Question about how long until diarrhea subsides

[cstein]

My mother, 84 years old, had a stoke in June, 2016. She spent 2 1/2 weeks in a rehab facility before returning home. She was tested for CDiff at the facility and the test came back "indecisive" so doctor ordered a 10 day course of Flagyl. She continued to have diarrhea the entire time she was on this - but it wasn't bad. The diarrhea continued and became terrible. We had another specimen (all liquid) tested, and it came back negative for CDiff. 5 days later she was in the ER dehydrated from extensive diarrhea, and while there formed a small solid stool - tested positive for CDiff. Began on Vancomycin 250 mg/ 4 times/day. Today is day 8 on the Vancomycin. It seems that at times the diarrhea is less frequent - but she has yet to form a solid stool. She is also now complaining more of cramping and nausea - although she hasn't vomited. To add to this frustration, my mom's stroke left her with Aphasia - so she isn't able to find her words. She has complete mobility - thank GOD. Are we being impatient for results - or should we be seeing some positive effect from the Vanco at this point?? ANY words of encouragement will be welcomed.

One more thing - her diarrhea has NEVER had the HORRIBLE smell that we have read about - has anyone else had CDiff without the characteristic odor???

[NanciT]

Hello Cstein and welcome to the site. Please read the first thread for all new posters

I am so sorry your Mom is dealing with CDIFF. On Vancomycin many don't have "solid" stool. While I was on it for months things were loose. In the case of your Mom who is 84 and has recently had a stroke, I would always check with her physician if you have any concern at all. Vanco can cause nausea, I used " Sea Bands" on my wrist which helped me a great deal. I also used a heating pad often and still do. Please make sure to check with a physician on all of this due to your Mom's health issues. If she has loose stools often, I would also ask about that. The risk of dehydration is high with frequent diarrhea.
I would also check with her GI about a probitoc. There are several including myself who did not have the typical"smell" we hear about with CDIFF.
I stuck with a bland diet while on medication, I found it took a long time to get back to regular foods.
I am so sorry she is going through this, hopefully the Vanco will take care of it and she will be feeling better soon.
Wishing her a speedy recovery
NanciT

[roy]

If she is still having frequent D this far into a course of Vanco her Dr needs to review her medication.
A higher dose or changing to Dificid might be needed.
DO NOT allow them to stop the medication at the end of the course if she is still having symptoms!!!!
Be her advocate and get involved with her treatment.
Most of all don't let the Drs take her off meds to "see what happens".

[Ril]

Totally agree with everything Roy said. I don't think we are being alarmists but there is no such thing as being too cautious when it comes to the elderly. Severe diarrhea can dehydrate elderly and cause electrolyte imbalance so your mom needs to be monitored and again, as Roy said, you should be her advocate.
The right medication and dose should be found and please make sure she takes in enough fluids with electrolytes such as vitamin water or sports drinks. With proper medication she should be fine but just be cautious and stay on top of things.

Rita

[georgina]

Yeap , Roy is right , the dosage of vanco needs to be reviewed , if dosage is too low she can still have symptoms although 250 mg X 4 times / day is a high dose , but there are some cases where the symptoms are controled with 500 mg x 4 times / day . She definitely needs to stay more on the meds , maybe a taper and pulse to avoid a full blown relapse. Dificid is the best treatment for Cdiff , but i'm not sure how she will respond to it , i never tried it but many posters complained that is a harsh drug and has side effects. Try a heating pad for the pain , or ask the doctor about antispasmodic medication.Keep her on a bland diet , BRAT diet and maybe some bone broth (excellent for hydratation and nutrition and also has calming effects on the gut).

[amyc]

I wonder if she could reduce her dose to 125 mg 4 times a day if she isn't having lots of D actually. My doctor used 125 mg 3 times a day for 14 days, and says it's enough even if you have quite a bit of D. it's possible the 250s could be causing the nausea? 250mg at 4 times a day could cause loose stools too. Has she ever seen a gastroenterologist or is she being treated by her primary care doctor?

