Definition

What is pseudomembranous colitis?

Pseudomembranous colitis, also called antibiotic-associated colitis or C. difficile colitis, is inflammation of the colon associated with an overgrowth of the bacterium Clostridium difficile (C. diff). This overgrowth of C. difficile is most often related to recent antibiotic use.

How common is pseudomembranous colitis?

Please discuss with your doctor for further information.

Symptoms

What are the symptoms of pseudomembranous colitis?

The common symptoms of pseudomembranous colitis are:

  • Diarrhea that can be watery or even bloody
  • Abdominal cramps, pain or tenderness
  • Fever
  • Pus or mucus in your stool
  • Nausea
  • Dehydration

Symptoms of pseudomembranous colitis can begin as soon as one to two days after you start taking an antibiotic, or as long as several weeks after you finish taking the antibiotic.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you are currently taking or have recently taken antibiotics and you develop diarrhea, contact your doctor, even if the diarrhea is relatively mild. Also, see your doctor any time you have severe diarrhea, with fever, painful abdominal cramps, or blood or pus in your stool.

Causes

What causes pseudomembranous colitis?

C. diff lives in soil, air, water, and feces and sometimes in foods like processed meats. You can get it when you touch a surface that has the bacteria on it and then put your hand near or in your mouth. Once it’s in your body, C. diff makes a kind of poison.

The good bacteria in your colon usually keep the amount of C. diff in your body under control, but antibiotics can kill the healthy bacteria and let C. diff grow too fast. This damages your colon and causes pseudomembranous colitis.

While practically any antibiotic can cause it, some are more likely to cause pseudomembranous colitis than others. These include:

  • Cephalosporins (Cephalexin, Suprax)
  • Clindamycin (Cleocin)
  • Fluoroquinolones (Cipro, Levaquin)
  • Penicillin (amoxicillin, ampicillin)

Pseudomembranous colitis also can be related to:

  • Changes in your diet
  • Chemotherapy
  • Hirschsprung disease (a condition that affects your colon)
  • Kidney disease or kidney failure
  • Malnutrition
  • Recent bowel surgery
  • Shock

Risk factors

What increases my risk for pseudomembranous colitis?

There are many risk factors for pseudomembranous colitis, such as:

  • Taking antibiotics
  • Staying in the hospital or a nursing home
  • Increasing age, especially over 65 years
  • Having a weakened immune system
  • Having a colon disease, such as inflammatory bowel disease or colorectal cancer
  • Undergoing intestinal surgery
  • Receiving chemotherapy treatment for cancer

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is pseudomembranous colitis diagnosed?

To find out if you have pseudomembranous colitis, you may need one of these tests:

  • Blood test to check your white blood cell count
  • Imaging tests, like an X-ray or CT scan of your lower belly (for serious cases)
  • Stool sample test to check for bacteria in your colon

You also may have a colonoscopy or sigmoidoscopy, which are exams that look inside your colon with a thin flexible tube. Your doctor may take a tissue sample during the exam for testing.

How is pseudomembranous colitis treated?

If an antibiotic caused the problem, your doctor may prescribe other antibiotics that help good bacteria grow back so your symptoms go away faster.

These include:

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

You take these medications by mouth, through a vein, or through a tube in your stomach. Probiotics may be helpful in treating mild C. diff infections. But talk to your doctor before taking any. While receiving an antibiotic, you may also be given bezlotoxumab (Zinplava). Given as a shot in a vein, this medicine helps reduce the recurrence of  a C. diff infection.

If your pseudomembranous colitis is severe or keeps coming back, you may need:

  • Extra rounds of antibiotics
  • Fetal microbial transplant (FMT), during which your doctor puts healthy stool from a donor into your system to help restore good bacteria
  • Surgery to take out part of your colon (less than 1% of people with pseudomembranous colitis need this.)

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage pseudomembranous colitis?

The following lifestyles and home remedies might help you cope with pseudomembranous colitis:

  • Drink plenty of fluids. Water is best, but fluids with added sodium and potassium (electrolytes) also may be beneficial. Avoid beverages that are high in sugar or contain alcohol or caffeine, such as coffee, tea and colas, which can aggravate your symptoms.
  • Choose soft, easy-to-digest foods. These include applesauce, bananas and rice. Avoid high-fiber foods, such as beans, nuts and vegetables. If you feel your symptoms are improving, slowly add high-fiber foods back to your diet.
  • Eat several small meals, rather than a few large meals. Space the smaller meals throughout the day.
  • Avoid irritating foods. Stay away from spicy, fatty or fried foods, and any other foods that make your symptoms worse.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Review Date: December 6, 2017 | Last Modified: December 6, 2017

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