Understanding the Symptoms of Clostridium Difficile Colitis

ByAgkidzone Staff

Updated: Oct 21, 2024

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Clostridium difficile colitis (CDC) is an intestinal infection triggered by the bacteria Clostridioides difficile. Though some symptoms are mild, the infection can lead to severe, life-threatening complications. Those most at risk include hospital patients and staff, the elderly or frail, and individuals taking antibiotics or proton pump inhibitors (medications that reduce stomach acid). Antibiotics can disrupt gut bacteria balance, increasing the risk of Clostridium difficile multiplying and producing toxins that damage the colon lining. Similarly, proton pump inhibitors alter stomach bacteria by changing acidity levels, which may allow the bacteria to grow.

Diarrhea

One of the first symptoms of CDC is mild to moderate diarrhea, usually occurring two to three times a day. At this stage, the stool may have a foul odor but typically lacks blood. The bacteria attack and kill the cells lining the colon, causing inflammation and resulting in watery diarrhea. If antibiotics trigger the infection, diarrhea can appear within one to ten days of starting the medication, but sometimes it may be delayed for up to two months.

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Abdominal Pain

Alongside diarrhea, abdominal pain is another early symptom. It often feels like cramping and may come with tenderness in the area. This discomfort can become so severe that it affects daily activities, sometimes making it difficult for the person to leave bed.

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Nausea

Nausea is another common early symptom of CDC. It can be problematic, as it may prevent individuals from consuming adequate fluids, increasing the risk of dehydration. Signs like headaches or excessive thirst indicate the body’s need for more hydration, emphasizing the importance of fluid intake during this stage.

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Loss of Appetite

Loss of appetite is another symptom that can appear early on. This lack of interest in eating might cause general weakness and fatigue, making it difficult to function normally. Often, these early symptoms are vague, so knowing the person’s recent medical history, such as antibiotic use, can be crucial for diagnosis.

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Fever

A mild fever may accompany the early stages of CDC. However, as the condition worsens, temperatures can spike, reaching 105 degrees Fahrenheit (40.5 degrees Celsius) or higher. Such a high fever suggests a severe infection. At this point, the white blood cell count may rise significantly, signaling the infection's escalation. Immediate medical intervention is crucial at this stage.

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Severe Diarrhea

As the infection advances, diarrhea becomes more severe, often exceeding ten watery stools a day. Blood or pus might become visible in the stool, showing that the inflammation has spread throughout the colon. In some cases, hidden blood (not visible in the stool) might be present even earlier. At this point, hospitalization is essential to prevent rapid health deterioration.

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Dehydration

With intense diarrhea, the risk of dehydration increases due to the loss of fluids and electrolytes, especially if fluid intake remains inadequate. Dehydration can cause a drop in blood pressure and a rapid heart rate. At this stage, intravenous fluids are often necessary to replace lost fluids. The fever and white blood cell count also tend to spike higher, and severe intestinal bleeding can worsen dehydration, leading to more significant drops in blood pressure and increased heart rate.

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Abdominal Swelling

Abdominal swelling is a later symptom indicating the worsening of the inflammation in the colon. It may also come with increased tenderness, particularly when a doctor examines the abdomen. At this stage, intensive care is usually required to manage the condition effectively.

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Kidney Failure

If dehydration continues without proper treatment, there’s a risk of kidney failure. The kidneys depend on a sufficient blood supply, and dehydration reduces blood pressure, impairing their function. Swift fluid replacement is crucial to prevent this severe complication and to restore kidney function.

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Severe Inflammation and Toxic Megacolon

In the most critical cases, CDC can lead to toxic megacolon—a dangerous, severe inflammation that causes the colon to swell significantly. When this happens, the colon may struggle to pass stools or gas and risks rupturing, which could spill bacteria and stool into the abdominal cavity, leading to fecal peritonitis. This complication requires immediate surgical intervention, but unfortunately, toxic megacolon can often be fatal if not treated promptly.

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