gut problems (c diff)

ScottS · 02-23-2004, 02:22 PM

i am now on my 5th round of a c diff infection since August. each time it has come back in about 3-4 weeks. it started after being given clindamycin for an infection in my toe. the 1st time, i was given 2 weeks of flagyl, 2nd time 2 weeks of flagyl, 3rd time 2 weeks of vancomycin (2,000 mg/day), 4th time 3 weeks of vanco(same dose). all the while i've been taking chewable lactobaccilus w/ meals & eating lots of yogurt as well as taking acidophilus pills. this 5th time i was referred to the gastro docs and they put me on 2 wks flagyl followed by 2 wks cholestyramine followed by 6 wks vanco (only 1 125mg capsule every other day).

i'm now in my 3rd of 6 wks of vanco, and am having some symptoms of the c diff again. it seems that the docs are giving me just the minimal amount of meds, even though the infection has proven to be robust. especially this current med schedule i'm on. 2 wks of flagyl has proven ineffective twice & my primary care doc wasn't sure why the gastro doctor chose cholestyramine. plus, vanco at that low dose despite 6 wks of it seems as though it will just string the c diff along for the time being.

my biggest concern is that it will cause the c diff to end up being even that much more resistant to the meds, leaving me in a BAD situation. does anyone have any thoughts/advice (especially Dr Young & SCI Nurse). will the c diff become more resiliant?

Sue Pendleton · 02-23-2004, 03:16 PM

First, the Cholestryamine is not for C. Difficile but to treat its major symptom--diarrhea. It's actually an anti-cholestrol drug that no one would take because it caused serious constipation in normal people.

Time to get an infectious disease doc involved. C. Diff is contagious when it starts causing accidents. Alll your family and hired aides should be tested and use gloves, etc until this is tracted down. I had it in rehab and had to be on IV drugs something that I have never had to use in the 11 years since. Make sure you're lacto source has been kept refridgerated or it dies.

Good luck Scott. TThat stuff really sucks.

Courage doesn't always roar. Sometimes courage is the quiet voice at the end of the day saying, "I will try again tomorrow."

SCI-Nurse · 02-23-2004, 03:53 PM

I agree with Sue. We are seeing more and more strains of c.diff which are resistant to the commonly used antibiotics for it (esp. Flagyl). This more true of strains caught in hospitals than at home, but still can occur. See an infectious disease specialist...ideally at a university teaching hospital. It is infectious, so meticulous use of gloves and cleaning of commodes, etc. with disinfectants is critical.

I have seen Cholestryamine used for some intractable c.diff, but also have not seen it work very well, even in treating the diarrhea associated with it.

It is not appropriate to use Lomotil, calcium polycarbophil or other antidiarrhea products until the c.diff infection is cleared up.

(KLD)

ScottS · 02-24-2004, 01:53 PM

what about the c diff getting stronger after beating all of these attempted cures? will it make it that much more difficult to finally clear it up?

SCI-Nurse · 02-24-2004, 02:53 PM

Yes, it could. This is why it is important to get an infectious disease consultation ASAP.

(KLD)

gvinton · 02-24-2004, 02:55 PM

I had it reappear about 3-4 times while in rehab and once I got home. I finally kicked it after they upped the dosage of flagyl and kept me on it for 2-3 weeks.

My white blood cell counts rose to dangerous levels with high fever each time it came back...

Meg1 · 02-24-2004, 03:24 PM

Could someone explain C. diff to me?

SCI-Nurse · 02-24-2004, 07:20 PM

c. diff is short for clostridium difficile-associated diarrhea (CDAD), which is what is called an opportunistic infection of the large bowel. It is most commonly seen in people who have been on a lot of antibiotics or had extensive (especially ICU) hospitalizations. It is infectious though, so can be passed from patient to patient with poor handwashing and equipment cleaning techniques.

