Clostridial Colitis

Clostridial colitis, or pseudomembranous enterocolitis, is a severe inflammatory disease of the large intestine. It is caused by the bacterium Clostridium difficile (C. difficile), which is activated when the balance of intestinal microflora is disrupted, usually after taking antibiotics. Understanding the causes, symptoms, and treatments for this condition can help you avoid developing a colon perforation.
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Causes of the disease

Clostridium is a bacteria naturally present in the intestines of many humans and animals. Under normal conditions, it coexists with other bacteria without causing any health problems. When the microflora balance is disrupted, C. difficile becomes active, begins to actively multiply, and secrete toxins. These toxins damage the intestinal mucosa and cause inflammation, leading to the development of clostridial colitis.

The Effect of Antibiotics on Intestinal Microflora

Antibiotics are widely used in medicine to combat bacterial infections. While they kill harmful microorganisms, they also affect beneficial bacteria, leading to intestinal dysbiosis. This creates favorable conditions for the active proliferation of C. difficile and the possible development of pseudomembranous colitis (ICD-10 code: A04.7).

Causes of the disease

Additional risk factors

In addition to antibiotic treatment, there are other factors that can increase the risk of developing clostridial colitis. These include:

  • Long-term hospital treatment
  • Advanced age
  • Recent abdominal surgery
  • Weak immunity
  • Malignant tumors
  • Renal failure

Sometimes the disease develops in patients with chronic obstructive pulmonary diseases. Another provoking factor is the use of H2-histamine receptor blockers and proton pump inhibitors.

Pseudomembranous colitis: symptoms

Symptoms of the disease may vary depending on its severity.

Mild form of pseudomembranous colitis

  • Diarrhea. The most common symptom, in which the stool can be profuse and watery, sometimes with mucus
  • Abdominal pain. Patients are bothered by cramping pain
  • Clostridiosis. Accompanied by fever, weakness, headache, nausea and vomiting

If the disease progresses, additional symptoms may appear, which continue even after stopping antibiotics.

Additional symptoms

  • Antibiotic-associated yellow or green diarrhea
  • Presence of mucus and blood in the stool
  • Metabolic disorders due to dehydration and water-electrolyte imbalance

In addition, patients experience weakness, rapid pulse, low blood pressure, as well as impaired muscle tone and paresthesia.

Features of severe pseudomembranous enterocolitis

  • Rapid development. Symptoms develop faster, intoxication increases, abdominal pain becomes more intense, and blood in the stool appears from the first days of the disease
  • Complications. Pathological expansion of the intestine (megacolon) may occur, which leads to rupture of the intestine and the development of peritonitis

Antibiotic-associated colitis (clostridium ramosum) requires immediate treatment. If you notice the above symptoms in yourself or a loved one, consult a doctor immediately.

General information

Diagnostics

The following methods are commonly used to diagnose Clostridium:

  1. Stool test. This method is used to determine the presence of Clostridium toxins in the stool of an adult or child. The test allows you to detect the presence of harmful bacteria that cause pseudomembranous colitis. The patient receives the test results within 24 hours, in some cases a repeat test is required
  2. Colonoscopy. Allows the doctor to examine the inner lining of the colon and detect possible changes caused by Clostridium difficile. During the procedure, the doctor uses a thin, flexible tube that is inserted through the rectum. Colonoscopy is not performed if toxic dilation is suspected, to avoid the risk of colon perforation
  3. CT scan of the abdomen. In some cases, a CT scan may be required to obtain a detailed image of the colon and determine the degree of inflammation. This method helps to clarify the diagnosis, especially in complex clinical cases
  4. X-ray examination. X-rays can detect swelling of the colon mucosa or its expansion, which are characteristic signs of clostridial infection
  5. Bacteriological analysis of feces. It is carried out in complex cases to confirm the diagnosis and determine the activity of Clostridium difficile

Sometimes doctors use additional research methods, including the agglutination reaction and polymerase chain reaction to detect Clostridium difficile toxins in the body. These tests help determine the best treatment strategy.

