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Pseudomembranous enteritis is closely related to long-term antibiotic therapy, which may leave behind an unpleasant memento of the disease.
Pseudomembranous enteritis – causes of occurrence
Broad-spectrum antibiotics, if used over a long period of time, can sterilize the physiological bacterial flora of the large intestine and cause an excessive multiplication of pathological anaerobic bacteria. Most often it is Clostridium difficile (Gram positive rods). These bacteria produce toxins (toxin A and B) which are the direct causes of pseudomembranous enteritis. Perform a Preventive Dispatch Test for Clostridioides difficile and toxins A and B from stools today.
The name of the disease comes from the specific gray-yellow pseudo-membranes that form on the surface of the mucosa of the large intestine.
Pseudomembranous enteritis may occur up to 2 months after antibiotic treatment. The disease most often occurs as a result of the use of antibiotics from the group of: cephalosporins (especially XNUMXrd generation), penicillins, fluoroquinolones and the lincosamide antibiotic clindamycin.
Factors that increase your risk of developing pseudomembranous enteritis include:
- long hospitalization (over 1 month),
- staying in medical care centers (e.g. a hospice).
In addition, pseudomembranous enteritis is more common in the elderly (over 65), especially those with chronic diseases.
Symptoms of pseudomembranous enteritis
The main symptom of pseudomembranous enteritis is diarrhea. Within a day, it may appear several, and in the more severe form of the disease, even several dozen loose stools. Fresh blood in the stool is rare. Frequent bowel movements are most often accompanied by lower abdominal pain and fever (up to the age of 40)oC). In the case of a very acute course of the disease, the following may occur:
- severe dehydration
- disturbance of consciousness (e.g. as a result of electrolyte loss),
- shock.
Pseudomembranous enteritis – diagnosis
The doctor makes the diagnosis of the disease on the basis of intelligence (long-term antibiotic therapy, hospitalization), symptoms and additional laboratory tests. Occasionally, stools are cultured for Clostridium difficile, an abdominal X-ray (which may show distended loops of the bowel). The most specific test that confirms the disease is the stool test for toxins A and B of Clostridium difficile.
Do you want to test for pathogenic strains? You can choose a mail-order test for Clostridium difficile from the Medonet Market offer.
How to treat pseudomembranous enteritis?
If the course of the disease is mild, it is usually enough to discontinue or change the antibiotic taken so far. In the case of severe diarrhea, treatment in a hospital and the use of the antibiotic Metronidazole and / or Vancomycin is necessary. It is often necessary to replenish the electrolytes and to balance the total protein level in the serum.
Diarrhea is self-limited within 7-10 days of stopping antibiotic therapy in most patients with pseudomembranous colitis. In the case of severe forms of the disease – within approx. 5 days from the application of Matronidazole and / or Vancomycin.
It should be remembered that the sick person becomes infected not only throughout the symptom period, but also during the asymptomatic faecal excretion of Clostridium (carrier period).
Prevention of pseudomembranous enteritis
The most effective methods of preventing pseudomembranous enteritis are:
- the use of probiotics during antibiotic therapy,
- application of basic hygiene rules – especially hand washing,
- use of protective gloves by medical workers.
Note: Measurement of rectal temperature should be strictly avoided in suspected and carriers.
Text: lek. med. Matylda Mazur
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