MedlinePlus Medical Encyclopedia: Pseudomembranous colitis

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Pseudomembranous colitis

Contents of this page:
Illustrations Alternative names Definition Causes, incidence, and risk factors Symptoms Signs and tests	Treatment Expectations (prognosis) Complications Calling your health care provider Prevention

Illustrations

Digestive system

Digestive system organs

Alternative names Return to top

Antibiotic associated colitis; Colitis - pseudomembranous; Necrotizing colitis

Definition Return to top

Pseudomembranous colitis is a complication of antibiotic therapy that causes severe inflammation in areas of the colon (large intestine).

Causes, incidence, and risk factors Return to top

Almost any antibiotic can cause pseudomembranous colitis. The bacterium Clostridium difficile, which occurs normally in the intestine, may overgrow when antibiotics are taken. The bacteria release a powerful toxin that causes the symptoms. The lining of the colon becomes raw and bleeds. In addition to antibiotic use, chemotherapy, advanced age, recent surgery, and history of previous pseudomembranous colitis are risk factors for this condition.

Ampicillin is the most common antibiotic associated with this disease in children. Pseudomembranous colitis is rare in infants less than 12 months old because they have protective antibodies from the mother.

Symptoms Return to top

Watery diarrhea
Urge to defecate
Abdominal cramps
Low-grade fever
Bloody stools

Signs and tests Return to top

Either or both of the following tests will confirm the disorder:

A stool culture positive for C. difficile toxin
A colonoscopy showing pseudomembranous colitis (a characteristic appearance of the colon)

Treatment Return to top

The antibiotic causing the condition should be stopped. Metronidazole is usually used to treat the disorder, but vancomycin may also be used. Rehydration with electrolyte solutions or intravenous therapy may be needed to replace fluids lost with diarrhea. In rare cases, surgery is required to treat infections that worsen or do not respond to antibiotics.

Expectations (prognosis) Return to top

If there are no complications, the outlook is generally good.

Complications Return to top

Perforation (hole) of the colon
Dehydration with electrolyte imbalance
Toxic megacolon

Calling your health care provider Return to top

Call your health care provider if you or someone else has:

Persistent diarrhea
Bloody stools after taking antibiotics
Severe abdominal pain
Signs of dehydration (dry skin, dry mouth, glassy appearance of the eyes, sunken fontanelles in infants, rapid pulse, confusion, excessive tiredness)
Other troubling symptoms

Prevention Return to top

People who have had pseudomembranous colitis should inform their doctors before taking antibiotics again.

Update Date: 5/3/2004

Updated by: Christian Stone, M.D., Division of Gastroenterology, Washington University in St. Louis School of Medicine, St. Louis, MO. Review provided by VeriMed Healthcare Network.

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