Pseudomembranous Enterocolitis

What is this Condition?

Pseudomembranous enterocolitis is an acute inflammation that damages the tissue of the small and large intestines. It usually affects the mucus coating but may extend into submucosa and, rarely, other layers of the intestine. Marked by severe diarrhea, this rare condition is generally fatal in 1 to 7 days from severe dehydration and from toxicity, peritonitis, or perforation.

What Causes it?

The exact cause of pseudomembranous enterocolitis is unknown, but Clostridium difficile may produce a toxin that may playa role in its development. It typically strikes people weakened by abdominal surgery or those receiving broad-spectrum antibiotics. The infection begins suddenly with lots of watery or bloody diarrhea, abdominal pain, and fever. Serious complications may follow this disorder, including severe dehydration, electrolyte imbalance, hypotension, shock, and perforated colon.

How is it Diagnosed?

The doctor may have difficulty making a diagnosis because onset of enterocolitis is sudden and creates an emergency situation. The doctor needs to know the patient’s history, but uses a rectal biopsy to confirm pseudomembranous enterocolitis. Stool cultures can identify C. difficile.

How is it Treated?

A person who is receiving broad-spectrum antibiotic therapy must immediately stop. The doctor usually prescribes orally administered Flagyl. Oral Vancocin is typically given for severe or resistant cases. A person with mild pseudomembranous enterocolitis may take anion exchange resins, such as Questran, to bind the toxin produced by C. difficile. The person must be protected from dehydration, hypotension, and shock.