C Diff questions

Gail, I've been lucky and never had c. diff, but they can do a titer blood test to check for it. Has you doctor done this? My GI does it every time I finish a course of any sort of antibiotics.

hey Nanners -

Do you know what kind of stool test is being done? There are different kinds of stool tests to check for c diff. The "old" way called Toxin ELISA requires at least 3-4 stool samples (preferably 1 per day) to completely rule out c diff. The "new" method is done using a PCR test which checks for the presence of the toxin genes which has a much higher specificity and sensitivity. Also, doctors can also do a culture for c diff which i think is totally useless in terms of diagnosing since it might not be "active" and releasing the toxins. Hopefully you can do the PCR test and insurance covers it (don't see why they wouldn't) - it will be just 1 stool sample and you will pretty much know if you have it within a day.

I am not sure what you usually use to treat your Crohn's....but the first line of treatment for c diff is Flagyl and then if that doesn't work or you relapse, then Vancomycin. So if you normally take Flagyl for your Crohn's....it might not matter except for doses/days you are on it.

Also, the tell tale sign of c diff (especially if you've had it for awhile) is the smell of gas/stool. I can't explain it, but trust me when I tell you, you'll know - it's a can't miss smell. Also, stools have a ton of mucus in them. Besides that, there might not be that much of a difference than your typical IBD flare - which makes it hard to diagnose in us IBD'ers.

The sad thing is that folks with IBD are more likely to get C. Diff (with or without recent antibiotic use), especially if there is colonic involvement w/ their disease. Most times, a colonoscopy might not even show the typical c diff pseudo-membranes in patients with IBD. I think going forward, most GI dr's will be checking for c diff as part of their check list during flares.

Also, from my research there are only about 3 probiotics that are proven to fight off and prevent c diff - Florastor (yeast), Culterelle, and Bio-K+. Not sure if VSL #3 is also in the list, but I haven't seen it being studied for c diff so not sure how effective it is.

Hope that helps....and I hope you feel better!

Post Edited (NiRo) : 6/24/2011 3:20:29 PM (GMT-6)

No worries Nanners - I thought of something else as to why your GI is being cautious w/ Entocort....if it is c diff, steroids (Pred too) are contradicted, especially early on in the disease, as you want your immune system to help fight off the infection and create antibodies to the toxins that c diff creates. So maybe once the doctor finds out it's not c diff, he might be more aggressive w/ treatment.