c-diff help

My husband's stool test results came back positive for c-diff, and he's just started on a course of vancomycin. Reading more about c-diff has seriously spooked me. Anyone have any experience with c-diff?

Also, I'm about to head to the store to pick up florastor because I read that saccharomyces boulardii can help with c-diff infections and help rebalance gut flora. Any other things I should know about?

I've managed to fill my head with all the bad things that can happen with c-diff, including death. The thing is, he's not been on any antibiotics, not been in any hospitals, etc. I'm so worried that he's got one of those strains that's resistant to antibiotics. I hope not, but it's hard for me not to worry.

Anyway, any positive steps we can take to combat c-diff other than vancomycin and florastor?

Thanks for any advice.

PV

My husband has really bad debilitating cramps when he takes flagyl - that's why he's on vancomycin. Also, he's been very good about probiotics too - he's already been taking a packet of VSL#3 every day for the past 2 years. And lo and behold, all of a sudden from out of the blue, he's got c-diff. I just don't get it. The only difference in his diet has been that he ate a little bit more sugar - he had some brownies, cake and ice cream that he normally avoids. He hasn't been anywhere near antibiotics or a hospital or nursing home - I just don't get how he's got c-diff. But has it he does.

I have one other question - can c-diff actually cause proximal extension of UC? My husband was diagnosed with UP - and I'm wondering if c-diff can cause a UC flare and proximal extension. MitzMN, in your case, it looks like you had proctitis for a long time, and then suddenly after you got c-diff, you were diagnosed with left sided UC. Is there a correlation there?

For the c-diff itself, my husband is taking vancomycin, VSL#3 (3 packets a day - one 2 hours after every vancomycin), and as soon as I get my hands on it, florastor. I know that vancomycin is only effective against active c-diff, not against the spores - is there anything we can do to get rid of the spores, to prevent recurrent infection?

Thanks for any help
PV

I read that folks with UC are more susceptible to c-diff infection. From what I read, there are two theories of thought as to why this is true:

a.) The gut flora of a person with UC somehow does not manage to crowd out and kill the few c-diff spores that a person my initially get infected with, thereby resulting in the c-diff bacteria multiplying and causes an imbalance. Therefore, even very minor exposure to c-diff can result in full blown infection. Taking antibiotics causes an imbalance in the gut flora, and allows the c-diff bacteria to multiply unbound.

b.) The breaks in the mucosal wall of a person with UC, allows c-diff to adhere to the mucosal wall and start multiplying.

Of course I'm not expert, so I have no idea if either theory holds credence or not. This still does not explain why my husband has a c-diff infection. He's not been taking antibiotics, he's been taking VSL#3 and yogurt every day to maintain healthy gut flora, he's not been flaring, so his mucosal wall should have been fine . . . it's a medical mystery to me. He did have a dental appointment a few days before he started flaring, for a routine cleaning and x-ray - could that have had unforeseen consequences? I did read though in one article, that people with UC are prone to c-diff infections even without cause (hospitals, nursing homes, antibiotics, etc).

We will be seeing the doctor again on Thursday afternoon - hopefully he'll be able to explain things a little more clearly to me. He thinks it may have been a latent infection (ie. he got it sometime in the past, and the numbers of c-diff have just grown enough to cause problems). For right now, I'm hoping the vancomycin and the florastor will take care of things.

Thanks for the links, I'll check them out. I guess I'll have to wait and see if he gets better with the vancomycin - I sure hope so, since there doesn't seem to be much else out there to combat this infection.

I'll update this thread in the morning, and let you guys know how my hubby is doing.

I had c-diff ten years ago. My doctor prescribed vancomycin right away. It took two courses of vancomycin to get rid of it - but it has never come back. Mine was from antibiotics (most likely clindamycin). The vancomycin should be effective for your husband.

Good luck!

M

Well, my husband is not doing so well. The doc confirmed through stool tests that my husband tested positive for c-diff, and put him on oral vancomycin 250mgs 3 times a day. My husband took that for 2 days, but got worse, not better with treatment. I took him into the ER last Wednesday, and through CT scan, they said he has pan colitis. They rehydrated him, increased his dosage of vancomycin to 250mgs 4 times a day, and added IV flagyl and added cholestid. In addition to they put him on 2.4g of lialda and canasa twice daily. Also, they put him on a full liquid diet.

Well, since Wed, my husband has shown very little symptomatic improvement. His cramping seems more tolerable, and he's able to eat with less pain, but his stools are still liquid and has some blood flecks and some fresh blood. Yesterday, the doctor did a sig scope (with my husband sedated), and said he went all the way up to the splenic flexture (so he covered the rectum, the sigmoid and the descending colon - about 50% of the colon).

He said from what he could tell, the c-diff pseudomembranous pancolitis is resolving - the pseudomembranes are gone, and there are red patches where the colon is healing itself. He said that his ulcerative proctitis is completely quiet, and this thing is completely c-diff, no UC involved. He also said the fresh blood we're seeing is from a couple of internal hemorroids that my husband has developed from all the D.

