Pseudomembranous Colitis: Pathophysiology, Clinical Manifestations, Diagnosis, and Treatment

Pseudomembranous colitis is an inflammatory condition of the colon caused by the bacterium Clostridium difficile. The disease is mainly caused by exposure to antibiotics. The article discusses the pathophysiology, clinical manifestations, diagnostic criteria, and treatment options for the disease. It also highlights the importance of awareness and education about the disease.

DISEASE AWARENESS
Learning points from
reflection
 Majority of the people are unaware
regarding the causal organism of the
disease
 Majority of the people are unaware
of the cause of infection, that is
exposure to antibiotics
 Awareness about the disease is
directly proportional to the
educational qualification of the
people
 People except from medical
background find difficulty in exactly
placing the different aspects of the
disease
 People may even confuse
pseudomembranous colitis with
ulcerative colitis
Pathophysiology
The initiates when the gut lining gets exposed
with antibiotics. The exposure leads to
overgrowth of the causal bacteria mainly C.
difficile. Due to the overgrowth of the bacteria,
there is an increase in the production of toxin.
The increased amount of toxin cause damage to
the mucosa which leads to inflammation and
necrosis, a condition known as the
pseudomembranous colitis
DIAGNOSTIC CRITERIA
 Stool test- stool specimen is taken and detected for presence
of the bacteria (c. difficile)
 Blood tests- blood test will show an elevated level of white
blood cell count, which may indicate pseudomembranous
colitis
 Colonoscopy or sigmoidoscopy- a tube is used to examine
the inside of the colon for signs of pseudomembranous colitis
with the help of a miniature camera at tip of the tube
 symptoms, an abdominal x-ray or an abdominal CT scan can
be done to look for complications such as toxic megacolon or
colon rupture
CLINICAL MANIFESTATIONS
Watery diarrhea
Abdominal cramps or tenderness
Fever
Pus or mucus in stool
Nausea
Dehydration
TREATMENT
Stopping the antibiotic is found to be the cause of the
infection.
Antibiotic effective against C. difficile
Faecal microbial transplantation (FMT) - In
extremely severe condition, a transplant of stool is
done from a healthy donor to restore the balance of
bacteria in the colon
McCance,K.L.,Huether,S.E., Brashers,V.L and N.S. Rote.Pathophysiology. The biologic basis for disease in adults and children. 2014, 7th Edition, Elsevier

Pseudomembranous Colitis
Pseudomembranous colitis is an inflammatory condition of
the colon aminly caused by the bacterium Clostridium
difficile. However, certain other bacteria may also be
responsible for it. It is also called antibiotic-associated colitis
or C. difficile colitis. As most of the time, it occurs as a side
effect of taking certain antibiotics.Pseudomembranous colitis
affects people of all ages, but most people are diagnosed
between the ages of 15 and 35. After age 50, another small
increase in diagnosis for this disease is seen, especially in
men.
Learning points from reflection
 Majority of the people are
unaware regarding the causal
organism of the disease
 Majority of the people are
unaware of the cause of infection
that is exposure to antibiotics.
 Awareness about the disease is
directly proportional to the
educational qualification of the
people
 People except from medical
background find difficulty in
exactly placing the different
aspects of the disease.
 People may even confuse
pseudomembranous colitis with
ulcerative colitis.
CLINICAL
MANIFESTATIONS
Watery Watery diarrhea
 Abdominal cramps or tenderness
 Fever
 Pus or mucus in stool
 Nausea
 Dehydration
Treatment
Stopping the antibiotic is found to be the cause of
the infection.
Antibiotic effective against C. difficile
Fecal microbial transplantation (FMT) - In extremely
severe condition, a transplant of stool is done from a
healthy donor to restore the balance of bacteria in
the colon.
DIAGNOSTIC CRITERIA
 Stool test- stool specimen is taken and detected for presence
of the bacteria (c. difficile)
 Blood tests- blood test will show an elevated level of white
blood cell count, which may indicate pseudomembranous
colitis.
 Colonoscopy or sigmoidoscopy- a tube is used to examine the
inside of the colon for signs of pseudomembranous colitis with
the help of a miniature camera at tip of the tube.
 Imaging tests- in serious cases showing severe symptoms, an
abdominal x-ray or an abdominal ct scan can be done to look
for complications such as toxic megacolon or colon rupture.
McCance,K.L.,Huether,S.E., Brashers,V.L and N.S. Rote.Pathophysiology. The biologic basis for disease in adults and children. 2014, 7th Edition, Elsevier
Diet considerations
 Drink plenty of fluids
 Soft and easily
digestible food s hould
be consumed
 Avoid irritating foods
Pathophysiology
The initiates when the gut lining gets exposed with
antibiotics. The exposure leads to overgrowth of the causal
bacteria mainly C. difficile. Due to the overgrowth of the
bacteria, there is an increase in the production of toxin. The
increased amount of toxin cause damage to the mucosa
which leads to inflammation and necrosis, a condition
known as the pseudomembranous colitis