Accuracy of EIA test

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Tired22
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Accuracy of EIA test

Postby Tired22 » Thu Oct 11, 2018 3:48 pm

Hello all!
So relieved to find this page. I'm a 37 year old mom of 3 & in dire need of advice.
I have bad teeth (3 extractions in a year) & have been on amoxicillin several times. 3 times last October, November and December. It never did anything but give me a stomach upset and slight loose stools. I wasn't on any antibiotics for the past 9 months but I had to start on amoxicillin about 10 days ago due to a tooth abscess. On day 7 I woke up with a violent diarrhea and had it 7 different times. Unfortunately that was the day of my extraction and I decided to go through with it but the oral surgeon said I could stop the amox so I did. He gave me flagyl for my tooth infection and I took one that morning and my doctor decided to do a stool test that afternoon. I dropped it off that afternoon around 4 and they emailed me today saying that my EIA test for toxins a and B was negative. Here's my question… I've been taking the flagyl and the diarrhea has stopped (formed stools now). I've been taking 200 mg twice a day. It's making me feel absolutely awful and I want to quit. The oral surgeon says I can from his standpoint. My question is : is the flagyl what stopped me from having the diarrhea or did stopping the amoxicillin stop that? I had no idea flagyl treated c diff so now I'm questioning everything. I don't know whether to keep taking it or to stop and see if the bad diarrhea will come back. I'm going out of town in 4 days and I'm a nervous wreck about it. Is the EIA test accurate? I keep reading conflicting things and I don't know who else to turn to. My PCP says it's accurate but I don't know. I have a bad stomach anyway because of endometriosis but I'm typically constipated rather than having diarrhea so that was new for me. It didn't smell horrific or anything and I never had a fever but I'm just not sure. Please help. My GI doctor is of no help and prescribed me immodium of all things. I refuse to take that stuff and of course she can't see me till January. I literally have no where to turn. Do I stop flagyl? I only have 13 pills left but I can barely function. I would just hate to be on my road trip and experience horrible diarrhea and have to go to an urgent care or something. Should I trust the stool test?
Any help appreciated!!!

roy
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Re: Accuracy of EIA test

Postby roy » Thu Oct 11, 2018 4:13 pm

Trust the test.
Flagyl does kill active c.diff but to do so the dose is 500mg 3x a day for 10 days.
What your on might tickle it to death but it's probably not why your D cleared up.

Tired22
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Re: Accuracy of EIA test

Postby Tired22 » Thu Oct 11, 2018 4:29 pm

Thank you so much Roy! I think what scared me is that I read that particular test is only 50% accurate but I don't believe everything I read on the Internet these days. I thought I would ask you folks since you know so much about it. I guess I will try to go off the flagyl since it's causing my face to feel tingly. That's never good! I just don't want to go out of town and get a C diff infection. Would one dose of it before the stool sample cause a false negative? Thanks again so much!

roy
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Re: Accuracy of EIA test

Postby roy » Thu Oct 11, 2018 5:30 pm

Cant give medical advice but one dose of 200 Flagyl is very low.
I doubt if it would have any effect on anything relating to a c.diff test (or anything else)
The test does not look for bacteria, it looks for the toxins and the toxins would still be there and detectable for several days even if 100% of the c.diff was dead.
If you have formed stool and a negative test you dont have much to worry about.

Tired22
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Re: Accuracy of EIA test

Postby Tired22 » Thu Oct 11, 2018 9:31 pm

Thank you Roy! I kept hearing the EIA wasn't as sensitive as the P something test. I hate worrying

georgina
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Re: Accuracy of EIA test

Postby georgina » Fri Oct 12, 2018 12:39 am

Is true that the EIA is not a very reliable test but if you are having solid stools i'd say you should trust it. The fact that you are not having classic symptoms it means that Cdiff is not producing toxins inside your gut. However , if you are having nasty side effects from Flagyl and you want to stop it , make sure you have a back up plan just in case full blown symptoms return . |Talk to your doctor and ask for a script of Vanco just to have it with you if , GOD FORBID something happens.

roy
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Re: Accuracy of EIA test

Postby roy » Fri Oct 12, 2018 3:48 am

All tests have to be looked a alongside symptoms
A negative test and no symptoms means no c.diff
A positive test but no symptoms means no c.diff that needs treating.
A negative test but Full on D means the test could be wrong so treat if its likely the patient has c.diff (medical history, antibiotic use, old, vulnerable, in hospital, etc.)
Treat the patient NOT the test!

