Taking Vancomycin with no stool results?

[EB80]

Hi there, female, 37. I had c.diff for the first time at age 23 after taking Levaquin, treated with flagyl. From that point on I’ve had issues, which were always chalked up to IBS-D. I’ve taken probiotics and generally avoid all antibiotics if possible. In 2015 I had to take them and got c.diff, treated with flagyl.
Fast forward to now, and for several weeks I’ve been having strange (new to me) digestive issues, lots of burping, bloating, intermittent diarrhea and constipation. So I decided to take a PPI (Prilosec). After about 3 weeks on the PPI I developed watery D and had some bloody mucus in my stool. (The bloody mucus is a sign of c.diff for me) Also, now I’m reading that PPIs can cause c.diff. It also had the distinct smell. I waited 24 hours and when it wasn’t better I took some Flagyl I had on hand and made an appointment with a GI doctor. I hadn’t seen one in years and so I’m a new patient. He reluctantly gave me vancomycin without the positive test and asked me to wait until results were back to begin taking it. I waited and waited for results. My D was getting worse, although not watery, likely due to the 2 doses of flagyl I had taken prior. I finally called and asked if I could start the vanco because I couldn’t leave my house and felt awful. He said yes. So I have been taking vancomycin for just 2 days and already see an improvement in my symptoms. I just got a call saying they didn’t even run the stool test because it wasn’t watery enough. I’m not sure why I needed to wait 5 days for them to tell me that. My doctor says just because I am having improvement on vancomycin it doesn’t mean I have c.diff. So that is my question. I truly don’t know if I have c.diff this time but I have read that vancomycin only treats 2 types of colon infections when taken orally. If I didn’t have c.diff, would I see any improvement on vancomycin? I don’t want to take something unnecessarily but I also don’t want to stop taking it so soon, I’ve I have c.diff. Also, now that I’m on vancomycin the urgency has subsided a lot, but when I pass stool it’s difficult to do, like I’m constipated, however it’s not the consistency of hard stool at all. I’m just wondering if that’s normal at this stage. Flagyl was awful to take with all the side effects, and this seems better, but given that it’s a strong antibiotic, I’m a little on the fence about continuing it without a positive stool test, or maybe my proof is the improvement of symptoms? Any insight would be much appreciated.

[roy]

Maybe whatever was causing it has resolved and the improvement is nothing to do with taking vanco.
Vanco does not treat the symptoms, it kills active c.diff and when the toxins are gone the symptoms resolve.
Its normaly 4 to 5 days before vanco does its job so symptoms resolving (D) quickly might indicate it's not the vanco that's responsible for the improvement.

DONT self medicate, even flagyl can cause c.diff!
If a lab rejects a sample because it's not watery it's because regardless of the result you do not have c.diff as a disease.
NOT because it cant be tested.

[EB80]

I had watery D, and probably shouldn’t have self medicated but having had c.diff before, I was fearful of how bad it would get. I was told they don’t test non watery D because it doesn’t work on the machines, not because I don’t have C.Diff. They didn’t test the stool at all but it seems some people here have had somewhat formed stool and tested positive. I assume they must have had the older type tests. My symptoms have improved on Vancomycin (day 3 now) but certainly not back to normal by any means. Thanks for your reply. My doctor told me to keep taking the vancomycin at this point but I am just wondering if anyone else has had a similar experience. I know some docs will treat right away while awaiting stool results.

[roy]

You were told wrong.
Solid stool can be tested but if you have solid stool the lab rejects the sample because c.diff is not causing a disease.

https://doi.org/10.1016/j.ijid.2018.07.006

[EB80]

Thanks for the link. In my case I had water D for over 24 hours at least 8 times, before I took Flagyl, which in hindsight I should not have done, in order to ensure I got an accurate test done. I was concerned that my test would be skewed anyway due to a few doses of Flagyl but when the bloody mucus started, I was concerned about it getting so severe that I'd need to be hospitalized. This article seems to contradict many posters here who say they tested positive for C. Diff even though they didn't have liquid stool. My stool was not formed, but not liquid enough apparently. I know more formed stool can be tested as I've done re-checks in the past, which I am now reading is debatable as well. I just don't know if I agree with a lab decision rejecting it based on only that, considering they don't know the background or medical history of the patient like a doctor would. I wish they would have simply tested the stool if they had the capability to do so.

