DE
Home Offer Syndromes Clostridioides (formerly Clostridium) difficile colitis

Clostridial colitis: causes, symptoms and treatment!

Colitis caused by Clostridioides difficile (C. difficile) is an inflammation of the large intestine (colon) that results in diarrhea. The inflammation is caused by the toxin produced by C. difficile bacteria and usually occurs after taking antibiotics that cause these bacteria to grow in the intestine.

Many terms such as antibiotic-associated colitis, pseudomembranous colitis, Clostridioides difficile-induced diarrhea or C. diff. Colitis are used today to describe Clostridioides difficile colitis.

  • Colitis due to C. difficile usually occurs after taking antibiotics.
  • Typical symptoms range from slightly loose stools to bloody diarrhea, abdominal pain and fever
  • doctors examine the stool and sometimes the colon using an observation tube in people with symptoms of colitis due to C. difficile.
  • In most people with mild colitis due to C. difficile, symptoms improve after stopping the antibiotic that caused the colitis, after which another antibiotic is taken.

Clostridioides difficile (C. difficile) does not need oxygen to live. For this reason, these bacteria are classified as anaerobes.

What causes can C. difficile colitis have?

In C. difficile colitis, bacterial toxins cause inflammation of the colon (colitis), which usually occurs after taking antibiotics to treat an infection. Many antibiotics alter the balance between the types and amounts of bacteria that live in the gut. As a result, certain disease-causing bacteria such as C. difficile can take over and crowd out the harmless bacteria that normally live in the gut. C. difficile is the most common cause of colitis that develops after taking antibiotics.

When C. difficile bacteria overgrow, they release Clostridium difficile toxins that cause diarrhea, inflammation and the formation of abnormal membranes (pseudomembranes) in the colon.

A more dangerous strain of C. difficile has been identified in some hospital epidemics. This strain produces significantly more toxins, the course of the disease is more severe with a higher likelihood of relapse, the disease is more transmissible and it does not respond as well to antibiotics.

Almost any antibiotic can cause this disease, but clindamycin, penicillins (such as ampicillin and amoxicillin), cephalosporins (such as ceftriaxone) and fluoroquinolones (such as levofloxin and ciprofloxacin) are most commonly implicated. Colitis due to C. difficile can also occur after very short courses of antibiotics. C. difficile-related colitis can also follow the use of certain anti-cancer chemotherapeutic agents or immunosuppressants.

The risk of developing colitis due to C. difficile increases with age, as does the risk of a severe course of the disease. Other risk factors:

  • Presence of one or more serious illnesses
  • A prolonged stay in hospital
  • Living in a nursing home
  • Gastrointestinal surgery
  • An illness or taking a drug that weakens stomach acid
    • Proton pump inhibitors
    • Histamine-2 blockers (H2 blockers), which are used to treat GERD and stomach ulcers.

Sometimes the affected person's own intestinal tract is the source of the bacteria. C. difficile bacteria are commonly found in the intestines of newborns, healthy adults and adults who have been hospitalized. In these people, C. difficile does not usually cause illness unless the bacteria get out of hand. However, these people can transmit clostridia to people at risk. The spread from person to person can be prevented by washing hands.

People can also pick up the bacteria from pets or the environment.

Colitis due to a C. difficile infection rarely occurs unless patients have recently taken antibiotics. However, physically stressful events such as surgery (typically on the stomach or intestines) can likely lead to the same type of imbalance in the type and amount of bacteria in the gut or disrupt the gut's natural defense mechanisms, which in turn promotes C. difficile infection and the development of colitis.

What symptoms can be caused by C. difficile colitis?

Symptoms of Clostridia difficile infection usually begin 5 to 10 days after the first dose of the antibiotic, but may appear as early as the first day or as late as 2 months later.

Symptoms vary according to the degree of inflammation caused by the bacteria, ranging from slightly loose stools to bloody diarrhea, abdominal pain with cramps and fever. nausea and vomiting are rare.

Very severe disease can cause life-threatening fluid loss (dehydration), lowered blood pressure (hypotension), a toxic magacolon and intestinal perforation.

How is the diagnosis of C. difficile colitis made?

  • Stool examinations
  • Endoscopically by sigmoidoscopy or colonoscopy

Your doctor will suspect colitis due to C. difficile in anyone who develops diarrhea within 2 months of using an antibiotic or within 72 hours of hospital admission.

The diagnosis is confirmed by a series of stool tests. doctors perform tests to detect toxins produced by C. difficile and a specific enzyme released by the bacteria. doctors also perform tests such as PCR to detect the presence of the bacteria's genetic material (DNA).

A doctor can also diagnose colitis due to C. difficile by inspecting the lower section of the inflamed colon (the sigmoid colon), which is usually done via endoscopy. If he observes a certain type of inflammation, known as pseudomembranous colitis, colitis due to C. difficile is diagnosed.

Treatment of colitis due to C. difficile

  • Discontinuation of the antibiotics causing the colitis
  • Taking an antibiotic that is effective against C. difficile
  • In severe, recurrent cases, a stool transplant (FMT)

If someone with colitis due to C. difficile develops diarrhea while taking antibiotics, the drugs are stopped immediately unless they are vital. Once the antibiotic is stopped, symptoms usually resolve within 10 to 12 days. If symptoms are severe or prolonged, patients are usually given an antibiotic that is effective against C. difficile.

Usually, drugs (e.g. loperamide) that people sometimes take to slow bowel movements and treat diarrhea are avoided. These drugs can prolong the illness by allowing the disease-causing toxin to remain in the colon.

Most cases of colitis due to C. difficile are treated with the oral antibiotic vancomycin. Fidaxomicin, a relatively new antibiotic, appears to be very effective and is less likely to cause a recurrence of symptoms.

Symptoms recur in 15 to 20 percent of patients, typically within a few weeks of stopping treatment. If the diarrhea returns for the first time, the patient is treated again with the same antibiotic. If the diarrhea persists, vancomycin is usually given for several weeks before the antibiotic rifaximin is sometimes prescribed. Fidaxomicin for 10 days is an alternative.

For severe and frequently recurring symptoms, fecal matter transplantation (FMT) is another option. In this procedure, approximately one cup of stool (around 200 to 300 milliliters) from a healthy donor is inserted into the patient's colon. The donor stool is first tested for microorganisms that can cause disease. This can be done in the form of an enema, through a tube through the nose into the digestive tract or through a colonoscope. It is believed that donor stool restores normal intestinal flora in a patient with colitis due to C. difficile. After this treatment, symptoms occur less frequently.

Occasionally, colitis due to C. difficile is so severe that the person needs to be hospitalized, where they receive intravenous fluids, electrolytes (such as sodium, magnesium, calcium and potassium) and blood transfusions.