Tired22
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Re: Accuracy of EIA test

Postby Tired22 » Fri Oct 12, 2018 9:34 am

Thanks everyone! D is back today. My dr is too ignorant to retest let alone prescribe vancomycin. I have 10 flagyl left. Should I take them? Ugh I hate stressing before a road trip weve been looking forward to! This seems like a nightmare. I will NEVER take amox again. Why do EIA A & B if it's so unreliable??? My dr seems to take is as gold & does not care I'm suffering. Ugh

Tired22
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Re: Accuracy of EIA test

Postby Tired22 » Fri Oct 12, 2018 11:36 am

CLOSTRIDIUM DIFFICILE TOXIN/GDH W/REFL TO PCR

Note: CLOSTRIDIUM DIFFICILE TOXIN/GDH W/REFL TO PCR MICRO NUMBER: 82687790 TEST STATUS: FINAL SPECIMEN SOURCE: STOOL SPECIMEN QUALITY: ADEQUATE GDH ANTIGEN: Not Detected TOXIN A AND B: Not Detected COMMENT: No toxigenic C. difficile detected For additional information, please refer to http://education.QuestDiagnostics.com/faq/FAQ136 (This link is being provided for informational/educational purposes only.)
These are my test results… does that mean they just did EIA. Can someone please tell me what all this jibberish means? Appreciate it!!!

roy
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Re: Accuracy of EIA test

Postby roy » Fri Oct 12, 2018 1:45 pm

No, they did the whole range of tests!
GDH followed by EIA and also they did a PCR.
It's the gold standard test.
Negative by all that is negative! (99%+)
Why are you so worried about c.diff?
Dr Google by any chance?
Someone here a few months back described c.diff as "an uncontrolable waterfall flowing from my butt".
If you get that 3x a day for 3 days you MIGHT have c.diff.
Anything other than that you should trust the test.

Tired22
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Re: Accuracy of EIA test

Postby Tired22 » Fri Oct 12, 2018 2:42 pm

Wonderful to hear Roy, thank you! My dr mentioned it & probably should not have with my health anxiety. Yes Dr Google is also to blame. I appreciate your help & I will try not to google!

Tired22
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Re: Accuracy of EIA test

Postby Tired22 » Mon Oct 15, 2018 12:00 pm

Well major D came back. Interestingly as soon as I discontinued Flagyl (it was awful). Dr suspected c diff without me asking. Said test is not 100 % & it sounds like antibiotics caused my D. Wrote me an ex for vancomycin. Here's the thing..... My teeth are awful and Im likely to get more tooth infections. What's to stop antibiotics from giving me
Cdiff in the future? And if I take big guns like this Vancomycin won't that create antibiotic resistance? I'm relieved she listened to my symptoms but I wish I didn't have to take this stuff. Does it sound like c diff and like I need the RX? She was concerned because my abdomen was distended and I was having left sided pain. Also does vanco give bad symptoms? Going on a family vacation in 2 days & nervous for side effects.
Thanks!!!!

roy
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Re: Accuracy of EIA test

Postby roy » Mon Oct 15, 2018 1:00 pm

4 out of 5 cases of antibiotic associated D are not c.diff!
Your test was negative so its almost certain it's not c.diff related.
I would be taking vanco with me on the trip as a back up "just in case" but even then I would not use it without a positive test.
If you had a previous positive test it's right to treat a relapse on symptoms alone, but to assume you need treating when the first and only test is negative might cause even more unwanted antibiotic side effects.

I would compare it to taking meds for diabetes because you have similar symptoms but all tests show you are not a diabetic!

Tired22
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Re: Accuracy of EIA test

Postby Tired22 » Mon Oct 15, 2018 1:31 pm

Very great advice! I will just take it with me. She scared me about colitis & inflammation but I'd rather wait. Thank you Roy

roy
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Re: Accuracy of EIA test

Postby roy » Mon Oct 15, 2018 1:42 pm

ALL c.diff that causes D is colitis but the far majority of colitis is NOT c.diff.
It's a "catch all" word, (much like IBS) and not a specific disease.


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