View Full Version : Antibiotic Associated Diarrhea (I Think)

Exnor
01-16-2004, 04:22 AM
I am just enquring as to how long it could take to recover from Antibiotic Associated Diarrhea. I am seeing the doctor this afternoon, but would like any other opinions.
I have been on various antibiotics for over a year for acne, I started with a course of Erythromicin, which was fine for many months (and I did not see much improvement in my acne), until I realised that it should be taken on an empty stomach.

This is when my problems began. Even though my acne was getting much better, I was experiencing some diarrhea and sometimes up to 6 bowel movements a day. I took some actimel (live bio culture) and this seemed to calm the diarrhea down a bit. It was still not normal, so I decided to see the doctor. I posted a thread here about it, and apparently Erythromicon is renowned for side effects like mine.

I believe I had taken the Erythromicon for around 9-10 months, and this new doctor put me on Minocin MR, which she told me would not produce any side effects. I was mostly ok during this course, still having 2-3 movements a day, but had another symptom, a watery discharge. This was on-and-off at first and has seemed to get worse with time.

I believe the watery discharge happens just before I need to urinate or just before I need a bowel movement. After either of these two I am fine until I then need the toilet again. I have never noticed blood in the stool. The stool seems always loose and soft, but not really watery. After going 2-3 times I am usually quite sore. I do not have stomach pain, headache, or any other symptoms other than after urination, it seems as if there are a few more drops than normal (I usually require a tissue), but no incontinence. I believe this could be due to my urinary sphincter and the control of when it closes (from the irregular bowel movements many times a day).

I had enough with antibiotics and thought I should just stop. I was on that Minocin MR for about 2 months, until I stopped on the 5th Jan (1 week 5 days ago). I have not noticed an improvement; on the contrary I seem to be slightly worse. I have the mentioned discharge before almost every time I need the toilet, but it seems much better at night. My acne is not getting any worse, if anything, it is improving.

Considering that I was on antibiotics for over a year – how long do you think it should take for a persons natural flora in their gut to neutralise? Or is this discharge some sign of another condition, possible an overgrowth of the “bad” gut bacteria, which may have taken over? There is a possiblity the doctor may take a stool sample to find this out.

Thanks for any replies.
Gyno Rhino
01-16-2004, 07:08 AM
It’s quite possible that you are experiencing a bwoel disorder.

Ask your doc for a referral to a GI specialist, and explain to him what is going on. They should check for occult blood in the stool, for one. If they find something, you may need a bunch of tests to eliminate diseases (Crohn’s, Ulcerative Colitis, IBD, etc).

This may be related to the antibiotics, it may not. It could be that those antibiotics triggered something in your body. Just get checked out. Don’t object to any tests (Small bowel series may be useful).
ectx
01-16-2004, 07:39 AM
First off, never discontinue a course of antibiotics without consulting your MD. While I think that doing it for acne is more acceptable than for other infections…just as a general rule, if you stop the antibiotics when you feel better and before the course of drug is complete you risk making the bacteria you’re fighting resistant. That ain’t coo’.

Second, taking any antibiotic for that long is not good. Unless you’re immunocompromised I just don’t think it’s good for your liver or your colonic flora.

Third, now addressing your question directly, depending on the literature and how your colonic flora is cleared, it can take anywhere from 24 hours to 10 weeks to get “normal” colonization of your gut. Keep in mind that you may be recolonizing with something that wasn’t there before. You actually start bacterial growth after 24 hours of a colonic irrigation and prophylactic antibiotic treatment, but it takes a bit longer to get the right balance of bacteria in there. You’re usually fine after about 3-4 days, but in some cases it takes a lot longer. What you’re experiencing doesn’t sound normal. I’d talk to a different doc, perhaps a GI specialist.
Exnor
01-16-2004, 04:51 PM
Firstly, thank you for the replies.

I started today like the recent days, having two bowel movements within the first 4 hours of me being awake. After this, I have not had a bowel movement since, and no discharge to speak of. My condition appears to be improving, touch wood. I have been doing “allergy testing” over the past 2 days, not drinking any milk, and avoiding my daily tablespoon of flaxseed oil. This could also be a reason for the improvement. After a week or so, I shall slowly introduce the various eliminated items back into my diet, and see which one, if any, is the culprit.

I saw the doctor this afternoon. The outcome is that he believes from the symptoms that I have Irritable Bowel Syndrome/Disease, that could have been triggered by the antibiotics which may have worked as a catalyst. I think this is very probable. While on erythomicin I experienced acute diarrhea (4-5 days) at a time when I was extremely stressed (very unusual for me) due to private problems. The stress was relieved in a very immediate fashion, and my diarrhea promptly stopped. This connection also suggests IBD/IBS.

