Case Reports in Surgery and Invasive Procedures

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Short Communication - Case Reports in Surgery and Invasive Procedures (2023) Volume 7, Issue 5

Recurrent pseudomembranous colitis: Understanding and managing recurrence

Sarah Zuber*

Department of Anatomy and Surgical Anatomy

*Corresponding Author:
Sarah Zuber
Department of Anatomy and Surgical Anatomy
Monash University

Received:28-Aug-2023, Manuscript No. AACRSIP-23-112556; Editor assigned:31-Aug-2023, PreQC No. AACRSIP-23-112556(PQ); Reviewed:14-Sept-2023, QC No. AACRSIP-23-112556; Revised:20-Sept-2023, Manuscript No. AACRSIP-23-112556(R); Published:27-Sept-2023, DOI:10.35841/aacrsip-7.5.164

Citation: Zuber S. Recurrent pseudomembranous colitis: Understanding and managing recurrence. Case Rep Surg Invasive Proced. 2023;7(5):164

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Recurrent pseudomembranous colitis, a challenging and often frustrating condition, poses a significant concern for both patients and healthcare professionals alike. This recurrent form of Clostridium difficile infection (CDI) can be debilitating, characterized by persistent and repeated episodes of inflammation and pseudomembrane formation in the colon. In this article, we will explore the complexities of recurrent pseudomembranous colitis, its underlying causes, management, and the hope it offers for improved outcomes [1].

Understanding recurrent pseudomembranous colitis

Pseudomembranous colitis is primarily caused by the overgrowth of Clostridium difficile bacteria in the colon. This bacterium proliferates when the normal balance of gut flora is disrupted, often as a result of antibiotic therapy. The overgrowth leads to the production of toxins, primarily toxin A and toxin B, which damage the lining of the colon and trigger inflammation. While many individuals experience a single episode of pseudomembranous colitis and respond well to treatment with antibiotics like metronidazole or vancomycin, others face a recurrent form of the disease. Recurrent pseudomembranous colitis is defined as the recurrence of CDI within a few weeks to several months after successful treatment of the initial episode. It can be particularly challenging to manage, as it often requires a more multifaceted approach. Persistence of C. difficile spores: C. difficile spores can remain dormant in the colon even after successful treatment, only to reactivate and cause another bout of infection. Patients who have previously experienced CDI are at a higher risk of being exposed to the bacterium again, either through healthcare settings or community sources. Antibiotics, which are often used to treat CDI, can disrupt the balance of gut bacteria, creating an environment conducive to C. difficile overgrowth. Patients with weakened immune systems, inflammatory bowel disease (IBD), or other chronic illnesses may be more susceptible to recurrent CDI [2].

Managing recurrent pseudomembranous colitis

The management of recurrent pseudomembranous colitis is a multifaceted and challenging endeavor, requiring a combination of strategies to address both the acute infection and the underlying causes of recurrence: The first step in managing recurrent CDI is often another course of antibiotics, typically vancomycin or fidaxomicin. The choice of antibiotic may vary depending on the severity of the infection and previous treatment responses. Fecal microbiota transplantation (FMT) involves the transfer of healthy donor feces into the colon of the patient, aiming to restore a healthy gut microbiome. This procedure has shown promising results in treating recurrent CDI, with high rates of success [3].

Probiotic supplements containing beneficial bacteria like Lactobacillus and Bifidobacterium may help restore the balance of gut flora and reduce the risk of CDI recurrence. Healthcare facilities must implement strict infection control measures to prevent the spread of C. difficile among patients. Proper hand hygiene, isolation of infected individuals, and thorough environmental cleaning are essential components of prevention. Managing underlying conditions that weaken the immune system or disrupt the gut microbiota, such as IBD or immunosuppressive therapy, is crucial in preventing recurrence. While recurrent pseudomembranous colitis can be a challenging condition to manage, there is hope for improved outcomes. Research into CDI prevention and treatment strategies continues to advance, offering potential new therapies and interventions [4].

Patients and healthcare providers must work together to develop a comprehensive plan for managing recurrent CDI, considering both acute treatment and long-term prevention strategies. By addressing the root causes of recurrence and taking steps to restore a healthy gut microbiome, it is possible to reduce the frequency and severity of pseudomembranous colitis episodes [5].


Recurrent pseudomembranous colitis is a complex and often frustrating condition that requires a multifaceted approach to management. Understanding the underlying causes of recurrence, such as C. difficile spore persistence and altered gut microbiota, is crucial in developing effective treatment and prevention strategies. With ongoing research and the development of innovative therapies like fecal microbiota transplantation, there is hope for improved outcomes and a brighter future for individuals dealing with recurrent pseudomembranous colitis.


  1. Emoto M, Kawarabayashi T, Hachisuga T, et al. Clostridium difficile colitis associated with cisplatin-based chemotherapy in ovarian cancer patients. Gynecologic Oncology. 1996;61(3):369-72.

Indexed at, Google Scholar, Cross Ref

  1. Valiquette L, Pépin J, Do X.-V, et al. Prediction of complicated Clostridium difficile infection by pleural effusion and increased wall thickness on computed tomography. Clin Infect Dis. 2009;49(4):554-60.

Indexed at, Google Scholar, Cross Ref

  1. Nielsen H, Daugaard G, Tvede M, et al. High prevalence of Clostridium difficile diarrhoea during intensive chemotherapy for disseminated germ cell cancer. Br J Cancer. 1992;66(4):666-67.

Indexed at, Google Scholar, Cross Ref

  1. Khan A, Raza S, Batul S. A, et al. The evolution of Clostridium difficile infection in cancer patients: epidemiology, pathophysiology, and guidelines for prevention and management. Recent Pat Antiinfect Drug Discov. 2012;7(2):157-70.

Indexed at, Google Scholar, Cross Ref

  1. Anand A., Glatt A. E. Clostridium difficile infection associated with antineoplastic chemotherapy: a review. Clin Infect Dis. 1993;17(1):109-13.

Indexed at, Google Scholar, Cross Ref

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