicine Department, we offer health care services with the highest quality and safety, from the prevention, diagnosis, timely treatment, and monitoring of infectious, respiratory, endocrinological, dermatological, rheumatic, nephrological, gastrointestinal, and hematological pathologies of both chronic-degenerative diseases and acute conditions, through a comprehensive and multidisciplinary model.

Fuentes:

  • cun.es
  • medlineplus.gov
  • mayoclinic.org
  • msdmanuals.com
  • cigna.com
  • topdoctors.es
  • medigraphic.com
  • Casanova-Cardiel LJ, Ornelas-Corral L, Vega-Nájera CA, et al. Colitis pseudomembranosa, un problema en México. Informe de un brote y su control. Med Int Mex. 2020;36(5):716-721.
  • Aldana-Ledesma JM, Velarde-Ruiz VJA. Colitis pseudomembranosa en paciente con íleo. Rev Med MD. 2018;9.10(2):196.
  • Ontañón ZD, Gutiérrez LI, Rivas NJP, et al. Estudio de concordancia y grado de acuerdo entre dos pruebas diagnósticas de infección por Clostridium difficile. An Med Asoc Med Hosp ABC. 2018;63(2):100-104.
  • Tartabull-Poutriel K, Toledo-Cabarcos Y, Nicolau-Pestana E. Colitis pseudomembranosa: a propósito de un caso. AMC. 2019;23(2):264-2698.

						
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