He did a general checkup getting information that he could not get from my medical records (Weight, BP, Stethescope exam, feeling my abdomin etc.)

It’s quite possible that you are experiencing a bwoel disorder.

Ask your doc for a referral to a GI specialist, and explain to him what is going on. They should check for occult blood in the stool, for one. If they find something, you may need a bunch of tests to eliminate diseases (Crohn’s, Ulcerative Colitis, IBD, etc).

This may be related to the antibiotics, it may not. It could be that those antibiotics triggered something in your body. Just get checked out. Don’t object to any tests (Small bowel series may be useful).

I told him exactly what I said in this post with some additional details. I have also had an examination by another doctor recently (the one with the lit silver impliment they insert, and look/feel around). Everything was fine. Previously to that I had many visual inspections.

I also had a blood test quite recently that according to the doctor cleared me of Crohn’s. I also have had no visible blood in my stool, which is a very common sign for this disorder.

First off, never discontinue a course of antibiotics without consulting your MD. While I think that doing it for acne is more acceptable than for other infections…just as a general rule, if you stop the antibiotics when you feel better and before the course of drug is complete you risk making the bacteria you’re fighting resistant. That ain’t coo’.

I had consulted a doctor many times about the possiblity of stopping them due to side effects. They told me that it was fine to stop them if the side effects were not managable.

Second, taking any antibiotic for that long is not good. Unless you’re immunocompromised I just don’t think it’s good for your liver or your colonic flora.

I agree. I never intended to take them for this long, and was assured my acne would clear within 6 months. Time seems to pass very quickly, and foolishly I still had hope for the antibiotics. I was under the impression they were maintaining my relatively clear skin (and ideally improving it), which now in retrospect I seem to have found is not the case.

Third, now addressing your question directly, depending on the literature and how your colonic flora is cleared, it can take anywhere from 24 hours to 10 weeks to get “normal” colonization of your gut. Keep in mind that you may be recolonizing with something that wasn’t there before. You actually start bacterial growth after 24 hours of a colonic irrigation and prophylactic antibiotic treatment, but it takes a bit longer to get the right balance of bacteria in there. You’re usually fine after about 3-4 days, but in some cases it takes a lot longer. What you’re experiencing doesn’t sound normal. I’d talk to a different doc, perhaps a GI specialist.

Thanks for the information, I hope that my improved state will remain for days and weeks to come.
ectx
01-17-2004, 03:38 AM
Glad to see that you’re doing better, and I’m also glad you asked your doc about discontinuing your antibiotic before you did. I apologize for sounding preachy, it’s just that folks who discontinue antibiotic use before the prescribed course make my job harder, on the other hand, it means I have a job. LOL.

I noticed your doc said you could have IBS. A primary cause of this could be that when you recolonized your intestine, C. difficile could have become a primary colonizer. It’s an anaerobe with a close tie to IBS. Ask him to check for it. Hope this helped, and best of luck.
Exnor
01-17-2004, 05:32 AM
Glad to see that you’re doing better, and I’m also glad you asked your doc about discontinuing your antibiotic before you did. I apologize for sounding preachy, it’s just that folks who discontinue antibiotic use before the prescribed course make my job harder, on the other hand, it means I have a job. LOL.

I noticed your doc said you could have IBS. A primary cause of this could be that when you recolonized your intestine, C. difficile could have become a primary colonizer. It’s an anaerobe with a close tie to IBS. Ask him to check for it. Hope this helped, and best of luck.

No problem about the “preaching”, it sounded to me more like you knew what you were talking about. ๐Ÿ™‚

If indeed my gut has been primarily colonised by C. difficile, will the bacteria remain there indefinitely, meaning it would need to be treated? Or over time will the Lactobatillic bacteria (I think thats what it’s called?) take over once again?
ectx
01-18-2004, 04:54 AM
No problem about the “preaching”, it sounded to me more like you knew what you were talking about. ๐Ÿ™‚

If indeed my gut has been primarily colonised by C. difficile, will the bacteria remain there indefinitely, meaning it would need to be treated? Or over time will the Lactobatillic bacteria (I think thats what it’s called?) take over once again?

Nah, eventually your flora would balance off again. I think there are ways of “helping it” along too. I’m not sure, as I’m not a physician and my field is STD’s and UTI’s. I’ll see what the journals I have access to say about it.
Exnor
01-18-2004, 01:51 PM
Ok, thanks very much.
Exnor
02-05-2004, 07:25 AM
bump, your journals reveal any interesting info?
Exnor
02-05-2004, 04:10 PM
My condition seems to have completely resolved itself after a sudden and severe bout of diarrhea lasting 2 days (accompanied by mild fever). Could this have been the delayed effect of the primary colonizer C. difficile being flushed out of my system?
Funny thing is, I took a couple of acidophilous pills before it started, mabye that prompted it ๐Ÿ™‚

My doctor seems to not think I could possibly have a problem with C. difficile but agrees that I had AAD and then possibly IBS. He believes if I had C. difficile as my primary colonizer I would not be in his office, probably hospitalized. He thinks my recent bout of diarrhea is a stomach bug. For some reason i’m not convinced.

