Overview
What is Clostridium difficile colitis?
Clostridium difficile (also called
C. difficile) are bacteria that can cause swelling and
irritation of the
large
intestine, or colon
. This inflammation, known as colitis, can cause
diarrhea, fever, and abdominal cramps.
You may get C. difficile colitis if you
take
antibiotics. C. difficile also
can be passed from person to person. The infection is most common in people who
are taking antibiotics while in the hospital. It is especially common in older
people in hospitals and nursing homes.
Colitis caused by C. difficile can be mild
or serious. In rare cases, it can cause death.
What causes it?
The intestines normally contain many good bacteria that keep
them healthy and do not cause disease. If you take antibiotics to kill bacteria
that do cause disease, the medication also may kill the good bacteria. This may
allow C. difficile bacteria to grow in your intestines
and release harmful substances called toxins. Experts also think that, in some
cases, antibiotics may cause these toxins to be released.
When the toxins are released, the colon becomes inflamed.
What are the symptoms?
C. difficile colitis may cause:
- Diarrhea (may be bloody).
- Fever
of up to 104°F (40°C) to
105°F (40.6°C).
- Abdominal cramps.
You also may have an abnormal heartbeat.
Symptoms usually begin 4 to 10 days after you start taking
antibiotics. But they might not develop until a few weeks after you stop taking
antibiotics.
The illness may be so mild that you have some diarrhea but no
fever or cramps. In rare cases, a person who is very ill may develop a hole, or
perforation, in the intestine. A perforation is a medical emergency and
requires surgery.
How is it diagnosed?
Your health professional may think you have C.
difficile colitis if you:
- Have symptoms of the illness,
and
- Are taking, or recently took, antibiotics.
To confirm the diagnosis, a stool sample will be tested to find
the toxins C. difficile produces.
Your health professional also may look at the colon through a
lighted instrument (sigmoidoscopy or
colonoscopy). In the most serious cases of
C. difficile colitis, patches of yellow and white tissue
may form on the inside of the colon.
How is it treated?
Your health professional will treat C.
difficile colitis with antibiotics other than the one that caused the
infection. Usually, you will take vancomycin or metronidazole by mouth.
If you have severe diarrhea, you also may be given fluids to
prevent
dehydration and to make sure you have the right amount
of minerals (electrolytes) in your blood. Sometimes the infection comes back a
few days after you stop treatment. If this happens, you may be given another
antibiotic.
In rare cases, you might need surgery to remove part of your
intestines. This would happen only if you did not get better with antibiotics
and you developed a perforation in your intestines.