I believe that I have pseudomembranous colitis; what should I, and/or my doctor be doing?

Hello Anonymous,

Welcome to EmpowHER. Thank you for reaching out to our community.

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.

Tests and procedures used to diagnose pseudomembranous colitis and to search for complications include:

Stool sample. There are a number of different stool sample tests used to detect C. difficile infection of the colon.

Blood tests. These may reveal an abnormally high white blood cell count (leukocytosis), which may indicate pseudomembranous colitis.

Colonoscopy or sigmoidoscopy. In both of these tests, your doctor uses a tube with a miniature camera at its tip to examine the inside of your colon for signs of pseudomembranous colitis — raised, yellow plaques (lesions), as well as swelling.
Imaging tests. If you have severe symptoms, your doctor may obtain an abdominal X-ray or an abdominal CT scan to look for complications such as toxic megacolon or colon rupture.

Treatment strategies include:

Stopping the antibiotic or other medication that's thought to be causing your signs and symptoms, if possible. Sometimes, this may be enough to resolve your condition or at least ease signs, such as diarrhea.
Starting an antibiotic likely to be effective against C. difficile. If you still experience signs and symptoms, your doctor may use a different antibiotic to treat C. difficile. This allows the normal bacteria to grow back, restoring the healthy balance of bacteria in your colon. You may be given antibiotics by mouth, through a vein or through a tube inserted through the nose into the stomach (nasogastric tube). Depending on your condition, doctors will use most often use metronidazole (Flagyl), vancomycin, fidaxomicin (Dificid) or a combination.
Having fecal microbial transplantation (FMT). If your condition is extremely severe, you may be given a transplant of stool (fecal transplant) from a healthy donor to restore the balance of bacteria in your colon. The donor stool may be delivered through a nasogastric tube, inserted into the colon or placed in a capsule you swallow. Often, doctors will use a combination of antibiotic treatment followed by FMT.
Once you begin treatment for pseudomembranous colitis, signs and symptoms may begin to improve within a few days.

Researchers are exploring new treatments for pseudomembranous colitis, including alternative antibiotics and a vaccine.

Treating recurring pseudomembranous colitis

The natural occurrence of new, more-aggressive strains of C. difficile, which are more resistant to antibiotics, has made treating pseudomembranous colitis increasingly difficult and recurrences more common. With each recurrence, your chance of having an additional recurrence increases. Treatment options may include:

Repeat antibiotics. You may need a second or third round of antibiotics to resolve your condition.

Surgery. Surgery may be an option in people who have progressive organ failure, rupture of the colon and inflammation of the lining of the abdominal wall (peritonitis). Surgery has typically involved removing all or part of the colon (total or subtotal colectomy). A newer surgery that involves laparoscopically creating a loop of colon and cleaning it (diverting loop ileostomy and colonic lavage) is less invasive and has had positive results.

Fecal microbial transplantation (FMT). FMT is used to treat recurrent pseudomembranous colitis. You'll receive healthy, cleaned stool in a capsule, nasogastrically or inserted into your colon.
(Mayo Clinic)

regards,
Maryann