Diet and Health FAQ

Tagged As: Ulcerative Colitis Disease

Question:
My 15 year old son was given Clindamycin for acne treatment (as well as whole range of other antibiotics which didn't work). About two weeks after finishing one month of the medicine he started having abdominal pain, urge to go to bathroom, and loose bloody stool (though he didn't have a sever diarrhea, in terms of frequency of discharge). We have a history of Ulcerative colitis in the family, so we got very scared, almost sure that that's what he had. It was a little strange that it hit him so hard so fast, as my husband remembers his disease progressing gradually. We got very happy when the Dr. suggested that he may have Pseudomembranous colitis caused by the antibiotic! H did a C diff test (we got the samples on Sat AM, and gave it to the lab on Monday). Today we got the results and it's negative. We are devastated, as this means he most likely has UC. We are going to see a GI in a couple of weeks. In the mean time, he has almost fully recovered (eating a lot of yogurt), doesn't seem to have cramps any more, nor any visible blood. Though he said he detected some mucus in the stool. As a result the doctor is not treating him right now. The whole episode took about 10 days, with only a few being really bad. He has never had anything like this before. My question for experts is how likely is it that the we got a false negative test result, and if the Pseudomembranous colitis is misdiagnosed is it dangerous to leave it untreated (and risk a return of the disease)? Also, are his symptoms typical of UC?

Answer:
http://www.1uphealth.com/health/pseudomembranous_colitis_info.html http://www.nlm.nih.gov/medlineplus/ency/article/000259.htm http://www.rxlist.com/cgi/generic/clindat.htm http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a682399.html There is some scary stuff in this and that is not the reason for giving you the information so please forgive me for this.  I believe you have the right to have information to make a decision that is best for you child.  Good luck and remember he is not in the extremes that these links say.  Please let us know how he is doing.   I would say pretty likely. The standard in the hospital is to run the test three times because it is often falsely negative. In the community it is not so easy to get people to do it three times so usually one is run and then if it is negative and they continue to have problems you send more. The fact that you stored it for two days makes a false negative all the more likely. If he is feeling better then I don't think he needs treatment for the C. dif. The organism lives in the gut naturally and tends to overgrow when antibiotics knock out its competition. It sounds like his gut has probably returned to a more normal balance. It could come back but if that happens you can always have him re-evaluated. Whether he needs a colonoscopy to rule out UC will largely be a matter of opinion with little evidence to support it. In the end it will depend on how risk aversive vs. procedure aversive you are. Did he get the Clindamycin orally or topically (in a gel to the face). Absorption of the last is not great. Clindamycin capsules are famous however for permitting C.diff overgrowth. The test isn't close to 100% sensitive. I think an empiric course for C. diff treatment might be reasonable. Metronidazole is cheap. Don't be too devastated by the dx. I have UC and it is almost completely under control. Antibiotics can kill most of the bacteria in the intestines. There is good bacteria and bad. You should get a good probiotic supplement. You can get this at a reputable health food store. I take one and it help replenish the good bacterial. Not all doctors are up to speed on this but most health practitioners are. Yogurt contains good bacteria but not the kind for UC so I recommend the supplements. Check around, if you need some suggestions as to products let me know. Hey Jeff this is about a 15 year old kid who's mom was just told about this disease.  Devastation, fear and all kinds of emotions go through a parent when their child is ill in any way.  Sorry but at his age killing off bacterias and taking probiotic isn't what is needed. Knowledge of the disease is power to make the best human decision and learning about the disease helps all of them understand what they are dealing with and hopefully they can fight for what is needed for best health need.  A new diagnosis in a young person is not going to be cared for by probiotic and this is something to definitely speak to he dr about as a possibility. And please quit saying that most drs don't know because this isn't true.  Some it doesn't need to be a clause in everyone of your posts but esp for young people and new people you could state check this or that with your dr so they can make a list of questions… It's early, way too early, I hurt so if this comes off harsh I am apologizing now. Sorry. If it was my son, I would have the test done to rule out any problems. If there is a problem then you can get it tended to before a bad flare up, if no problem well wonderful and you won't need to worry anymore.  The test itself he should be asleep and make sure of it. The prep, cleaning out the system isn't fun but livable. I guess I see the fact that he got the symptoms after coming off of antibiotics as a sign that their doctor did not tell him to take any type of probiotic. Antibiotics can definitely make things worse. There are even studies that show this. Apparently their doctor may have been one of the few who don't know about the need for probiotics when killing off all of the gut bacteria. That's why I try and try again to make this information available to anyone who may benefit from it. No one else seems to be doing that and it is an important and indisputable fact. As you say, many doctors even know this and you support this as well. I don't see why this should not be brought up as it is very relevant to the situation, and like I said, no one else has bothered to try to educate them about this. Not trying to cause controversy, here. Just trying to give them a more complete picture of the disease and treatment etiology.