Friday, May 10, 2013

C. Diff Colitis - Treatment and Info on A Silent Threat

C. diff colitis: A Bug on the Rise

C. diff colitis, also known as Clostridium difficile colitis, is a really nasty, debilitating infection that has gone relatively unnoticed over the last 20 years. And while most pandemic attention has been focused on bird flu or other foreign invaders from overseas, a sharply rising C. diff infection rate has been silently on the rise. Symptoms can span a range from mild diarrhea to painful and life-threatening inflammation of the colon.

C. diff infections have not only been increasing in numbers, but also the bacterial strain has become more and more difficult to treat. It can strike anyone. Tens of thousands of people including those in the best of health and not on antibiotics, residing in a hospital, or other risk factors are stricken each year.

A carrier can spread C. diff infections without even being aware of the symptoms themselves. It can take weeks, months even for some to notice they are ill and by that time they have probably not taken precautions to contain the bug from contaminating things. And because C. diff can become an increased threat when taking antibiotics for a different condition, it can hide in the periphery until the "good" intestinal bacteria is in the minority and gain the upper hand.

C. diff Symptoms

Early, common symptoms of a C. diff infection are:

  • Runny, liquid diarrhea which occurs 3+ times per day, two or more days in a row

  • Slight abdominal cramping and discomfort

In contrast, more severe instances of C. diff would actually cause colitis (inflammation of the colon). A variant of colitis is pseudomembranous colitis which includes colon bleeding or discharge. Symptoms of these escalated C. diff infections are:

  • Runny, liquid diarrhea occurring up to 15 times per day

  • Severe abdominal cramping and discomfort

  • Feces containing blood or pus

  • Nausea

  • Dehydration

  • Fever

  • Weight loss

  • Loss of appetite

If you experience loose stool or any of the symptoms for longer than three days while taking or after taking antibiotics, you should consult your physician at once.

C. diff Causes

Contrary to the belief that C. diff bacteria is only found in feces or restrooms, it is actually found in our air, water, and even the soil. Though it can be carried by healthy people in their intestines, it is most commonly found in sick people. Those that are healthy have a much stronger immune resistance to C. diff exposure. And there are many more carriers of it where concentrations of the sick are found: hospitals and with other health service providers. This bacteria can thrive when the feces they live in is transmitted from a carrier's unwashed hands to food, clothing, counters, and other common objects (scissors, remote controls, utensils, money, doorknobs, etc.). This bacterial contamination can be very hearty and remain in a room or on an object even after several months. Once a person picks up the C. diff on their hands, they could accidentally ingest it by touching their mouth, a piece of gum, a toothpick, etc. or spread it to more locations.

As mentioned earlier, while taking antibiotics can help with some infections, it can reduce the number of "good" bacteria that your body has too. When there are not very many good guys, the bad bacteria has a chance to overpower and gain the upper hand. Once it has control over your gut, toxins are produced which erode the lining of the intestines and causes decay within the colon itself.

It is good to keep in mind that the antibiotics which most commonly result in a C. diff infection are: clindamycin, fluoroquinolones, cephalosporins, and penicillins.

C. diff Superbugs

As a result of years and years of overly-perscribed antibiotics to treat ailments, some bacterial strains have evolved as more resistant to medicine. These new C. diff strains are much more robust and harmful than the ones of the past, and excrete toxins which are more caustic to the intestines and colon. Also, starting around the year 2000, cases of the new-and-improved bug have been found in patients who are in good health and are not staying in a healthcare facility. This is in contrast to the infection traditionally needing an unhealthy or hospitalized person to strike.

Increasing the odds...

Let's be clear. Anyone can be at risk for getting a C. diff infection. Nursing homes, emergency rooms, and hospitals where tables, carts, desks, stethoscopes, phones, and pens present easy ways for the bacteria to become transmitted. Your odds are greatest for getting the infection if:

  • You have had a C. diff infection before

  • Have had abdominal or gastrointestinal surgery

  • Are 65 years of age or older. The odds are 10 times or greater for those 65 or older when compared to younger adults

  • If you are taking antibiotics or have been recently

  • Have an existing condition or weakened immune system

  • Have colon cancer or an inflammatory bowel issue

  • You are hospitalized or are staying in a long-term care facility

Additional Problems

Here are some of the additional problems that can result from C. diff colitis or infections:

  • Toxic Megacolon. It is not as fun as it sounds. It is when the colon is unable to expel gas and feces, which cause it to greatly enlarge and distend. When this condition is not taken care of immediately, the colon may rupture and send deadly bacteria gushing into the abdominal cavity. Emergency surgery must be performed at once in these circumstances.

  • Kidney Failure. With all the diarrhea, dehydration can happen fast enough that the kidneys cannot function normally and quickly deteriorate.

  • Dehydration. Extreme diarrhea can create a great loss of electrolytes and fluids. Your body must have these things in order to maintain a healthy system and organ support.

  • Bowel perforation. When the infection has caused enough damage to the intestines to erode all the way through, the result is a hole which leaks out bacteria. The bacteria then flow into the abdominal cavity creating an immediate life-threatening condition. Emergency surgery is required to seal the hole and save the patient.

Screening for C. diff

Whenever anyone has been using antibiotics and develops diarrhea within around two months since last use, or if there is watery stool soon after hospital admission, medical providers usually suspect a C. diff infection. There are a few tests which can rule this out:

  • Colon check. Your physician may need to inspect the insides of your colon to rule out an infection. Theflexible sigmoidoscopy, as it is called, consists of inserting a flexible tube with a little camera into your colon to check for any spots of inflammation or pseudomembranes.

  • CT Scan. When there is a possibility of complications stemming from C. diff, a scan called a computerized tomography (CT scan) can give highly detailed information and imagery about the colon. It can even give a report on how thick the wall of the colon is -a wall that is too thick is indicative of pseudomembranous colitis.

  • Stool test. The most simple and least invasive test. There are a few types of stool tests, but what they all are trying to detect is the presence of signature, telltale toxins excreted by a hidden C. diff infection. The most common type of stool test is called a enzyme immunoassay, or EIA, test. It is one of the fastest test but can produce some false-positives. Sometimes it is used in conjunction with a tissue culture for best accuracy.

C. diff Colitis and related infections are on the rise and many cases are starting to make the headlines. Through greater pubic awareness and prevention, we can significantly lower the odds of contracting such a debilitating affliction. Old treatments from the late 1950s such as the Fecal Transplant are re-emerging as viable, incredibly-effective curing alternatives to pill popping and pharma-cures.

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