Wednesday, October 20, 2010

Antibiotic and PPI Associated Diarrhea

Endoscopic image of pseudomembranous colitis, ...Endoscopic Image of Pseudomembranous Colitis Our gut harbors a number of bacteria; many of them protect us from colonization and harmful effect of deadly bacteria. In recent times pathogenic bacteria like C. difficile are more often found causing diarrhea; what is called pseudomembranous colitis a suferinfection.
This is most commonly seen following use of prolonged antibiotic therapy and use of proton pump inhibitors (PPI).
Commonly used antibiotics damage the normal gut flora and tilt the balance towards invasion and overgrowth of pathogenic bacteria. Prolonged PPI use decreases the acidic environment and allows multiplication of organisms harmful to body.
Clostridium difficile,  a bacterium that takes this opportunity to overgrow and causes diarrhea. It is also difficult to eradicate as is not susceptible to conventional antibiotics. A tough antibiotic called vancomycin is being used to treat it along with metronidazole. Some cases of vancomycin resistance have also been reported.
It is wise at the first place to prevent this superinfection by restricted use of antibiotics and supplementing with good bacteria during its use. Peudomembranous colitis can be treated by vancomycin, toxin‐binding medications, active vaccination, intravenous immunoglobin, and fecal bacteriotherapy (FB). Fecal bacteriotherapy is putting feces from healthy donors to the intestine of patient through colonoscopy.
Further, indiscriminate use of PPIs needs to stop making it available strictly on prescription.
In several interesting researches of recent times it has been seen that curcumin an active agent found in turmeric helps to improve gut health. It's likely that daily use of turmeric in hospital settings, in food products like curry or soup, can potentially decrease the incidence of Clostridium difficile associated diarrhea.
More studies are needed to determine the mechanism of action of turmeric and the physiological effects of turmeric in animal models of pseudomembranous colitis.
If this is ignored communities is likely to face situations like development of superbugs like (New Delhi Metallo) NDM-betalactamase1 and much more resistance strains of bacteria.
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