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Gastroenterology  (Expert Forum)
 | 
pseudo membraneous colitis due to Clindamycin
Answered by
Kevin Pho, MD - Internal Medicine
Kevin, M.D. Boston - MA
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.

pseudo membraneous colitis due to Clindamycin

by slager, Dec 16, 2005 12:00AM
Hello.

I would like to follow up on a recent diagnosis by my doctor.

I was prescribed Clindamycin adn Bactrum at my local hospital due to an insect bite that resulted in Cellulitis.

The CLindamycin caused me constant loose stools. MY doctor re-examined and wanted me to take the antibitotics for an additional 10 days resulting in 20 days of taking this medication.



Well that was a month ago.. the cellulitis cleard up nicely but the loose stools have not.. as well as extreme bloating and abdominal pain..



As of today, my doctor said as a result of the clindamycin, I have developed pseudo membraneous colitis. and gave me Flagyl  for 10 days.



My questions:

1. Will Flagyl relieve the symptoms?

2. Is this type of colitis curable or will I always have it?

3. Is there a special diet I must follow to prevent it from coming back?

4. IS alcohol intake ( socailly speaking) casue problems as well?

I am  a 49 yo male who has been taking digestive medicines for years now.. Protonix is the current one prescribed after an upper endoscopy revealed an acid reflux condition



I appreciate the advise..

Regards

by Kevin Pho, MD, Dec 18, 2005 12:00AM
To answer your questions:

1) Pseudomembranous colitis is caused by C Difficile.  This is most commonly associated with Clindamycin.  Flagyl is normally the first-line treatment.  Normally, this should relieve the symptoms.  If not, there are other treatments available (Vancomycin for instance).



2) Normally, this is curable with the appropriate antibiotics.



3) I am not aware of diet affecting the treatment course.



4) I am not aware of alcohol intake affecting the treatment course.



I would discuss this further with your personal physician.



Followup with your personal physician is essential.



This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.



Kevin, M.D.

kevinmd_b
Member Comments (2)

by Bibsy, Dec 19, 2005 12:00AM
DO NOT drink alcohol while taking Flagyl. It will make you very ill!!!

I have been suffering with clostridium difficile colitis for two years. Go to cdiffsupport.com for more information. There is a new more virulent strain out there that needs to be treated aggressively. Google clostridium difficile and check out the news from CDC....

Clindamycin is one of the bigger offenders in causing cdiff colitis, but the fluroquinolones are how I came down with this terrible bacterial infection. I took Cipro for a UTI.

You are not alone. The cdiff support group has helped me get through this and are continuing to help me deal with relapses...

by CalGal, Dec 19, 2005 12:00AM
You may want to consider taking some probiotics. There are several decent brands on the market, and some people who have problems following the intake of antibiotics (which may have destabilized the decent environment that is found in the GI tract) they are of benefit. I'd also suggest you not wait until the course of flagy is over, start them now, but take them with at least a 2 hour interval after you have taken the flagyl. And continue them for many months, if not longer.



Not all probiotic products work the same in each individual, so it's somewhat of a trial and error effort to find one that may be helpful to you. I'm not sure if we can suggests brands, but several that I know that people to be 'live' and work are: Culturelle, PB8, FloraQ, Digestive Advantage-IBS (not for IBS alone and they're inexpensive), and I know I've forgotten some, but those might help. If necessary and you needed to 'step up' to a more potent and clinically tested variety, look into VSL#3 (very expensive).



There's a fair amount of scientific literature on the efficacy of probiotics that can be found if you care to learn more about them. Medscape is a decent source of literature and information. Many medical professionals don't believe in probiotics, but many who are GI-challenged do. I can't say that anything you put in your mouth can do no harm, but from what I understand unless you are immunocompromised, probiotics are not thought to have a downside.

by slager, Dec 28, 2005 12:00AM
Thanks for the  good advice.. Fortunately I did not take any alcohol ( very hard around the holidays of course) and have finished the Flagyl.. However, during the course of the Flagyl the symptons returned and the doctor ( prior to his leaving for vacation) gave me Cipro as well.

Well. .all meds are done as of today and guess who still cannot venture far from the "facilities"? .. I will check out the

C-diff suport group and see if there is any advice on "next steps" before I head back to the doctor..

Thanks Again.. and Be well to all!

by mrose2, May 01, 2008 11:06PM
A related discussion, Clindamycin side effects was started.
Continue discussion
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