Should I be seeing a GI Dr?

[Hellerhs]

Hi guys sorry if this is a stupid question. Up until I came down with it I have never even heard of a Cdiff infection. Dentist then root canal specialist had me on 3 back to back rounds of Clindamycin, few weeks later, weird terrible diarrhea ensues. When I went to family Dr, he originally said stomach flu and if it persists because of antibiotic usage could be Cdiff. He actually told me to take anti diarrhea pills , two of them twice a day. Those made me sicker so quit after 2 days. Ended up in ER week later badly dehydrated and feeling like death. Cat scan showed swollen colon and labs showed everything messed up, liver kidney pancreas. They put me on flatly 4 times a day. Question is, I'm thinking I should take the case away from family Dr , who is a PA not even an actual Dr and go to my GI guy. I'm leery as he knew it could be cdiff but put me on anti diarrhea meds. Do you guys follow up with your reg Dr of go right to a specialist? I felt petty confident about whooping this thing but after reading through here I see it's always not as simple as just taking the antibiotics and resuming a normal healthy lifestyle!

[OCmama]

C. diff can be a very serious infection and with the holidays coming, in my opinion, it would prudent to make an appointment with your GI. Wishing you a speedy recovery!

[Hellerhs]

Thanks OC, it ruined Thanksgiving, hate to see it take out Christmas to! Just wasn't sure if this was something normally felt with through family Dr or specialist. Think I'm definitely calling GI guy Monday and won't worry about offending my Dr, this is kind of a big deal. I finish my antibiotics on Monday, I also return to work Monday. Still have diarrhea but it's down to once a day, only feeling like I'm at 60% though. Hoping I'll feel better without antibiotics, they mess with my stomach and don't each much so always feel week.

This stuff seriously sucks!

[NanciT]

You do need to see a GI especially if the diarrhea has not gone away, it sounds like they put you on Flagyl which sadly is the first line for many MD's out there.

Often patients start with the PA but you need to see a GI and request a change in medication to either Vancomycin( this is usually the next step) or Dificid. Dificid is expensive so often the next step would be the Vanco. Put a call in Monday, you may need a referral depending on your insurance, if that is the case, talk with the PA and tell them they need to call and get you in with a GI since you continue to have symptoms.

NanciT

[Hellerhs]

Thanks Nancy, I will call my GI guy in the morning. I'm fortunate the insurance I have doesn't require a referral.

[maxny2]

Abridged version of the CDiff treatment guidelines: http://www.asp.mednet.ucla.edu/files/vi ... /CDiff.pdf - it's useful to print that out and bring with you to all your appointments, to corroborate when a switch to Vanco is suitable.

Be proactive, self-advocate, read the current treatment guidelines if you can (which most primary care providers and even some specialists are apparently clueless about.) Look for Providers knowledgeable about C diff best practices.

GI society full guideline: http://gi.org/guideline/diagnosis-and-m ... d-colitis/

ID Society full guideline: https://www.idsociety.org/uploadedFiles ... 2010a.pdf'

Updates to these guidelines (emphasis on Vanco, Dificid, and FMT) are overdue. Flagyl/Metronidazole is far less effective for CDI than it once was and should be "deprecated." This presentation: https://youtu.be/CeV70YFZGXU by Harvard/MIT CDI expert Ciaran Kelly explains more recent findings. His brogue and expertise were quite comforting to me when I was seriously ill in bed ;)

At my first hospital stay, my docs and even the GI specialists put me on Flagyl, even though by the Rx guidelines I clearly had at least moderate to severe infection with complications, for which Vanco is indicated.

The Flagyl (metronidazole) did next to nothing for me. My condition worsened days after discharge, I returned to ER and the Doc refused to admit me or switch me to Vanco. He said maybe it was "something else" causing the D, wrote me pain and anxiety meds, kept me on the flagyl, and sent me back home. I was terribly ill, 30lbs underweight, etc. Again, this was counter to the Rx guidelines (adverse reaction or no response after 5-7 days on Metro, then switch to Vanco).

I was so depressed, but thanks to urgings of kind members on this forum, I went to a walk in clinic to ask for Vanco and luckily was seen by a younger Nurse Practitioner who knew all about C diff and wrote me a Vanco script immediately. I remember breaking into tears because he was the first provider who "got it."

On my second hospitalization, I lucked into an ID doc very knowledgeable about CDI who prescribed me a 4 month Vanco tapered pulse regimen (with probiotic adjunct), and a year later I haven't had a recurrence.

[georgina]

The best way to get the proper treatment for Cdiff is to find a knowledgeble GI or a infectios disease doctor , definitely don't rely on the family doctor especially since he gave you anti-diarrhea meds . Iomodium , Loperamide are a big NONO as will slow down your gut and trap the toxins inside.