C. difficile help.

August 8, 2009 5:47 AM

Questions about C. difficile (and dealing with illness).

About three weeks ago, Mom had a root canal and was put on strong antibiotics. As a result, she ended up in the hospital with Clostridium difficile, which they treated with Flagyl. Gradually she was able to resume her normal daily activities again.

A few days ago, she started feeling sick again and went back to the emergency room. The doctors said the C. diff is back. She started taking another antibiotic (I'm pretty sure it's Vancocin because when we picked up her medication for her, I commented to Dad that at first glance I thought the label said "Vicodin").

Mom is obviously in terrible discomfort and she seems really worried. What can she do to help her situation? What can I do to help her? Is there any way I can cheer her up and make her more comfortable? She's pretty bummed right now. I'm also getting very worried about this and I don't have much experience dealing with sick people.

I'm also wondering about the short and long-term effects of this on her heatlh. Mom is 61. She has never been overweight, no major health issues, quit smoking 15+ years ago, eats well, and is under doctor supervision. You are not her doctor AskMe, but I hope you can help.

posted by futureisunwritten to health & fitness (11 comments total)

futureisunwritten, my heart goes out to your mother, you, and your family. I was hospitalized for a week last year after I came down with a c. diff. infection, and I understand what a miserable experience it is. I was treated with IV Metronidazole (Flagyl) and one thing other people had a hard time understanding is that it made everything taste terrible. I ended up losing about 25 lbs. It sounds like she is receiving vancomycin now, probably because the Flagyl didn't do the job completely. Is she hospitalized again?

I don't have any secret insights into getting better, I'm afraid. My thoughts in no particular order:

- The bacterial toxins can do serious damage to the large intestine, and my greatest worry was that I would end up with a colostomy bag or need to have surgery. So I would make sure she is seeing a gastroenterologist. After she recovers she should be evaluated by some kind of endoscopy to assess the extent of any damage. Damage can result in long term problems with bowel health.

- If she's having diahhrea, make sure she's not getting dehydrated. Gatorade is her friend. I also had one of those protien drinks like Boost or Ensure every day because they were easy to digest and guaranteed I was getting some calories.

- Be assertive about her care. She feels miserable and probably doesn't have the energy to manage her care well. Ask about pain control. Learn about c.diff, and about Pseudomembranous colitis.

- Consider a probiotic supplement. Physicians have mixed feelings about them (and I would ask her doctors first, of course) but I found it helped me once I got home from the hospital. I used a rather pricey one from a food coop, about $30 for a month supply.

- I have no idea where you or she stand on the use of cannabis, but I have reason to believe it could help with pain control and appetite. Obviously that's a contoversial one, so I'll just leave it at that.

I'm a male in my thirties, with a different health history, so all this is necessarily anecdotal. But please mefimail me if I can help somehow.

Finally, just simple comfort - rub her back, make sure she has help, feels supported. This condition feels awful. It feels like a knife in your guts. When you feel like that, the smallest kindnesses break your heart. So be there for here.
posted by werkzeuger at 6:23 AM on August 8 [1 favorite]

When my doctor thought I had it, he had me supplement my diet with beneficial bacteria, acidophilous, etc which had been killed off.

He recommended skipping the yogurt and getting capsules from the health food store, since it would be more concentrated and work faster. I took a Whole Foods brand, Probiotic Complex Plus which was really effective. It doesn't require refrigeration.

He also said to avoid milk and milk products, including soft cheeses because that would exacerbate the problem.

It took about two weeks for me to get back to normal.
posted by elle.jeezy at 6:24 AM on August 8

So be there for her.

Ahem.
posted by werkzeuger at 6:27 AM on August 8

My girlfriend just got over this. (She's 58, and has had some health issue lately). She also had it come back on her after one round of antibiotics failed to do the trick. There's really not much you can do beyond offering your support (which sucks, I know).

Misc. notes about what happened with her:

--Gatorade yes, the Ensure...not so much; she tried it and it didn't help her tummy at all.

--avoid raw fruits & veggies, stick to bland, starchy stuff. (Fiber is good, but not in a 'raw' form. She's going to have to play it by ear a bit to figure out what she can keep down.)

--the probiotics pills, she did take these (expensive, 'bout $1 a pill). There is a war going on in her intestinal track between the good bugs and the bad bugs, anything you can do to help the good guys is a good thing. (Hopefully she won't need a 'poop transplant'; seriously, that's one treatment option.)

I thought the Mayo Clinic had some pretty good info on it.

Good luck. It's going to take some time.
posted by Bron at 7:02 AM on August 8 [1 favorite]

Learn about c.diff, and about Pseudomembranous colitis.

If she really is taking oral Vancomycin it means that the doctors have definitely diagnosed her with pseudomembranous colitis becuase that is, as far as I am aware, the only use for oral vancomycin which is otherwise always given intravenously. So that's definitely the key words to brush up on.
posted by Justinian at 8:30 AM on August 8

the only use for oral vancomycin which is otherwise always given intravenously.

No, the reason it is given orally is because C. diff is an intestinal infection. Vancomycin is very poorly absorbed and has to be given IV if it is used to treat anything but intestinal infections.
posted by Brennus at 9:45 AM on August 8

Pseudomembranous colitis seems to be the real definition of C. diff colitis.

Seconding that oral vancomycin is a drug of choice for it. It may be used prophylactically, too.
posted by SLC Mom at 10:30 AM on August 8

No, the reason it is given orally is because C. diff is an intestinal infection.

I'm confused; isn't that what I said? That if she is taking vancomycin orally it indeed means the doctors are sure she has pseudomembranous colitis? Because its the only thing treated with oral vancomycin?
posted by Justinian at 12:09 PM on August 8

I don't know if oral Vancomycin is the only used to treat C. diff, but Wikipedia explains why it is oral and not IV:

"Vancomycin must be administered orally because IV administration does not achieve gut lumen minimum therapeutic concentration."
posted by werkzeuger at 12:28 PM on August 8

Justinian - pseudomembranous colitis is a symptom of the intestinal infection (she probably has colitis if she has been diagnosed though). This means that the drug is not given orally to treat the symptom, but because the bacteria live in the gut and not the blood.

An important piece of advice is DO NOT rely on alcohol based hand sanitizers to clean up. C. diff is a spore forming bacteria so it is extremely hardy and can stick around for a while. Your doctor should be able to recommend specific cleaners that target spores, especially if she is in contact with at risk people (elderly, immunosuppresed, or people on fluoroquinolones)
posted by fermezporte at 6:14 AM on August 9

Update: Mom is still taking vancomycin but she is feeling a million times better than she did a couple of weeks ago. This thread also gave her some really good advice she might not necessarily have gotten at the doctor. Thanks MeFites!
posted by futureisunwritten at 11:08 AM on August 18