[cstein]

Hi everyone, and thank you so much for your posts - they are so helpful. So last night my mom had NO diarrhea - or any bowel movement!!! This morning she had an actual formed stool - thought she had FINALLY turned the corner. Since however the watery diarrhea has returned. After two bouts, I called her IM and he saw her immediately. He told us to keep on the Vancomycin - which will finish this Friday. He also prescribed Questran Powder 2x/day - trying to "bulk" her stool. He did blood work to review the electrolytes and CBC. He has been our family's doctor for many years, and I completely trust him. He is consulting with her GI doctor (who still hadn't responded to his page 5 hours later) to be sure he is in agreement with this treatment. He also has her taking a Lomotil before breakfast, another one 4 hours later and then a final one immediately before bedtime. Has anyone been on the Questran Powder in an attempt to control diarrhea??

[Acres]

Hi,
Ask your doctor about dificid if things persist....I went on a 10 day course and it worked (after flagyl and vanco). My experience with it was ok....no side effects....
Scott

[cstein]

Thanks Scott - the doctor did mention that after my mom is off the Vanco for two days (which will be this coming weekend) if the diarrhea doesn't subside - there is "another medication"

[Nancy1]

I took Questran during one of my relapses, to control D. My doc wouldn't prescribe any more vanco until my test results came back, and it was a 3- day weekend. I was having D every 20 minutes night and day. So they gave me Questran until my (positive) result finally came back, in attempt to tide me over until I could get vanco. The Questran made my D "only" every hour or two, which was some improvement, but not a lot! (After that, I made sure to have some extra vanco whenever I finished a series, so in case of another relapse I could take a sample in for testing, and then have better control over the D while waiting for the result.)

[Ril]

I also took questran but after c diff for IBS-D . I needed it several times/day to control the PI IBS.
You might want to ask your dr about Enteragam, a medical food that GI drs are using now for d because it also binds with and removes c diff toxins.

[roy]

Questran does not cure c.diff.
It binds with the toxin so it passes out of the body and causes less harm, the c.diff will still be there and multiplying so effective antibiotic treatment is still required.
I am VERY concerned that your Dr has prescribed lomatil.
Anything that slows the gut is dangerous with C. Diff.
The body reacts to the toxin by trying to expell it and the result is D.
As always nature knows best
If the D is slowed by lomatil the toxins stay in the gut and can cause severe damage.
My mom died of toxic megacolon, lomatil, imodium etc have been implicated as causing a huge increase in that type of severe complications.
Check the advisability of lomatil with her GI or even your pharmacist.
To be honest I would want to be switched to Dificid.
If she still has D this far into vanco treatment it's clear it's not working.
Questran and lomatil might mask the symptoms but will not cure it.
From experience I can state that masking the symptoms is NOT an option for an elderly person and can be fatal.
Sorry if this post sounds negative but my Moms c.diff treatment failure and relapses mirror what your moms going through.

[Ril]

Sorry I missed the lomotil. Of course Roy is absolutely right.
And as good as your dr is, seeing a GI directly is the best. Unfortunately yours doesn't seem to be responsive.
Given your mom's situation perhaps your family dr can help with that.
I would ask him tactfully if he could get you an emergency appointment with a GI-yours or another- who is an expert in c diff, to evaluate your mom ASAP and decide on best treatment. It could also be ID dr but for me, GI dr is best.

C diff is not usually dangerous in younger healthy people but things can go badly in older people if you don't stay on top of it. I am sure your mom will be fine but you have less "wiggle room". No point taking chances.

[Acres]

When I went to the er and tested negative for c diff I was taking flagyl. The er doc told me to take Imodium since I "did not" have c diff. Well that's when the intense pain started for me. I took 3 pills after 3 consecutive watery D movements in about 5 hours and then for the next 3 days had severe pain lower right side, which my GI said later it was the toxins "stuck" in my gut causing damage. Turned out, I did have c diff....Been with aches and rumbles ever since.....I take pepto now for ibs issues....
Scott

[georgina]

Agree ,Lomotil is not recommended , it can aggravate things! I would only stick to the Questran if I were you.