Pseudomembranous Colitis – Symptoms and Causes
Overview
The colon is a tube-shaped organ in the abdomen that makes up most of the large intestine. It moves waste through the body until it’s eliminated. The rectum forms the final few inches of the colon.
Pseudomembranous colitis happens when the bacterium Clostridioides difficile (C. diff) grows too much in the colon, causing inflammation. This condition often follows antibiotic use or hospital stays.
People over 65 face higher risks for C. diff infections. The bacteria can damage the lining of the colon, leading to symptoms like:
- Watery diarrhea
- Stomach pain
- Fever
- Nausea
- Loss of appetite
Several treatments help manage pseudomembranous colitis:
- Stopping antibiotics that may have triggered the infection.
- Taking specific antibiotics that target C. diff.
- Probiotics to restore healthy gut bacteria.
- Fluids and electrolytes to prevent dehydration.
For severe cases, doctors might recommend fecal microbiota transplantation or surgery if other treatments don’t work.
Signs and Symptoms
People with pseudomembranous colitis may have:
- Watery diarrhea
- Stomach pain or cramping
- Fever
- Mucus or pus in bowel movements
- Feeling sick to the stomach
- Loss of body fluids
These problems can start 1-2 days after beginning antibiotics. Sometimes symptoms appear months after finishing antibiotic treatment. If you notice these signs while taking medication, contact your doctor.
When to See a Doctor
Contact your healthcare provider if you develop diarrhea while taking antibiotics or shortly after finishing a course, even if symptoms seem mild. Seek medical attention right away if you experience:
- Severe diarrhea
- Fever
- Painful stomach cramps
- Blood or pus in your stool
These symptoms might indicate a serious condition that requires prompt medical evaluation and treatment.
Why It Happens
Several things can upset the balance of bacteria in your gut beyond just antibiotics. Cancer treatments like chemotherapy drugs may kill good bacteria while letting harmful ones grow too fast. This change creates a perfect place for C. difficile to multiply and release toxins that harm your colon.
People with existing bowel diseases face higher risks. If you have ulcerative colitis or Crohn’s disease, your colon may already be inflamed and weak, making it easier for C. difficile to cause damage.
C. difficile can spread easily in healthcare settings. The bacteria form spores that regular cleaning products can’t always kill. These spores can live on surfaces and travel on healthcare workers’ hands from person to person.
More concerning is that C. difficile now affects people who haven’t been to hospitals or taken antibiotics recently. This “community-acquired” infection happens outside healthcare settings and can surprise people with no typical risk factors.
New Stronger Strain
Scientists have discovered a more dangerous form of C. difficile bacteria. This aggressive strain produces much more toxin than older versions, causing worse symptoms and damage to the colon.
The new strain fights back against common treatments better than previous types. This makes infections harder to cure with standard medicines.
Worryingly, this powerful strain has appeared in people without the usual risk factors. It can affect those who haven’t recently been in a hospital, taken antibiotics, or had healthcare treatments.
Risk Factors
Several factors can raise your chance of getting pseudomembranous colitis:
- Antibiotic Use: Taking antibiotics is the main risk factor.
- Healthcare Settings – Staying in hospitals or nursing homes.
- Age: Being older than 65 years.
- Weak Immune System: Having conditions that affect your body’s defenses.
- Existing Colon Problems: Having inflammatory bowel disease or colorectal cancer.
- Surgery: Having operations on your intestines.
- Cancer Treatment: Receiving chemotherapy.
Complications
Pseudomembranous colitis treatment often works well, but this condition can become serious even with quick medical care. Several complications may develop:
Severe Dehydration
Intense diarrhea can drain the body of fluids and essential electrolytes. This fluid loss may cause dangerous drops in blood pressure and disrupt normal bodily functions.
Kidney Problems
When dehydration happens rapidly, kidney function can quickly decline, sometimes leading to complete kidney failure.
Toxic Megacolon
This rare but dangerous complication occurs when the colon cannot expel gas or stool, causing severe swelling. Without treatment, the colon might rupture, releasing bacteria into the abdomen. This emergency requires immediate surgery and can be fatal.
Bowel Perforation
Extensive damage to the large intestine lining can create holes in the bowel. When this happens, intestinal bacteria leak into the abdominal cavity, causing peritonitisโa life-threatening infection.
Recurring Infection
The condition may return days or weeks after seemingly successful treatment.
Preventing C. difficile Spread
Healthcare facilities follow strict rules to stop C. difficile from spreading. These preventive steps are important for everyone to know.
Good Hand Hygiene
- Wash hands with soap and warm water (not just sanitizer)
- Healthcare workers should wash before and after patient care
- Visitors should wash hands when entering and leaving patient rooms
Isolation Measures
- Patients with C. difficile stay in private rooms or with others who have the same infection
- Staff and visitors must wear gloves and isolation gowns
- They should wear protective equipment until at least 48 hours after diarrhea stops
Proper Cleaning
- All surfaces need thorough disinfection
- Cleaning products containing chlorine bleach work best
- Regular cleaning helps destroy C. difficile spores
Smart Antibiotic Use
- Only take antibiotics when truly necessary
- Avoid antibiotics for viral illnesses
- Ask for narrow-spectrum antibiotics
- Take medications for the shortest effective time period
If you have a loved one in a hospital or nursing home, don’t hesitate to remind caregivers about these precautions. Everyone plays a role in preventing the spread of this infection.