I checked out his history; he’s an experienced ex-surgeon who has been in the field for many years, im not sure where he comes from, I would guess India.

Anyway, hes given me a tube and has asked for the testing of the presence of C.Difficile (on my request), as well as 2 other things (I can’t read his awful handwriting), I suspect something to do with bacteria for the stomach bug, could also be blood (I hope so).

The main thing is I feel completely normal, however I have not eaten a huge amount since Sunday. Even so, I have only had one solid bowel movement for 2 days, no pain, bloating or discharge, and I believe gas (flatulance) a couple of times. I feel normal again, but time will definitely tell.
ectx
02-16-2004, 07:56 PM
My condition seems to have completely resolved itself after a sudden and severe bout of diarrhea lasting 2 days (accompanied by mild fever). Could this have been the delayed effect of the primary colonizer C. difficile being flushed out of my system?
Funny thing is, I took a couple of acidophilous pills before it started, mabye that prompted it ๐Ÿ™‚

My doctor seems to not think I could possibly have a problem with C. difficile but agrees that I had AAD and then possibly IBS. He believes if I had C. difficile as my primary colonizer I would not be in his office, probably hospitalized. He thinks my recent bout of diarrhea is a stomach bug. For some reason i’m not convinced.

I checked out his history; he’s an experienced ex-surgeon who has been in the field for many years, im not sure where he comes from, I would guess India.

Anyway, hes given me a tube and has asked for the testing of the presence of C.Difficile (on my request), as well as 2 other things (I can’t read his awful handwriting), I suspect something to do with bacteria for the stomach bug, could also be blood (I hope so).

The main thing is I feel completely normal, however I have not eaten a huge amount since Sunday. Even so, I have only had one solid bowel movement for 2 days, no pain, bloating or discharge, and I believe gas (flatulance) a couple of times. I feel normal again, but time will definitely tell.

Glad to see you’re better, sorry it took so long for me to get back to you. My guess is the acidophilous fixed you right up. You may have had a skewed ratio of C. difficle…just enough to throw you off. Antibiotics can really screw up your stomach when taken over a long period of time. Ultimately listen to your doctor…but don’t be afraid to question him. I’m sure he’s great…it’s just that the breath and scope of human disease is overwhelming, and you can’t expect your doctor to know immediately what your problem is. I don’t think it was a stomach virus as this persisted for a long period of time. Stomach viruses are usually self limiting. Then again, I’m not an MD and I haven’t seen you like your doc has. Best of luck with everything.
Exnor
02-17-2004, 04:34 AM
Thanks for the reply.

My bowel movements have slowly returned to what seems normal (2-3 times a day, formed much more normally). Whatever did happen to me obviously gave me some kind of detox. However, I am still experiencing a little watery discharge sometimes, and i’m unsure of the reason. I saw a different doc this morning who very quickly examined me, and gave me some cream (Daktacort, micanozole nitrate 2%/ Hydrocortisone 1%) to put around the area twice a day. This suggests he thinks I have some kind of infection. Hopefully it will do the trick, if it doesn’t in 2 weeks i’ll hassle them some more.

edit: Hopefully I should get the result of that test this afternoon.

edit: I phoned up for the results just now. The doctor wants me to come in to discuss the results, I have an appointment at 4:45pm… I’m slightly anxious as to why they have asked me to come in rather than the receptionist telling me over the phone. Wish me luck.
Exnor
02-17-2004, 10:48 AM
I tested positive for Campylobacter, the cause of my acute illness 3 weeks ago. Quite odd, as I have not travelled abroad for some time. I believe I got it from some chicken that I ate. I am quite relieved it was this and nothing more serious.

“Campylobacteriosis is an infectious disease caused by bacteria of the genus Campylobacter. Most people who become ill with campylobacteriosis get diarrhea, cramping, abdominal pain, and fever within 2 to 5 days after exposure to the organism. The diarrhea may be bloody and can be accompanied by nausea and vomiting. The illness typically lasts 1 week.”

source: http://www.cdc.gov/ncidod/dbmd/diseaseinfo/campylobacter_g.htm

Suffice to say I shall make sure my chicken is nearly burnt before eating it from now on ๐Ÿ˜‰ The doctor prescribed some antibiotics that I can take to make sure the infection is gone from my system (Ciprofloxacin). The course is 2 tablets a day, for 5 days. Quite understandably, I am hesitant to take more antibiotics!
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