I'm really worried that my husband has no symptomatic improvement yet - though the doc say it'll come with time. He says endoscopically, things are looking good, and that he's healing well - but that he's going to have IBS for a while. He wants to let my hubby come back home and recover. He also pulled the IV flagyl, and lialda from treatment, increased cholestid to 4 times a day, and added bentyl to deal with the cramping. Here are my concerns:

* My husband's 2 week course on vanco ends on Sunday (3/30). Should he be on another 14 day course if his symptoms don't improve (even if a colonoscopy shows he's clear of c-diff colitis)?

* Should I insist that my husband pulse taper from vancomycin use rather than abruptly stop?

* The doc said it's common for folks with c-diff to end up having IBS for a while at least - how do I know if his symptoms are caused by IBS or c-diff recurrence in the future?

* He's taking florastor (4 250mgs caps/day), and is now on a "soft foods" diet - ie. low residue diet. Is there anything else I can do?

Please folks, I am really really worried. I have never seen my husband look so sick. I am beside myself with worry and anxiety. Please help with any advice, suggestions or personal experience you have with c-diff.

Thanks so much.

I have uc and during my last trimester it started flareing so uped my asacol and started prednisone again. After I had baby I was put on two diff types of antibiotics which in turn caused c. Diff. I was hospitalized from it cuz I couldn't take the oral stuff for it had to have it through iv well I recently got bit by a spider went to dr she said looks like staph( turns out it wasn't) and she put me on an antibiotic that can cause c. Diff. In colitis patients. Any one have any advice for me please my son is 6 months old I don't wanna be put back in hospital and not see him again last time was week or so he was only 1 or 2 months they didn't realize it was c. Diff. For a while

Post Edited (Kbqt) : 6/26/2010 3:33:27 PM (GMT-6)

I am taking vancomycin for C-Diff and it is in liquid form. If you can't take pills then you may get the Vancomycin in liquid form at one of the compounding farmacies.

American College of Gastroenterology meeting just finished in San Antonio.

There were a couple of presentations on C. difficile.

Fighting C. Diff With Feces:  http://www.medpagetoday.com/MeetingCoverage/ACG/22841.

"... Brandt said fecal transplantation was first reported in 1958, and more than 100 procedures via nasogastric tube, rectal enema, or colonoscopy have been performed in the U.S. since then. Its use is increasing as more physicians are searching for better treatments for C. difficile infection, which has increased significantly across U.S. hospitals...."

If you have the stomach for it, this link inside the above page:  http://www.medpagetoday.com/MeetingCoverage/EASD/22352   has a video which shows the transplant "mixture" being prepared.

This presentation at the meeting discusses the use of tumeric/curcumin as a potential treatment for C. diff.

C. Diff No Match for Cheap Spice:   http://www.medpagetoday.com/MeetingCoverage/ACG/22832

Trivialpersuit, I don't know where you live, but perhaps you could print and show the articles to your doctors and they could help you find the nearest hospital or center that would do the fecal transplant procedure. Would you be able to travel? It sounds like you could really use some help. I hope you find some effective treatment soon.

Good luck!

Jan

Oh, there was lots of good info from the ACG meeting; here's a page of the coverage:  http://www.medpagetoday.com/MeetingCoverage/ACG/ 

trivial
Don't you have the Mayo Clinic in Jax? They should be up on all the latest info on C. diff and UC. Have you ever been there?

A new drug to treat c. diff. came on the market in 2013 called Dificid. It worked better for me than Vancomycin. Very expensive, but worth it if your insurance covers it. This last time even that didn't work and I ended up having a fecal transplant by enema. It did the trick.

It's worth noting that Prednisone can make c. diff. caused UC worse.

It turened out I also had CMV (cytomegaloirus) that was successfully treated with Valganciclovir. I had the triple crown. C. diff, CMV and UC, probably caused by one of the former.

A couple of interesting links:

Here is an article on CMV and UC including pathology findings.

http://www.ccjm.org/content/79/1/12.full

And here is an article on C. Diff and UC.

http://www.medpagetoday.com/InfectiousDisease/GeneralInfectiousDisease/6792

You are right. C. diff causes C. Diff colitis CMV can cause CVM colititis. To me colitis is colitis, but that's pehaps because I probably have those forms rather than UC although my GI doc calls it UC.

I just wanted to alert people that UC like symptoms can be caused by C. diff. and CMV and the treatments need to be different as cortecosteroids if given to patients with C. diff. can make their colitis worse.

I think the links state this more clearly. Not sure what you don't like about them.

My doc has been saying for years that I had UC and after Sigmoidoscopy still called it UC. Yet I first had C. diff. and CMV. After treatment for those two conditions I improved signficantly.

My point is that those diagnosed with and treated for UC unsuccessfully should have their doctors check for C. diff. and perhaps CMV to ensure that that's not what's causing the symptoms.