Pseudomembranous colitis

Pseudomembranous colitis refers to acute, potentially serious diseases of the colon. The development of the disease is associated with the use of antibiotics. Pseudomembranous colitis is characterized by the formation and liberation of a filmy material with calculous masses. These structures are represented by fibrin and mucus.

Pseudomembranous colitis can be manifested by moderate diarrhea or severe forms. The disease is characterized by acute and recurrent course.

As a rule, pseudomembranous colitis affects people between the ages of forty and seventy-five. In a hospital, approximately ten to twenty percent of patients are diagnosed with Klostridia diffoxile enterotoxins (an anaerobic bacterium that is ubiquitous).

It should be noted that the progression of the disease is noted in cases of resistance of this microorganism to antibiotic drugs that can suppress the vital activity of the rest of the microflora in the intestine. In this case, accelerated reproduction of the bacteria is provoked by the lack of competition. Along with this, there is an increased isolation of toxins.

Most often the disease develops as a result of the use of clindamycin, ampicillin. However, it should be noted that the use of any drugs that have an antimicrobial effect (for example, penicillin, levomycetin, erythromycin, tetracycline) may contribute to the progression of the disease.

The risk factors should include, apart from the prolonged intake of antibiotics, chemotherapy (methotrexate, fluorouracil, and also complex drugs), surgical interventions in the intestine, uremia, ischemia in this department of the gastrointestinal tract, bone marrow transplantation.

Pseudomembranous colitis. Symptoms

The most common manifestation is a frequent stool. As a rule, it occurs by the end of the second week of using antibiotics as a treatment. In rare cases, the symptom is manifested after their withdrawal (sometimes after six weeks).

The chair has a green, watery color, an unpleasant odor, can go to diarrhea with bloody impurities. Together with the feces, a filmy material is released. The process of defecation is accompanied by cramping pain in the lower abdomen.

A characteristic symptom is also fever. It should be noted that in ten percent of all cases it is the only manifestation of the disease.

Pseudomembranous colitis. Treatment

The main and first therapeutic measure is the reversal of the antibiotic that provoked the disease. This measure in many cases, especially with mild forms of the disease, prevents the progression of pseudomembranous colitis.

Therapeutic measures also include the administration of etiotropic treatment. It consists in the use of antibacterial drugs that affect the bacteria Clostridium difficile. As a rule, metronidazole and vancomycin are prescribed for this purpose. The latter has a poor absorption in the intestine. Oral reception provokes a rapid increase in concentration.

Metronidazole can be administered intravenously (in case of difficult oral administration).

Of great importance is pathogenetic therapy. This is especially true for patients with severe forms of pseudomembranous colitis. Its main directions are the correction of protein metabolism and water-electrolyte disturbances. In addition, the measures also suggest the restoration of a normal balance of the intestinal microflora and the binding of the toxin of the exciter bacterium. Expressed water-electrolyte disorders suggest the use of sufficiently intensive therapy.