Dr. M.J. Bazos, MD. Patient Handout

About Your Diagnosis
Pseudomembranous colitis is an inflammatory disorder of the small and large bowel. It is associated with antibiotic use. The most commonly associated antibiotics are the penicillins, cephalosporins, clindamycin and sulfa drugs. However any antibiotic may be associated with the disease. When an individual is given an antibiotic to treat an infection, the bacteria in the bowel can be affected . Certain bacteria such as Clostridium difficile and Staphylococcus can flourish and cause the disease. Pseudomembranous colitis affects 6 per 100,000 individuals treated with antibiotics. It occurs more commonly in hospitalized and nursing home patients. Patients who have had recent surgery or are undergoing cancer treatments are at greater risk. The condition is detected by stool cultures that grow the bacteria. A sigmoidoscopy or colonoscopy, a procedure where a lighted flexible instrument is inserted into the rectum to view the colon, is done to look for the abnormal findings of this disease. Tissue samples are taken from the colon and sent for microscopic examination. Most individuals will respond to treatment within a couple of days and have no long-term effects. If untreated, the condition can be fatal.

Living With Your Diagnosis
Pseudomembranous colitis presents with diarrhea that is classically watery, green, foul smelling, and bloody. Abdominal cramps and pain occur commonly. Fever also occurs. The symptoms usually start 4–10 days after beginning antibiotics; however, a significant portion of individuals do not have symptoms until after the antibiotics are stopped. There will be an elevated white blood cell count because of the infection. If severe, symptoms of shock, low blood pressure, weak pulse, and increased heart rate may be present.

The key to treatment is stopping the antibiotics and bed rest. If symptoms are severe, hospitalization with intravenous fluid and nutrition may be necessary. The diet is then gradually returned to normal. In severe cases, antibiotics such as metronidazole and vancomycin are given to help treat the

The DOs
• Stop all antibiotics.
• Bed rest is important.
• Avoid Dairy Products (may worsen diarrhea).

The DON’Ts
• Do not use antidiarrheal agents unless prescribed by your doctor.
• Do not have a barium enema x-ray done. It can cause complications.
• Avoid inappropriate use of antibiotics.

When to Call Your Doctor
• If you have symptoms of pseudomembranous colitis, particularly when taking or just finishing a course of antibiotics.
• If symptoms do not resolve after 4 days of treatment.
• If new symptoms appear during treatment.

National Digestive Diseases Information Clearinghouse