A Family Doctor's Tale - PSEUDOMEMBRANOUS ENTEROCOLITIS

DOC I HAVE PSEUDOMEMBRANOUS ENTEROCOLITIS

Pseudomembranous Enterocolitis is an inflammatory disease of the small and large intestine often associated with antibiotic use and with serious illnesses requiring chemotherapy or postoperative conditions.

The causes of Pseudomembranous Enterocolitis are:

The illness is believed to be due to the eradication of normal bowel flora from excessive use of antibiotics resulting in exposure to Clostridium difficile and its toxins.

The involved bowel mucosa is friable(thin) and has yellow green plagues which coalesce and form a thin membrane on the mucous lining.

The membrane consists of fibrin, mucus, and inflammatory cells.

The submucosa is edematous and necrotic in the advanced stage.

Besides clostridium, staphalococcus aureus has been isolated in cases of Pseudomembranous Enterocolitis.

The  symptoms and signs of Pseudomembranous Enterocolitis are:

The disease may be suspected from the clinical picture of abdominal discomfort especially a history of prolonged antibiotic usage.
The main symptoms of Pseudomembranous Enterocolitis are:
1. watery diarrhea with blood,pus and mucus

2. cramping abdominal pain and distension

3. fever up to 39 degrees centigrade

4. headache and bodyaches

5. serious fluid loss and dehydration

6. metabolic acidosis

Signs:
Typical pseudomembrane seen on sigmoidoscopy</p>

The diagnosis of Pseudomembranous Enterocolitis  is made by  :

1.Doctors generally diagnose Pseudomembranous Enterocolitis based on the symptoms and history

3.typical pseudomembrane seen on sigmoidoscopy

The treatment of Pseudomembranous Enterocolitis is:

1.Because of the excessive fluid loss, correction of fluid and electrolyte balance is the most important part of treatment.

Prompt treatment may be needed to prevent dehydration which is the loss of fluids from the body. Important salts or minerals, known as electrolytes, can also be lost with the fluids. Dehydration can be caused by diarrhea, excessive urination, excessive sweating, or by not drinking enough fluids because of nausea, difficulty swallowing, or loss of appetite.

The symptoms of dehydration are
excessive thirst
dry mouth
little or no urine or dark yellow urine
sunken eyes
severe weakness or lethargy
dizziness or lightheadedness

Mild dehydration can be treated by drinking liquids.

Severe dehydration may require intravenous fluids and hospitalization.

Untreated severe dehydration can be life threatening especially in babies, young children and the elderly.

2.Stop all antibiotics if still administered

3.Relief of symptoms include an antispasmodic drug to stop abdominal cramps, medicine to harden the stools such as kaolin and slow down the intestinal movement (lomotil or loperamide).

4.Get plenty of rest.

5.surgery may be necessary if perforation of intestine has occurred.

Prognosis of  Pseudomembranous Enterocolitis:

Outcome is usually excellent with early diagnosis and appropriate treatment.

Prevention of Pseudomembranous Enterocolitis is by:

No prolonged antibiotics.