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Pseudomembranous colitis

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Contents of this page:

Illustrations

Digestive system
Digestive system
Digestive system organs
Digestive system organs

Alternative Names    Return to top

Antibiotic-associated colitis; Colitis - pseudomembranous; Necrotizing colitis

Definition    Return to top

Pseudomembranous colitis is a specific infection of the large intestine (colon) due to overgrowth of a bacteria called Clostridium difficile.

Causes    Return to top

The Clostridium difficile bacteria is normally present in the intestine. However, it may overgrow when antibiotics are taken. The bacteria release a powerful toxin that causes the symptoms. The lining of the colon becomes raw and bleeds.

Ampicillin, clindamycin, and cephalosporins are the most common antibiotics associated with this disease in children. Pseudomembranous colitis is rare in infants younger than 12 months old because they have protective antibodies from the mother and because the toxin does not cause disease in most infants.

Most cases of pseudomembranous colitis happen while the person is in the hospital, because the bacteria can spread from one patient to another.

Risk factors include:

Symptoms    Return to top

Exams and Tests    Return to top

Either or both of the following tests will confirm the disorder:

Treatment    Return to top

The antibiotic or other medicine causing the condition should be stopped. Metronidazole is usually used to treat the disorder, but vancomycin or rifaximin may also be used.

Electrolyte solutions or fluids given through a vein may be needed to treat dehydration due to diarrhea. In rare cases, surgery is needed to treat infections that get worse or do not respond to antibiotics.

Outlook (Prognosis)    Return to top

If there are no complications, the outlook is generally good. However, up to 20% of infections may return, requiring additional treatment.

Possible Complications    Return to top

When to Contact a Medical Professional    Return to top

Call your health care provider if the following symptoms occur:

Prevention    Return to top

People who have had pseudomembranous colitis should inform their doctors before taking antibiotics again.

References    Return to top

Aslam S. An update on diagnosis, treatment, and prevention of Clostridium difficile-associated disease. Gastroenterol Clin North Am. Jun 2006;35(2):315-335.

Update Date: 11/13/2007

Updated by: Christian Stone, M.D., Division of Gastroenterology, Washington University in St. Louis School of Medicine, St. Louis, MO. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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