Dr. Lee was born in Shanghai, China, and received his college and medical training in the United States. He is fluent in English and three Chinese dialects. He graduated with chemistry departmental honors from Harvey Mudd College. He was appointed president of AOA society at UCLA School of Medicine. He underwent internal medicine residency and gastroenterology fellowship training at Cedars Sinai Medical Center.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
Treatment options for relapses of C. difficile colitis include:
A second course of the same or a different antibiotic
Six weeks of treatment with decreasing doses of
antibiotics
An oral resin by mouth such as cholestyramine (Questran) that
binds toxins and inactivates them
Non-pathogen (harmless) yeast by mouth such as Saccharomyces boulardii,
for example, Florastor
Doctors usually treat patients who relapse with another 10 or 14 day course of
metronidazole or vancomycin, and a majority of the patients so treated will
recover. Nevertheless, some patients will have another relapse.
Treatment options for multiple relapses include:
Treatment with one of the options listed above that
has not already been tried.
Vancomycin for six weeks in decreasing doses (125 mg
four times a day for one week, three times a day for another week, twice a day
for another week and so on), followed by four weeks of
cholestyramine
(Questran).
Two weeks of vancomycin or metronidazole along with four
weeks of S. boulardii (Florastor).
Fecal enemas from healthy relatives and family
members. Feces from non-infected donors are made into a suspension and
administered as enemas to the patient with multiple relapses. The normal
bacteria from the donor's stool displaces the C. difficile bacteria.
Passive immunizations with human gammaglobulin.
Patients with multiple relapses typically have low levels of antibodies to C.
difficile toxins. By giving patients who relapse gammaglobulin containing
large amounts of antibodies to C. difficile toxins, the patients' levels of
antibody to C. difficile toxins are increased. Pooled human gammaglobulin can
be administered intravenously.
Active vaccination for C. difficile toxins. Vaccination can increase a patient's levels of antibodies to
C. difficile toxins. This is a new treatment
that has not become widely available.
Clostridium Difficile Colitis - How Was Diagnosis EstablishedQuestion: What kinds of treatments have been effective for your clostridium difficile colitis (antibiotic-associated colitis, c. difficile colitis)?
Abdominal pain is pain in the belly and can be acute or chronic. Causes include inflammation, distention of an organ, and loss of the blood supply to an organ. Abdominal pain can reflect a major problem with one of the organs in the abdomen such as the appendix, gallbladder, large and small intestine, pancreas, liver, colon, duodenum, and spleen.
Diarrhea is a change is the frequency and looseness of bowel movements. Cramping, abdominal pain, and the sensation of rectal urgency are all symptoms of diarrhea. Absorbents and anti-motility medications are used to treat diarrhea.
Dehydration is the excessive loss of body water. There are a number of causes of dehydration including heat exposure, prolonged vigorous exercise, and some diseases of the gastrointestinal tract. The best way to treat dehydration is to prevent it from occurring.
Crohn's disease is a chronic inflammatory disease,
primarily involving the small and large intestine, but which can
affect other parts of the digestive system as well. Abdominal pain, diarrhea, vomiting, fever, and weight loss are
common symptoms.
Ulcerative colitis is a chronic inflammation of the colon. Symptoms include abdominal pain, diarrhea, and rectal bleeding. Ulcerative colitis is closely related to Crohn's disease, and together they are referred to as inflammatory bowel disease. Treatment depends upon the type of ulcerative colitis diagnosed.
Although a fever technically is any body temperature above the normal of 98.6 degrees F. (37 degrees C.), in practice a person is usually not considered to have a significant fever until the temperature is above 100.4 degrees F (38 degrees C.). Fever is part of the body's own disease-fighting arsenal: rising body temperatures apparently are capable of killing off many disease- producing organisms.
Stool color is generally brown. When stool color changes, often, an individual becomes concerned. The presence of the bilirubin in bile is generally responsible for stool color. Bilirubin concentration can vary bile color from light yellow to almost black in color. Changes in bilirubin can cause stool to turn green, gray, or clay-like in color. Intestinal bleeding may turn stool black, tarry, red, maroon, or smelly stool. Medication and food may also affect stool color.
Inflammation of the inner lining of the colon is referred to as colitis. Symptoms of the inflammation of the colon lining include diarrhea, pain, and blood in the stool. There are several causes of colitis including infection, ischemia of the colon, inflammatory bowel disease (Crohn's disease, Ulcerative colitis, or microscopic colitis). Treatment depends on the cause of the colitis.
Digestion is the complex process of turning food you eat into the energy you need to survive. The digestive process also involves creating waste to be eliminated, and is made of a series of muscles that coordinate the movement of food.
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