Open AccessRecent developments on the role of Clostridium difficile in inflammatory bowel disease
Author(s) -
Hugh James Freeman
Publication year - 2008
Publication title -
world journal of gastroenterology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.427
H-Index - 155
eISSN - 2219-2840
pISSN - 1007-9327
DOI - 10.3748/wjg.14.2794
Subject(s) - pouchitis , inflammatory bowel disease , toxic megacolon , clostridium difficile , medicine , ulcerative colitis , pseudomembranous colitis , exacerbation , gastroenterology , colectomy , ileitis , dysbiosis , disease , colitis , enterocolitis , crohn's disease , microbiology and biotechnology , antibiotics , biology
Clostridium difficile (CD), specifically its toxins, have been implicated as a risk factor for exacerbation of the inflammatory process in up to 5% of patients with ulcerative colitis or Crohnos disease. Typical evidence of colonic changes with CD infection, including pseudomembranous exudate, are often not present; however, a severe clinical course may result, including precipitation of toxic colitis and toxic megacolon. Recently, hypervirulent CD strains have been reported raising concern for a more severe disease process in patients with underlying inflammatory bowel disease. Moreover, small bowel involvement or CD enteritis has been increasingly described, usually in those with a history of a prior colectomy or total proctocolectomy for prior severe and extensive inflammatory bowel disease. Finally, refractory or treatment-resistant pouchitis may occur with CD infection.