How quickly can c.difficile come back after stopping Vanco?

Hello,

Gumby did you do a taper? My son took a second round of Vanco 4 times a day for 14 days and then did a big taper which took about another 4 weeks or maybe even longer. I think the key is the taper because the first round he didn't taper and I think it was back in 2 or 3 days. Hope you get it under control soon.

Thanks for your responses. The doc didn't do a taper. I took 125 mg Vanco 4 times a day for a month. The major D went away, but I continued with gas pain and loose bowels throughout the month. I have a requisition for a repeat stool culture and I'll bring it in tomorrow. I was just surprised it could come back so fast. I feel awful all over again!

Thanks Pmedic!
My dad is in the ICU with heart problems and I'm not going to see him. I feel so bad for my brother who is orchestrating everything. My brother is an ER doc, so he is managing, but I wish I could be there too. this just stinks!! What did you decide to do about Thanksgiving?

My guess is it never fully went away, even though that's such a high dose of vanco. :(

When my husband was first diagnosed, and was on a large amount of steroids (80mgs of solumedrol) and remicade, he was on vancomycin for c-diff as well. He tested positive for c-diff while on vancomycin because his immune system was really dampened on the steroids and remicade. Another time, my husband was on remicade and 10 mgs of prednisone, and had just stopped vancomycin. I think he tested positive for c-diff like 4 days after he stopped vancomycin. So, I don't think there's any hard and fast rule that you will not test positive for c-diff within 2 weeks of stopping vancomycin. It is just it is unlikely that you'll test positive.

Also, c-diff does a number on your bowels, so you may have something called post infectious IBS. My husband had this. I read on a c-diff forum about the 3-day rule - if diarrhea, cramping and other symptoms you would normally ascribe to c-diff linger for more than 3 days, it is most likely a recurrence of c-diff. However if the symptoms come and go and don't last longer than 3 days, it is most likely post infectious ibs. My husband was on a very simple diet for about 6 months after his last c-diff infection because of post infectious ibs. Everytime he had diarrhea, I'd worry that the c-diff came back; but thankfully in his case, it was just post infectious ibs.

My husband takes 4 caps of florastor daily (even when he doesn't have c-diff) and VSL3 daily along with yogurt. Do you think you need to up your probiotics? Also,when my hubby had c-diff problems, he was followed by an infectious disease doctor who had dealt with difficult to treat c-diff cases before. If my husband continued to have problems, her course of action was to do a slow vancomycin taper as others have mentioned.

Another thing I would ask the doc if you do have c-diff, is about using fidaxomycin instead of vancomycin. From what I understand it is a more narrow spectrum antibiotic (so won't affect your gut flora as much), and also has a lower recurrence rate than vancomycin.

I hope you are just having a few bumps of Post infectious IBS and not c-diff. I'll keep my fingers crossed for you.

PV

Another test is in order. If that GI won't give it to you, go to someone else to write the order. If you are positive for c-diff again, find a Dr.that does the fecal transplant. This is the route I will take if I get it again.

You are bringing back bad memories of my time with c-diff. Each time I stopped the Vancomycin, I felt sick. I had the post infectious IBS and it didn't go away until I started the LDN. It made me feel just as bad as the c-diff. Vancomycin did calm my symptoms when I was on it . My GI said Vancomycin has been shown in some cases to coat the colon and induce remission in some patients. She was even considering having me stay on it for extended period if nothing else worked. Luckily I finally got past it.

A colonoscopy may not be a bad thing. My husband had both cdiff and crohns flare up at the same time. They knew about the cdiff and were treating it, but the crohns was completely untreated until they did a colonoscopy and found a colon that according to the GI looked like hamburger meat.

Your doc maybe trying to get a few biopsy samples to see if crohns is active again. I really hope it isn't, but if it is, you need meds to bring it under control again.

Just offering a different perspective I guess. I hope you feel better soon gumby.

Thanks Erin,
I drove all the way to Chicago for a SBFT and they couldn't visualize the re-section site because it was tucked under my ribs. It was a big waste of time and a major challenge going through the prep with c.diff on top of it. Now I have to figure out how to get back to Chicago for a colonoscopy. I'm feeling pretty sick and this is all very challenging. Thanks for your input...it sounds exactly like what my doc is suspecting...that I have scar tissue that may be contributing to SIBO. The barium flowed through ok though, so that is confusing.

NCOT,
I'm glad you filled me in. I was so annoyed after the SBFT that I couldn't even post for awhile. My guess is that if I have disease recurrence, it will be at the resection site, so a colonoscopy should be able to visualize things. My suspicion is that the c.diff is causing more trouble than scar tissue, and I wish we could just clear that up first. Besides, if I need a fecal transplant, they do that by colonoscopy, so we could do both at once. I don't know....just frustrated and sick!

I'm really glad your MRI was good but I do understand your frustration with no explanation for your symptoms. Its like going back to square one pre-diagnosis. What happened with your flex sig? Didn't you have that too?

What does diversion colitis in the rectum mean? Could that alone explain your elevated CRP? Do you need treatment for that? How do you go about getting an appointment with the GI and can you request an ileoscope? You were very sick....I remember it all. I think you needed the surgery that you had, but I do understand why you are stuck wondering about it.

I'm sorry you are so frustrated. I think I'm right there with you. This new doc in Chicago is supposed to be the "expert." My local GI was an extremely nice guy who listened well and always believed me when I told him I was sick. This new doc may be smart, but he's very full of himself. I find it hard to communicate with him as I'm used to an actual conversation or dialogue. He actually said to me," I don't want to hear your theories as to what you think is wrong with you. I want you to tell me your symptoms and I will tell you what to do."

He wouldn't allow me to have the SBFT in my home town because he claimed the radiologists were better at his hospital, but then I only saw a medical resident, who barely knew how to work the machinery. I know an attending radiologist looked at the films, but I wonder if a more experienced doc would have known how I could maneuver to make it so my colon at the resection site was visible. It was a 6 hour drive each way with me having D all the way home from the barium. My poor husband had to stop the car a million times and I was completely miserable. Soo, I really don't know what I want to do. Part of me thinks the new doc will be smarter and I should just suck it up and go back to Chicago for the colonoscopy, and the other part wants to call my nice, kind local GI and beg to go back. Thanks for listening....I'm definitely in an irritable and bad emotional place these days!!

Yeah, it's Dr. Rubin. I do think he is genuinely trying to help....it's probably me. I'm just frustrated with being sick. He likes being the "expert," but the truth is, he IS the expert. I think I just need to hang in there. I'm sorry you have to wait until January to see the GI....sooo frustrating!!

Thanks Pmedic....The D has stopped and I'm doing better now. Thanks for your support!