[Whyme111]

Hi,
My Dr considered my symptoms severe enough to treat and I didn't have the watery D. My symptoms were mucus and a little blood. The lab I went to tested my sample and confirmed a positive test for toxins A and B. This is what confuses me with this disease; not all individuals present with water d however I understand it is the main symptom, followed by other various horrendous symptoms. I didn't have a fever either however I was very nauseaus and lethargic. I feel if I had let my symptoms go, it may have developed in to servere watery d however my anxiety caused me to alert my Dr immediately when I noticed a difference (mucus) and immediately called my Dr. and I was tested immediately. I think this infection had been lingering for a while and my last dose of Keflex set fuel to it, leading to the alarming symptoms. I'm currently on a Vanco pulse. I hope it works.... This has been horrible. I hope you feel better.

[EB80]

Thank you Whyme111. I am unfortunately familiar with c.diff but had a several year reprieve where I dealt with manageable (or mostly manageable) IBS. However this is my first time taking vancomycin. Have you had any side effects with vanco? I am drinking a ton of water but finding my urine output is less and now I’m having pretty bad middle back pain. It’s definitely helping the c.diff issues but some people have reported no side effects with vanco, I wis that were the case for me. I hope your pulse/taper works! Sounds like you’ve taken other meds before this.

[Whyme111]

Hi,
I understand the frustration that comes along with this. It's so up and down... One day is manageable to find the next is all over the place! Yes, I was prescribed Flagyl at first and actually didn't have any side effects. I felt so much better and then, WHAM! Relapsed 3 wks following my last dose. My Dr told me he should have treated with Vanco first and then prescribed me that. When I started taking Vanco, I remember asking myself, is this getting worse with this med? I was having urgency and frequency; not watery d though, just very loose. I was fatigued as well. I relapsed after taking Vanco. I was THEN (ugh) put on Flagyl and Vanco together and have been on the Vanco since... I am now on the pulse and have about 4 weeks to go. Just recently, I was having bladder pressure and discomfort. I am prone to UTI's as well as possible interstitial cystitis and became really scared it was an infection however the symptoms lessened as I drank a lot of water and watched what I ate. This has been a battle. I'm 39 and just want to enjoy life! AGAIN.

[Mindy]

My c diff started off with pure mucus tinged with blood. I didn't even have diarrhea every day. I was in horrible pain, sick to death. My quest will run anything. I know that a lot on here think you must have full blown watery diarrhea to be considered a bad case. I disagree. I was hospitalized 5 times, lost 35 pounds in 10 weeks. Ended up having an fmt.

[Whyme111]

Hi Mindy,
How long ago did you have the FMT? How are you feeling now?

[Mindy]

I had my fmt three years ago. Obviously better, but I believe I'll never be as I was pre c diff.

[EB80]

Whyme 111, I’m sorry to hear you’ve been through it so much and that the vanco doesn’t seem to be working for you. It’s making me constipated, which is strange, and I’m pretty sure I’m now getting a yeast infection. It’s a vicious cycle and I wonder what is in our chemical makeup that makes some of us so prone to this. I’ve taken probiotics for years.

[EB80]

Mindy, that is awful and I agree about the stools. I did start out with watery D but eventually I only pass bloody mucus. Just like anything, it seems people here have varying symptoms and I have dealt with the IBS diagnosis for 15 years now. C. Diff takes its toll on the colon in a way that’s hard to completely remedy. How much treatment did you go through before FMT? I was taking probiotics all these years and it seems no match for c.diff. Every single time I take an antibiotic or in this case a PPI, its just waiting to rear its ugly head.

[Mindy]

I took Flagyl and had such horrible side effects! You'd have to tie me up to give it time me again. Next I was on Vanco.