Pseudomembranous colitis: clinical guidelines for treatment

Treatment of pseudomembranous colitis requires a comprehensive approach. Its goal is not only to relieve unpleasant symptoms, but also to restore healthy intestinal microflora.

In most cases, doctors undertake the following treatment methods:

  • Stopping antibiotics. It is worth stopping taking medications. This helps restore the balance of intestinal microflora and stops the growth of the C. difficile bacteria
  • Replenishing fluid balance. Often, the antibiotic causes associated diarrhea, which can lead to dehydration. Doctors ensure normal levels of water and electrolytes in the patient's body using intravenous solutions
  • Special diet. During treatment, it is important to exclude fatty, fried, smoked foods, as well as white bread and carbonated drinks
  • Antibacterial therapy. Antibiotics may be prescribed to destroy the Clostridium difficile bacteria. The choice of drug depends on the situation and the severity of the disease
  • Probiotics. These drugs contain beneficial bacteria that help restore healthy intestinal microflora
  • Fecal microbiota transplant (FMT). This treatment method involves transplanting healthy microflora from donor feces into the patient's intestines. FMT is used if other treatments do not lead to improvement
  • Surgical intervention. It is performed in case of severe complications or ineffectiveness of conservative therapy. During the operation, the doctor removes the affected areas of the intestine or creates an artificial outlet (stoma).

For mild infections, Metronidazole is considered the first-line drug. If the patient is diagnosed with a severe form of the disease, the doctor prescribes Vancomycin.

Disease prevention

Prevention of clostridiosis includes several basic measures:

  • Cautious use of antibiotics. Drugs should be taken only as prescribed by a doctor and for a strictly limited period of time
  • Hygiene. Thorough hand washing with soap can prevent the spread of clostridia
  • Isolation. If the disease is detected, it is necessary to limit contact with relatives and be treated in a hospital
  • Compliance with the rules of antisepsis and disinfection. All medical institutions strictly comply with the rules of antisepsis and disinfection, which helps prevent the spread of infection

If you have any symptoms of clostridia in the intestines, do not hesitate to contact your doctor for help and advice.

Our doctors

Anikina Natalya Yuryevna
Experience 24 years
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Anikina
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Galimova Saida Faritovna
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Stanke Daria Alexandrovna
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Daria Alexandrovna
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Yuryeva Anna Evgenievna
Experience 27 years
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Lyashenko Olga Sergeevna
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Dvornikova Marina Victorovna
Experience 35 years
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Komkova Inna Igorevna
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Rodimova (Efremova) Irina Vyacheslavovna
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Ivanova Marina Nikolaevna
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Kolomytseva Elena Vladimirovna
Experience 18 years
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Therapist, gastroenterologist, pulmonologist
Guseva Anna Konstantinovna
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Anna Konstantinovna
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Purveeva Kermen Valerievna
Experience 27 years
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Kazarov Aram Armenovich
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Wonderful doctor, attentive, highly professional. Thank you!
15.12.2025
K. Marina Dmitrievna
A very attentive and caring doctor.
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As always, everything is excellent! Professional doctor. I recommend him.
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12.12.2025
B. Mikael Smbatovich
I'd really like to thank the wonderful doctors: gastroenterologist E.A. Klippenstein and endoscopist A.N. Bachurin for their high professionalism, friendliness, attentiveness, and detailed explanations of my problems and treatment. I felt no discomfort after the colonoscopy and endoscopy under sedation. Excellent doctors. Thanks to nurse S.Yu. Vorobyeva for her attention and care after the procedure. Excellent clinic! Thank you.
08.12.2025
M. Tatyana Ivanovna
A competent doctor with a modern approach. I really liked him.
05.12.2025
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An attentive and sensitive doctor. Based on the clinic visit, she explained everything clearly and prescribed treatment.
03.12.2025
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This is the first time I've seen doctors so involved in the process and communicating about their patients' situations via messaging apps. By the time I visit, the doctor is already aware of the results and how I've handled the procedure I just came in for. It's truly wow!
03.12.2025
S. Evgenia Dmitrievna
Attentive attitude and constructive explanations
01.12.2025
K. Antony Vladimirovich

About doctor:

Lyashenko Olga Sergeevna

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