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c.difficile is back!!!

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Crohn's Disease
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Posted 2/13/2012 4:17 PM (GMT 0)
I was doing great, and thought I was finally going in to remission and getting my life back...even just began my gluten free diet. Starting about 3:00PM yesterday, I started again with the severe abdominal contractions and eventually vomiting. By 9:00PM I called my GI. He thinks it's probably a return of the c. diff as opposed to my Crohn's because I'm about one week out from finishing my Flagyl, and this would be about the time to relapse if I was going to. I asked about Vancomycin, but he said that he thinks I just need a longer course of Flagyl. I was in severe pain until about 3:00 AM, but now I feel better. I am anxious all over again...worried that he is wrong, and it's really a stricture or Crohn's, and worried if it is c.diff, that he maybe should have given me Vanco instead this time. I wasn't having any D, but I did a few days ago, and I usually am chronically constipated. I did read on the internet that you can have c.diff without massive D, so maybe that's what it really is. The pain was excruciating....don't want to go back there again, but I did manage to stay out of the hospital this time with Vicodin and Phenargan. Any advice as always is appreciated!!
Posted 2/13/2012 6:50 PM (GMT 0)
You can have c-diff without diarrhea. My husband complained of feeling very run down, and had stomach discomfort and pain. The doc tested him for c-diff just to pacify me. It turned out positive. So it could still be c-diff without diarrhea.

Also, recurrence with c-diff is quite common, no reason to panic. It doesn't mean the flagyl is not working. C-diff is a spore forming bacteria and the antibiotics only work on the bacteria, not the spores. So, you take the antibiotics, it kills the c-diff bacteria, but the spores are still there. So, you stop the antibiotics, and the spores become bacteria and you have a c-diff infection again. It may take a few rounds of antibiotics, and maybe even a slow taper of the antibiotics, but you will be able to beat c-diff. Flagyl and vancomycin have pretty much the same recurrence risks.

Also, there's a chance that this is not c-diff, and it is not crohn's, but that it is post infectious IBS caused by your gut being really sensitive after having a c-diff infection. My husband experienced this - it slowly got better over time. We had to employ the 3 day rule a few times.

If it is c-diff, this is what the infectious disease doctor that my husband worked with recommended. First you try the normal course of antibiotics, it comes back, you try the normal course again and see if that does it. If not, you try it longer, and then you try to pulse it down (ie. reduce how much you take each day, and then get to alternate days, and then every 3 days, etc.).

I hope you feel better soon, and that it is just post infectious IBS.

PV
Posted 2/13/2012 8:21 PM (GMT 0)
Thanks PV,
I had Salmonella several years ago, and did experience post infectious IBS after that for several months. Last night, the cramps were horrendous, so that's why I suspected either c.difficile or a return of a Crohn's flare. At any rate we are starting another round of Flagyl. You made me feel better about doing Flagyl again instead of Vanco. Hopefully, this will be my last round and we will beat it this time. I've cleaned all the bathrooms with bleach. Do the spores live inside of my gut, or am I re-infecting myself from the outside? I did start the Florastor on I think your suggestion. Hopefully that will help too.
Posted 2/14/2012 1:54 PM (GMT 0)
Thanks tdawg,
I was so disappointed to get sick again.....but you know how that is:( I hope you are doing ok
Posted 2/15/2012 5:24 PM (GMT 0)
I hope you get better soon!
Posted 2/15/2012 6:04 PM (GMT 0)
Thanks Andi and T'dawg! You are both dealing with much tougher stuff than me. I think about both of you often and hope you continue to get better. I feel much better since going back on the Flagyl. He increased the dose from two to three times a day this time. Hopefully that and my obsessive cleaning with bleach will do the trick:) Thanks again. Dawg, my doctor is great, but I just have an annoying personality of questioning everything! He has a lot of patience with all my questions, and what I like the best about him is that he always believes me when I tell him my symptoms...a rarity for most doctors I know.
Posted 2/16/2012 3:33 PM (GMT 0)
Thanks Dawg,
You are such a kind person! I do like my GI. He is very kind and honest and admits when he makes mistakes. He missed the c.diff, probably for months because I wasn't having diarrhea, but instead nausea, exhaustion and abdominal pain. He has a med student in with him at my last visit and he told her "this was the strangest case of c.diff that I've ever seen in my 25 years of practicing medicine." He was just increasing the prednisone thinking it was all Crohn's related, which was only making the infection worse. That being said, he believed me when I came to his office and said "I feel like I'm dying." He immediately hospitalized me, and did stool cultures and found the infection. Doctors are just human beings....he feels bad that he didn't order stool studies sooner, but I can totally forgive that over an arrogant doctor who doesn't listen to me. You are right though....I have a hard time getting myself to call him when I am having trouble, because I have fears of looking like a whiner, even though he never treats me that way.
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