Pseudomembranous Colitis

Pseudomembranous colitis, also known as Clostridioides difficile colitis or antibiotic-associated colitis, is a type of infection that occurs in the colon. It is characterized by inflammation of the colon and the formation of pseudomembranes, which are visible on endoscopy.

Causes

Pseudomembranous colitis is typically caused by an overgrowth of the bacteria Clostridioides difficile (C. diff) in the colon. This can occur when the normal balance of gut bacteria is disrupted, often as a result of antibiotic use. Antibiotics can kill off the beneficial bacteria that normally keep C. diff under control, allowing it to overgrow and produce toxins.

Symptoms

The symptoms of pseudomembranous colitis can range from mild to severe and may include:

• Diarrhea, which may be bloody or watery
• Abdominal pain or cramping
• Nausea and vomiting
• Fever
• Loss of appetite
• Weight loss

Risk Factors

Certain individuals are at increased risk of developing pseudomembranous colitis, including:

• People who have taken antibiotics, especially broad-spectrum antibiotics
• Older adults
• People with weakened immune systems, such as those with HIV/AIDS or undergoing chemotherapy
• People who have had a recent hospitalization or surgery

Diagnosis

The diagnosis of pseudomembranous colitis is typically made based on a combination of clinical symptoms, laboratory tests, and imaging studies. Diagnostic tests may include:

• Stool tests to detect the presence of C. diff toxins
• Endoscopy or colonoscopy to visualize the pseudomembranes
• Imaging studies, such as CT scans or X-rays, to rule out other causes of symptoms

Treatment

The treatment of pseudomembranous colitis typically involves stopping the use of antibiotics and starting antimicrobial therapy to target C. diff. Medications may include:

• Metronidazole (Flagyl)
• Vancomycin (Vancocin)
• Fidaxomicin (Dificid)

In severe cases, hospitalization may be necessary to manage symptoms and prevent complications. In some cases, surgery may be required to remove the affected portion of the colon.

Prevention

To reduce the risk of developing pseudomembranous colitis, it is essential to:

• Use antibiotics only when necessary and for the shortest duration possible
• Practice good hygiene, such as washing hands frequently
• Avoid close contact with individuals who have C. diff infection