Antibiotic-associated Colitis—C difficile

(Antibiotic-associated Diarrhea, Clostridium difficile-induced Colitis, C diff)

by Krisha McCoy, MS

Definition

Antibiotic-associated colitis is when the colon (large intestine) becomes inflamed due to an infection. You may have diarrhea and abdominal cramping. The infection is often very serious.

The Stomach, Liver, and Intestines

© 2009 Nucleus Medical Media, Inc.

Causes

Your colon is normally full of good bacteria. When you take antibiotics, they often killall the good bacteria in your intestine. This creates a perfect environment for bacteria called Clostridium difficile, which are not killed by the antibiotics, to grow out of control. The overgrowth of this bacteria leads to inflammation and irritation.

Risk Factors

A risk factor is something that increases your chances of getting a disease or condition. The following risk factors increase your chances of having this condition. If you have any of these risk factors, tell your doctor:

• You use antibiotics.
• You are elderly.
• You are or have been hospitalized.
• You have a severe illness.

Other possible risk factors include:

• Enteral feeding
• Taking medicine to decrease the amount of acid the stomach makes.
• Gastrointestinal surgery (stomach or intestine surgery)
• Chemotherapy
• Bone marrow transplant

Symptoms

If you have any of these symptoms, do not assume it is due to antibiotic-associated colitis. These symptoms may be caused by other, less serious health conditions. If you experience any one of them, see your doctor.

• Loose stools
• Watery or mucousy diarrhea
• Abdominal pain
• Fever
• Nausea and vomiting (rare)
• Dehydration
• Low blood pressure

Diagnosis

Your doctor will ask about your symptoms and medical history, and do a physical exam. Tests may include:

• Stool samples—to identify the toxins made by the bacteria
• CT scan—a type of x-ray that uses a computer to make pictures of the inside of the body
• Colonoscopy—a thin, lighted tube inserted through the rectum and into the colon to examine the lining of the colon

Treatment

If you are diagnosed with this condition, follow your doctor's instructions.

Talk with your doctor about the best treatment plan for you. Treatment options include the following:

Prevention

The best way to prevent this condition is to reduce using antibiotics. Antibiotics should only be used when your doctor has confirmed that you have a bacterial infection.

If you are prescribed antibiotics, ask your doctor if you should take a probiotic also, which may help protect the normal bacterial growth in your intestines.

Crohn’s and Colitis Foundation of America
http://www.ccfa.org

National Digestive Diseases Information Clearinghouse
http://digestive.niddk.nih.gov

Canadian Association of Gastroenterology
http://www.cag-acg.org/default.aspx

Canadian Digestive Health Foundation
http://www.cdhf.ca/index.html

REFERENCES:

Antibiotic-associated colitis. Merck website. Available at: http://www.merck.com/mmhe/sec09/ch127/ch127a.html. Accessed November 30, 2006.

Antibiotic-associated diarrhea. DynaMed website. Available at: http://dynamed102.epnet.com/Detail.aspx?id=114443. Accessed November 30, 2006.

Antibiotic-associated diarrhea. Mayo Clinic website. Available at: http://www.mayocli.... Accessed November 30, 2006.

Clostridium difficile colitis. DynaMed website. Available at: http://dynamed102..... Accessed November 30, 2006.

Use of gastric acid-suppressive agents and the risk of community-acquired Clostridium difficile-associated disease. JAMA . 2005 Dec 21;294(23):2989-95.

Last reviewed April 2009 by Daus Mahnke, MD
Last Updated: 11/11/2009