Antibiotic-associated Colitis—C difficile
Condition
(Antibiotic-associated Diarrhea, Clostridium difficile-induced Colitis, C diff antibiotic-associated colitis)
Definition
Antibiotic-associated colitis is an inflammation of the large intestine. It happens when there is too much Clostridium difficile (C. diff) bacteria in the intestines after taking antibiotics.
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Causes
Antibiotics can kill good bacteria in the large intestine. They do not kill C. diff . Instead, C. diff grows with no control and makes toxins. This bothers the lining of the intestine and causes swelling.
Risk Factors
This problem happens in people who use antibiotics. It is also more common in older adults and people staying in care centers.
Other things that may raise the risk are:
- Being very sick
- Having a weak immune system
- Using medicines that reduce stomach acid
- Having other digestive problems, such as Crohn disease or ulcerative colitis
- Past surgery on the digestive system
- Chemotherapy
Symptoms
Problems may be:
- Watery stools (poop) that may have mucus in it
- Belly pain
- Fever
- Lack of hunger
- Nausea
Diagnosis
The doctor will ask about symptoms and past health. A physical exam will be done.
Tests may include:
- A stool sample to look for signs of infection.
- Blood tests to look for signs of infection
- A colonoscopy to see inside the large intestine (rarely needed)
- A CT scan to view the large intestine
Treatment
The goal is to treat the infection. Options are:
- Stopping antibiotics—or switching to one that treats this infection
- Having a stool transplant from a healthy donor—to balance bacteria in the intestine
- Surgery to remove intestine that has a lot of damage
Prevention
- Taking certain probiotics—if advised by the doctor to do so
- Using antibiotics only as the doctor advises
Crohn’s and Colitis Foundation of America
National Institute of Diabetes and Digestive and Kidney Diseases
CANADIAN RESOURCES:
Canadian Association of Gastroenterology
Canadian Digestive Health Foundation
Crohn’s and Colitis Foundation of America
National Institute of Diabetes and Digestive and Kidney Diseases
CANADIAN RESOURCES:
Canadian Association of Gastroenterology
Canadian Digestive Health Foundation
References
- Clostridioides (Clostridium) difficile infection in adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/clostridioides-clostridium-difficile-infection-in-adults-19.
- Clostridium difficile (C. diff). Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/cdiff.
- Clostridium difficile infection. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/HAI/organisms/cdiff/Cdiff_infect.html.
- McDonald LC, Gerding DN, et al. Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children: 2017 Update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA). Clin Infect Dis 2018 Mar 19;66(7):e1.
- Probiotics to prevent antibiotic-associated diarrhea. EBSCO DynaMed website. Available at: https://www.dynamed.com/prevention/probiotics-to-prevent-antibiotic-associated-diarrhea-19.
Contributors
- Mark D. Arredondo, MD
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