Here is some additional information about it:

c. difficile

Clostridium Difficile Infection

clostridium difficile colitis

There is even a web-based support group:

http://www.cdiffsupport.com/

(KLD)

02-23-2004, 02:22 PM	#1
ScottS Senior Member Join Date: Aug 2003 Location: CA Posts: 376	gut problems (c diff) i am now on my 5th round of a c diff infection since August. each time it has come back in about 3-4 weeks. it started after being given clindamycin for an infection in my toe. the 1st time, i was given 2 weeks of flagyl, 2nd time 2 weeks of flagyl, 3rd time 2 weeks of vancomycin (2,000 mg/day), 4th time 3 weeks of vanco(same dose). all the while i've been taking chewable lactobaccilus w/ meals & eating lots of yogurt as well as taking acidophilus pills. this 5th time i was referred to the gastro docs and they put me on 2 wks flagyl followed by 2 wks cholestyramine followed by 6 wks vanco (only 1 125mg capsule every other day). i'm now in my 3rd of 6 wks of vanco, and am having some symptoms of the c diff again. it seems that the docs are giving me just the minimal amount of meds, even though the infection has proven to be robust. especially this current med schedule i'm on. 2 wks of flagyl has proven ineffective twice & my primary care doc wasn't sure why the gastro doctor chose cholestyramine. plus, vanco at that low dose despite 6 wks of it seems as though it will just string the c diff along for the time being. my biggest concern is that it will cause the c diff to end up being even that much more resistant to the meds, leaving me in a BAD situation. does anyone have any thoughts/advice (especially Dr Young & SCI Nurse). will the c diff become more resiliant?

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02-23-2004, 03:16 PM	#2
Sue Pendleton Moderator Join Date: Jul 2001 Location: Wisconsin USA Posts: 9,172	First, the Cholestryamine is not for C. Difficile but to treat its major symptom--diarrhea. It's actually an anti-cholestrol drug that no one would take because it caused serious constipation in normal people. Time to get an infectious disease doc involved. C. Diff is contagious when it starts causing accidents. Alll your family and hired aides should be tested and use gloves, etc until this is tracted down. I had it in rehab and had to be on IV drugs something that I have never had to use in the 11 years since. Make sure you're lacto source has been kept refridgerated or it dies. Good luck Scott. TThat stuff really sucks. Courage doesn't always roar. Sometimes courage is the quiet voice at the end of the day saying, "I will try again tomorrow."

02-23-2004, 03:53 PM	#3
SCI-Nurse Moderator Join Date: Jul 2001 Location: USA Posts: 41,515	I agree with Sue. We are seeing more and more strains of c.diff which are resistant to the commonly used antibiotics for it (esp. Flagyl). This more true of strains caught in hospitals than at home, but still can occur. See an infectious disease specialist...ideally at a university teaching hospital. It is infectious, so meticulous use of gloves and cleaning of commodes, etc. with disinfectants is critical. I have seen Cholestryamine used for some intractable c.diff, but also have not seen it work very well, even in treating the diarrhea associated with it. It is not appropriate to use Lomotil, calcium polycarbophil or other antidiarrhea products until the c.diff infection is cleared up. (KLD)

02-24-2004, 01:53 PM	#4
ScottS Senior Member Join Date: Aug 2003 Location: CA Posts: 376	what about the c diff getting stronger after beating all of these attempted cures? will it make it that much more difficult to finally clear it up?

02-24-2004, 02:53 PM	#5
SCI-Nurse Moderator Join Date: Jul 2001 Location: USA Posts: 41,515	Yes, it could. This is why it is important to get an infectious disease consultation ASAP. (KLD)

02-24-2004, 02:55 PM	#6
gvinton Senior Member Join Date: Dec 2001 Location: Chino Hills, CA Posts: 521	I had it reappear about 3-4 times while in rehab and once I got home. I finally kicked it after they upped the dosage of flagyl and kept me on it for 2-3 weeks. My white blood cell counts rose to dangerous levels with high fever each time it came back...

02-24-2004, 03:24 PM	#7
Meg1 Senior Member Join Date: Sep 2003 Posts: 225	Could someone explain C. diff to me?

02-24-2004, 07:20 PM	#8
SCI-Nurse Moderator Join Date: Jul 2001 Location: USA Posts: 41,515	c. diff is short for clostridium difficile-associated diarrhea (CDAD), which is what is called an opportunistic infection of the large bowel. It is most commonly seen in people who have been on a lot of antibiotics or had extensive (especially ICU) hospitalizations. It is infectious though, so can be passed from patient to patient with poor handwashing and equipment cleaning techniques. Here is some additional information about it: c. difficile Clostridium Difficile Infection clostridium difficile colitis There is even a web-based support group: http://www.cdiffsupport.com/ (KLD)