Colitis Caused by Antibiotics

QUESTION: After a recent chest infection, I developed a terrible bout of
diarrhea. This came on with severe stomach cramps and weakness. I took some
medicine we had at home, but to no avail. When I finally visited my doctor,
he performed a complete examination with a scope, and informed me that I had
colitis that was caused by antibiotics. Despite my request, the doctor gave
me no medications. I am wondering about both the diagnosis and the treatment.
Will you please comment?
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ANSWER: You may be aware of the fact that many types of bacteria normally
live in our digestive system without causing us any ill effects. However,
when antibiotics are given to combat infections in any portion of our body,
these potent medications kill the normal bacteria in the intestines as well
and allow certain resistant bacteria types to take over the territory usually
occupied by the "friendly" germs. The most frequently recognized, Clostridium
difficile, is a gram-positive rod that produces a poison that can damage the
cells that line the colon. When this occurs, all the symptoms which you
experienced may be provoked; diarrhea, abdominal pain, and fever. In some
cases the disease, known as "antibiotic associated colitis," may be so severe
that dehydration, hypotension (low blood pressure) and even perforation of the
colon may occur. The diagnosis is based upon the findings of a colonoscopy
(examination of the colon with a telescope-like instrument) as well as the
results of a stool culture which finds the presence of Clostridium difficile,
and the history of recent use of antibiotics. Taking medications which reduce
the normal movement of the bowels (peristalsis), and which can help with
ordinary diarrhea, is a no-no in this case as it may prolong the time that the
bacteria and toxins remain in contact with the tissue of the colon. Treatment
varies with the severity of the disease and the findings of the colonoscopic
exam, but always requires stopping the antibiotic. Once the antibiotic has
been discontinued, the colitis will generally subside by itself in 10 to 12
days, without any additional medication or treatment. Although the presence
of the bacterial toxin may remain for several months, no further treatment is
necessary if you remain without symptoms.