Symptoms of pseudomembranous colitis

The symptoms of pseudomembranous colitis range from mild diarrhea, which limits itself after some time, to a severe feeling of illness with massive watery, bloody diarrhea and fever. In addition, the affected patients complain of severe abdominal pain and abdominal cramps. However, the symptoms are not directly related to the severity of the disease.

The clinical picture should therefore not be used exclusively to assess the severity of the disease. Due to the damage to the intestine, an intestinal rupture (perforation) may occur, which can lead to peritonitis. If the disease is so advanced, it is fatal if left untreated.

Is pseudomembranous colitis possible without diarrhea?

A pseudomembranous colitis without diarrhea is very rare. Diarrhea is actually the leading symptom of the disease. Without the presence of diarrhea, the diagnosis is significantly more difficult. In rare cases, pseudomembranous colitis can also be noticed only by abdominal pain.

Is pseudomembranous colitis contagious?

Pseudomembranous colitis is not contagious. It is caused by certain bacteria in the intestine, which, however, only play a role in patients whose intestinal flora (the totality of microorganisms that colonize the intestine) has been significantly weakened by antibiotic intake. Infection is therefore not possible.

Duration

The duration of pseudomembranous colitis depends largely on the severity of the disease and the therapy.In patients who are seriously ill and are not receiving any therapy, the disease can in the worst case lead to death. If treatment is carried out by discontinuing the antibiotic that triggered the illness and by drug therapy with another antibiotic, the symptoms (diarrhea, abdominal pain) usually subside relatively quickly, depending on the severity of the illness.

Diagnosis

The pseudomembranous coatings are visible endoscopically in the rectum as yellow deposits (pseudomembranous colitis). In addition, the clinic and anamnesis play an important role. The question of a previous antibiotic therapy is a particularly important indication of the diagnosis.

The symptoms of pseudomembranous colitis can, however, start immediately with the antibiotic therapy as well as up to 4 weeks after the therapy. It is important to differentiate between “real” pseudomembranous colitis and antibiotic-associated colitis in order to be able to choose the right therapy. Evidence for the presence of active Clostridium difficile is the detection of toxins in stool and a stool culture.

A histological examination, i.e. a histological examination of fine tissue, is required for the diagnosis of many diseases. This is not the case with pseudomembranous colitis. In this case, the diagnosis is made on the basis of clinical information (diarrhoea, antibiotic intake) and possibly imaging measures (abdominal ultrasound, computer tomography, magnetic resonance imaging) and, above all, by means of a colonoscopy. It is also possible to detect the triggering bacterium in the stool.