C difficile

[WeNeedToLeaveInFiveMinutes]

I was in hospital for five days, starting four weeks ago. For most of the past five weeks I have been on antibiotics.

Over the past ten days I have had some shocking diarrhoea with increasing cramping/gut pain. It has not been every day but then that's not surprising as I am expelling everything in my system during each episode.

Am I mad to worry that this may be C Diff? The ABs have not been those listed on the wikipedia page as most responsible, but it does say those sort are responsible for 55% of cases.

Spoke to my GP yesterday so don't want to call again today unless I have a leg to stand on!

Is it an interesting colour? Ie quite green?

Antibiotics often cause loose stools/diarrhea but C diff is quite distinctive - me and my colleaugues could often identify C diff from a look and the smell[nice]

I would certainly ask GP so send off a poo sample as it will be easy to find out if it is c diff or not, and it is very treatable if diagnosed.

Poo is all brown. First bit is just "loose" then watery.

Smell was crap on augmentin (as it always is) but not too vile on other ABs.

You need to ring them first thing and they might ask you not to come in.

This is really really serious and you could be in serious danger if you don't get treatment immediately.

i'm so sorry to scare you but having had this myself I know a lot about it.

Please ring them ASAP and insist on starting immediate treatment, it's highly likely this is what you have.

sorry. will write more in a mo.

Green?

I've never heard of that.

Moaningminnie - I'm so sorry to question what you've said without knowing your background but = easy to treat? Without wanting to make WN feel worse, I had it for about 3-4 months, not continuously but it kept coming back - it's one of the hardest things to treat that there is!

I'm not sure where you're getting your information from.

Some people never have a recurrence in which case yes, it could be described as easy to treat but it is by no means a given.

WN - augmentin is a big culprit for this. They will want you to do three samples to send off...keep these well contained in the fridge until they are taken in to the hospital - if you live near enough, deliver them yourself to save it sitting around at GPs waiting to be collected by the path lab.

The bacteria die at room temp therefore there are a lot of false negatives.

They will likely start you on metronidazole immediately as a precaution, which should help very quickly, - however after you've done that for 10 days you'll need to watch that symptoms don't start again after a few days/weeks. If they do, go back and ask for vancomycin. This has a lower recurrence rate.

There's also a new drug since I had it which is meant to be even better so you might be lucky!

If you don't receive treatment your gut could get into such bad shape that you need surgery - it is often fatal in older, compromised people but being fairly young you should be fine.

Hope you are not too freaked out but please talk to them URGENTLY as soon as surgery opens - ok?

Also keep lid down when you flush, make sure you bleach the loo and taps after each use, clean all light switches and door handles and wash your stuff at 60, anything contaminated needs to be done at 95 really so sheets etc.

This can all ease off once you've finished the metronidazole. Your family shouldn't be at risk unless they too have been on antibiotics. Try not to worry but it does need seeing to.

and btw I didn't even have diarrhoea when I had it - hardly, anyway - just a lot of discomfort, needing to go when there wasn't any need, and some bleeding.

It can present like that. I was also told by a doctor and NHS direct that I couldn't possibly have it. There is a lot of ignorance even in the medical profession.

Surgery lines open at eight. I can ask for a call from the doc (often do) and will mention CDiff.

I have a colostomy so I can (yeurgh) extract a sample from the bin if they need one today. I have nothing in my system now to produce one!

No they will need a fresh (sorry) sample. I really think, if your doc has already said he doesn't think it's likely, that you need to INSIST on being tested and also insist on starting metronidazole today.

He will be in serious trouble if you actually end up being hospitalised for this.

Mine didn't think it was c diff, so a different doctor agreed to test for it and it was rushed through and he rang me to say 'you need to start metronidazole today!!'

I think if you've already had this going on for 10 days you cannot afford to wait another few days. Metronidazole is fairly common antibiotic and won't do you any harm to have it in the meantime, even if you don't have c-diff.

Hope you can talk some sense into him - a lot of GPs don't believe younger people can get it, which is silly.

I'm just wondering how a colostomy might affect the situation.

Often the colon is affected but the C-diff lives higher up in the gut.

Having a colostomy might affect the choice of drugs, this is going to be a challenge for them. There is a UK c-diff forum which is very informative and there could be more info on this situation on there.

Good luck - hope it isn't what we think - let me know!

It was the length of time that concerned me too, Fliight. I don't know if I can provide a sample before the labs close for the weekend tomorrow though. That will mean eating something today, won't it?

It's one of the locum/trainee/associate GPs calling back as neither of my usuals are in today (aargh) so will be very definite.

My GP didn't fob me off about it yesterday. We were talking about something else and I mentioned he diarrhoea. She asked if it was getting better and I said I thought so.

My colostomy is low down so not a big issue usually. I've had metronidazole before so I know it's OK.

Hiya,
glad you sound so cool about it, I admire that! (Mrs Panic here)

It's the best attitude to take, as long as you push for what you need and I hope you will make very sure to demand treatment. Metronidazole is the first line therapy.

Vancocin does something slightly different - it's meant to sit in your gut, killing the bacteria - it doesn't circulate in the bloodstream like metro, which means (happily) far fewer side effects! but it would depend which part it's meant to build up in, iyswim. I should think it'll be just the same as with anyone's colon tbh.

But anyway - they need to get reading and make sure they treat you properly.

Often locums are really nervous about getting it right so you can play on this!
You should be able to take in samples through the weekend, really, and leave them at the reception of the pathology unit - but tell them to refrigerate it, as it'll be useless otherwise. Getting poo in a pot is never fun is it.
Hope you get on OK.

Fliight- I definitely said very treatable, not easy to get rid of. I only mean that if she gets a sample sent off and some metronidazole prescribed there is a good chance it will improve relatively soon

WN - hope you get a sample and/or treatment organised ok today.

Ah Ok, sorry. You were probably being non-scary as well, which is a good thing! I have no bedside manner

Thanks for making me up-front about it. GP has asked me to provide two samples, one of which will be tested for CDiff.

Their samples are collected at 2pm. Almost tempted to have some dried apricots to get the sample to perform in time .

Don't worry about being scary. I've been through a lot!

Oh well done - hope you managed it! lol at apricots. Remember if it comes back clear and the symptoms persist, get another done - your Dr should know about high rate of false negs.

Good luck!