Pseudomembranous Colitis - Causes, Symptoms And Treatment

2024 Author: Josephine Shorter | [email protected]. Last modified: 2023-12-16 21:43

Pseudomembranous colitis

What is pseudomembranous colitis?

Pseudomembranous colitis is an inflammatory process characterized by an acute course, localized in the large intestine, or rather, in the mucous membrane lining it. Always accompanied by diarrhea. More often women suffer from this pathological process. The disease has no age limits and is equally likely to occur in both adults and children.

It is important that this pathology never occurs independently, but develops against the background of other diseases, that is, it has a secondary character.

Content:

• Symptoms of pseudomembranous colitis
• Causes of pseudomembranous colitis
• Diagnosis of pseudomembranous colitis
• Treatment of pseudomembranous colitis

Symptoms of pseudomembranous colitis

An inflammatory process of the large intestine of this type cannot go unnoticed by a sick person.

Symptoms include:

• The appearance of loose stools, which is in the nature of diarrhea. It is most often watery and occurs frequently, at least every two hours. Most often it develops a week after taking antibiotic therapy, although cases of colitis are not uncommon after a single dose of an antibiotic. In 20% of cases, diarrhea may occur even 1.5 months after completion of treatment. Sometimes blood impurities can be found in the stool, as well as a high white blood cell count.
• The patient complains of pain that is spastic or convulsive. They are especially pronounced when pressing on the abdomen. In this case, there is no irritation of the peritoneum.
• Fever often accompanies this disease, and the temperature can rise to high values, up to 40 ° C.

This triad of symptoms most clearly characterizes this inflammatory process.

However, they can manifest themselves in different ways:

• With a mild form of pain, the person practically does not bother, the discomfort in the abdomen is barely perceptible. The chair is rare and does not exceed 5 times per knock. If the antibiotic is canceled, all violations will regress on their own.

• With a moderate form, the stool becomes more frequent and can be observed every hour, it contains both mucus and blood. At the same time, the temperature rises significantly, the pains cause tangible discomfort and intensify when probing the abdomen. Cancellation of the provocateur drug alone cannot be dispensed with, treatment is required.
• In severe cases, the temperature is kept at high values, the stool is very frequent, it can occur every half hour, and complications of the disease often develop.
• The fulminant form is characterized by a rapid increase in symptoms with severe pain, diarrhea, turning into constipation, up to intestinal obstruction. Often this form of the disease is observed in those patients who receive treatment with anticancer drugs.

Causes of pseudomembranous colitis

The cause of the development of inflammation is a certain anaerobic bacillus - clostridium difficile, which, produced by toxins, poisons the body of a sick person.

Among the factors provocateurs are the following:

• Passage of therapeutic treatment with certain drugs. Most often, inflammation is caused by antibacterial agents (cephalosporins, macrolides, ofloxacins, penicillins, levofloxacins). In addition, chemotherapy, drugs that suppress the immune system, gold preparations, cytostatics, NSAIDs, drugs for the treatment of diarrhea and psychotropic drugs can provoke the development of inflammation.
• Chronic intestinal colitis.
• The presence of oncological formations in the intestine.
• Ischemic colitis associated with impaired blood circulation in the intestinal vessels.
• Postponed surgery on organs located in the peritoneal region.
• Prolonged pastime in a hospital setting.
• Frequent studies of the intestine, in this case, means a colonoscopy, sigmoidoscopy.

Diagnosis of pseudomembranous colitis

When a patient turns to a doctor with characteristic complaints of loose stools and abdominal pain, the doctor must first of all collect an anamnesis. It is important to find out how long the patient has been suffering from such symptoms, whether any medications have been taken. After that, the doctor performs a physical examination, which includes palpation of the abdomen and abdomen and measures the body temperature.

Laboratory tests will be necessary to confirm the diagnosis. In addition to standard procedures, such as taking blood and urine for a general analysis, a biochemical blood test and stool analysis are necessary. It is by it that you can determine the presence or absence of an anaerobic bacillus pathogen. Feces culture is required to determine the microflora that populates the intestines.

If there is a need to distinguish diarrhea from another diagnosis, an endoscopy or colonoscopy may be performed. When it is not possible to conduct a colonoscopy, the doctor sends the patient to a CT scan of the abdominal cavity. In some cases, a small section of the intestine is required for examination. The biopsy is done during the colonoscopy.

If necessary, the patient is sent for consultation to a gastroenterologist.

Treatment of pseudomembranous colitis

Treatment is reduced primarily to the elimination of the provoking factor. Therefore, if colitis was caused by taking a drug, it must be abandoned. As a rule, treatment already after two days leads to an improvement in the patient's condition. As for diarrhea, it completely stops a little later, depending on the characteristics of the body. If the disease is severe, additional treatment with certain medications may be required.

Metronidazole is active against the anaerobic bacillus that causes this type of colitis. It is prescribed in a dosage of 250 mg 4 times a day. This scheme is applicable for adults. Treatment must be continued for at least 10 days, and sometimes two weeks.

In addition, enterosorbents are prescribed to the patient, which help to remove toxic products from the body. It is advisable to restore the intestinal microflora after the completion of the course of metronidazole.

During treatment, the patient will need a lot of fluid, since he loses its impressive volumes during frequent bowel movements. If it is insufficiently replenished, persistent diarrhea can lead to dehydration, so it is so important to monitor how much the patient drinks.

Nutrition is an important part of treating this type of inflammation. You need to eat a little, but often. As a therapeutic diet, the patient is recommended to adhere to table number 4. This dietary diet is reduced to the fact that the diet includes bananas, rice, jelly, baked vegetables, toast. That is, all those foods that help stop diarrhea. In addition, it is necessary to completely abandon fried, spicy and fatty foods. Dairy products are contraindicated, as they can aggravate the patient's condition. Learn more about what you can and cannot eat.

As for the treatment of children, they are also shown to cancel the drug that caused the process of inflammation in the large intestine. Metronidazole is prescribed with caution and in lower dosages, which are selected only by a doctor and strictly individually.

In some extremely rare cases, surgery may be required. It is shown when the disease progresses with lightning speed. In this case, the affected part of the intestine is subject to removal. This is done in order to save a person's life and avoid formidable complications.

Meanwhile, the complications of the disease can be quite serious. In particular, colitis threatens with intestinal rupture, ascites, dehydration, and a sharp drop in blood pressure. Sometimes, in especially severe cases, renal failure, the development of superinfection and even sepsis can be observed.

Preventive measures are reduced to the fact that it is strictly forbidden to use antibacterial drugs on your own, without medical advice. Moreover, for preventive purposes. Antibiotics have a lot of side effects, including the development of pseudomembratic colitis, and should be used under medical supervision. Not only the choice of antibacterial agent, but also the duration of its administration should be determined by the doctor.

As for the prognosis, with timely treatment for medical help and elimination of the provoking factor, it is possible to get rid of the disease in the shortest possible time.

The author of the article: Gorshenina Elena Ivanovna | Gastroenterologist

Education: Diploma in the specialty "General Medicine" received at the Russian State Medical University named after N. I. Pirogova (2005). Postgraduate studies in the specialty "Gastroenterology" - educational and scientific medical center.