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The following is an Editorial Resource from YourTotalHealth.

ulcerative colitis questionHow can I get off medication when it is the only thing that helps?

I have chronic IBS with predominant diarrhea rather than constipation. No matter what I eat or how much I eat, I end up with agonizing lower abdominal pain and end up rushing to the restroom at a moment's notice. I can't go out with friends and family without knowing where every bathroom is..."just in case". It is really embarrassing. I have taken various medications including Trazodone, Ranitidine, Protonix, probiotics, Tramadol and Percocet. Every time I have a new catscan, MRI, X-ray or other invasive procedure, they can't seem to find anything. I did have an episode of Clostridium difficile about 8 months ago and it took 3 months for me to recover because of the IBS.

The only thing that has somewhat managed my pain and diarrhea at the same time is taking a Percocet right before I eat. It dulls the abdominal pain i would normally have from eating — my concern is that I don't want to have to take this medication for the rest of my life.


AnswerIrritable bowel syndrome may sometimes occur after an intestinal infection. There are a lot of important facts that need to be evaluated before a diagnosis of irritable bowel can be made.

You will need a doctor who can spare time to review your symptoms, history, diagnostic tests and physical exam. There are many things that can cause diarrhea. Infections are the most common cause of diarrhea. You mentioned a very important infection — Clostridium difficile. At the present time C. difficile is the most common cause of infectious diarrhea of the colon. It is a spore forming bacteria (this means that the bacteria can protect itself in hostile environments such as heat and cold etc.) that can live in the colon without symptoms. If antibiotics are taken this allows the C. difficile to overgrow while the other bacteria are decreased by the antibiotic.

C. difficile produces a toxin that cause inflammation of the bowel wall leading to diarrhea and lower intestinal bleeding. A new strain of C. difficile has also been identified that produces 20 times more toxin and does not need the use of antibiotics for this bacteria to cause intestinal damage. Because the bacteria is a spore former the bacteria survives in the environment and can cause reinfection.

I always ask my patients to clean their bathrooms with a 10% Chlorox solution (one part Chlorox plus 9 parts water). It is important to make sure that you do not have C. difficile infection again.

Sometimes a bacterial infection can unmask another type of inflammation that can only be diagnosed by taking biopsies of the colon or small intestine and looking at the biopsies under the microscope to look for microscopic inflammation. You should speak to your primary care doctor to see if they can recommend someone or somewhere that you can see a specialist who will take the time to understand your problem.

—Dr. Silverman

What's Next: Finding the Right Doctor


Review Date: December 03, 2009


Ask the Expert

ulcerative colitisGot a question? Dr. Ann Silverman, Director of the Inflammatory Bowel Disease Center at Henry Ford Hospital in West Bloomfield, MI, will answer your IBD questions every week on the message board.

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