Stool consistency while on vancomycin and its significance

Posted by wty2020 @wty2020, Jan 17 11:48pm

I apologize up front if this is not the right “board” to ask this question, but can anyone share with me what I should expect regarding my stool consistency while on vancomycin? I am on my second course (actually in the first week of a four week taper right now) and the consistency of my stools seem to have regressed back to what they were after I had been on vancomycin a few days. When I started the vancomycin, my stools were watery diarrhea with small flecks in it. After a few days, I had formed but very soft loose stools that did not stay intact when flushed. Then they progressed to firmer but still soft stools that partially stayed intact. After I started Florastor (saccharomyces boulardii) 10 days into that 14 day course, my stools started firming up to well-formed small stools (usually three or four at a time). I thought that was a sign of curing cdiff. Then I read that saccharomyces boulardii can cause constipation, and figured that could be the cause of the firm stools. I was dejected. Then about the time I started on the taper, I started having softer looser, stools, like a step or two better than watery diarrhea. Then a couple days of firm stools, then back to very loose, soft “stools” nearly the consistency of diarrhea. Is this a sign of recurrence? If so, how can that be when I am still on vancomycin, albeit a lesser dose?

@wty2020 Welcome to Mayo Clinic Connect.

You are taking vancomycin for C diff and experiencing stool changes. You want to connect with members that have been through the same thing and may be able to offer help and support.

You will notice that I added this discussion to the Digestive Health group as well as keeping it in infectious disease. I did this so you could talk to members like @sarasally2 @david33 @ngorman25 @losthope @mhi @dilly69 @cece55 @mhi @pines in a central location.

Below I have linked a previous discussion related to C diff. If you haven't already done so I suggest reading through the past comments.
– C Difficile: Do you have memory issues, disoriention, confusion? https://connect.mayoclinic.org/discussion/c-diff-4/

May I ask when they will retest your stool for C diff?

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Thank you Erika. I will look for responses from those you listed. In the meantime, I will follow the link to the previous discussion.
to answer your question, the subject of retesting has not come up yet. I have not gotten to an Infectious Disease doctor yet. My surgeon (from the surgery in October in which I was given an antibiotic which resulted in the cdiff) is still managing this. He has been in contact with an ID who instructed him on the taper that I am on now.

I am 63 y/o male who had a small part of colon removed late October (there was a polp in the neck of my appendix where it attaches to the colon that could not be removed during a colonoscopy). They had to take the neck of the appendix (and the appendix) and a small portion of the colon off to make sure they got the polyp. Surgery went great. I was told after the surgery that my bowels would not return to normal from anywhere from 3 days to 3 months and to expect diarrhea and loose stools over that time. I was put on a soft diet until they returned to normal. I had one stool 2 days after surgery and it was very loose, Then 3 days after the surgery I had severe diarrhea. It was like during colonsocpy prep, but painful in abdomen. I thought it was part of the recovery, thinking each day it would get better. I didn't say anything for 2 weeks (I know, I'm an idiot), and I just stopped eating. At two weeks I questioned the surgeon whether this was normal recovery and he said no, that it sounded like cdiff. They took a stool sample, and the test was positive for cdiff. But the result was not returned for another week, so I had watery diarrhea with small carmel colored flecks in it for 3 weeks. Lost 12 lbs. My surgeon put me on vancomycin for 10 days. My stools never returned to normal, never firm formed stools, just mostly loose, but, again, I was told this was all part of the colon surgery recovery now complicated by cdiff. I simply did not educate myself at this point (regrettably). Over the twelve days that followed the last dose of vancomycin my stools, which never returned to normal, steadlily increased in loosness and began smelling like cdiff, so I called my surgeon. He recommended another test and in the meantime he would put me on another course of vancomycin. I asked if there was something else becasue I thought the vancomycin was causing prostatitis type issues. He did not think that was possible but I persisted so he prescribed 10 days of metronidazole. The results came back four days later as "positive PCR, but negative toxin." He thought it might be false negative because of my descripton of the stool looseness and smell, so he had me I finish the metronidazole. Toward the end of the metronidazole, my stools showed a little improvement (if partially formed and semi firm are improvements), but they fluctuated between that and very loose. Afer I finished the metronidazole, the stools steadily loosend and four days after the end of the metronidazole they started to become watery and by eight days after the metronidazole I was going every hour or two and they all were watery diarrhea with only flecks. My surgeon put me on a 14 day course of vancomycin and said he would talk to an ID regarding seeing me and discussing a taper at the end of the 14 day course. The ID said they did not need to see me because they would just do the same as the surgeon –put me on vancomycin (though they told him only a 10 day course) and they would not see me until I failed vancomycin twice, at which time they would consider either a third round of vancomycin or possibly fidaxomicin. My surgeon later talked to them and they apparently agreed on a taper at the end of this 14 day course. I am in the second week of the taper. (1st week 2 125mg a day; 2nd week 1 125 mg a day; 3rd and 4th week 1 125 mg every other day).

REPLY
@erikas

@wty2020 Welcome to Mayo Clinic Connect.

You are taking vancomycin for C diff and experiencing stool changes. You want to connect with members that have been through the same thing and may be able to offer help and support.

You will notice that I added this discussion to the Digestive Health group as well as keeping it in infectious disease. I did this so you could talk to members like @sarasally2 @david33 @ngorman25 @losthope @mhi @dilly69 @cece55 @mhi @pines in a central location.

Below I have linked a previous discussion related to C diff. If you haven't already done so I suggest reading through the past comments.
– C Difficile: Do you have memory issues, disoriention, confusion? https://connect.mayoclinic.org/discussion/c-diff-4/

May I ask when they will retest your stool for C diff?

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The doc said after 6 months. I've had 4 relapses in 7 months so think you'll know when it's gone.

REPLY

I'm finding that l'm getting weaker and now have fissures from extreme diarrhea, so painful

REPLY
@wty2020

Thank you Erika. I will look for responses from those you listed. In the meantime, I will follow the link to the previous discussion.
to answer your question, the subject of retesting has not come up yet. I have not gotten to an Infectious Disease doctor yet. My surgeon (from the surgery in October in which I was given an antibiotic which resulted in the cdiff) is still managing this. He has been in contact with an ID who instructed him on the taper that I am on now.

I am 63 y/o male who had a small part of colon removed late October (there was a polp in the neck of my appendix where it attaches to the colon that could not be removed during a colonoscopy). They had to take the neck of the appendix (and the appendix) and a small portion of the colon off to make sure they got the polyp. Surgery went great. I was told after the surgery that my bowels would not return to normal from anywhere from 3 days to 3 months and to expect diarrhea and loose stools over that time. I was put on a soft diet until they returned to normal. I had one stool 2 days after surgery and it was very loose, Then 3 days after the surgery I had severe diarrhea. It was like during colonsocpy prep, but painful in abdomen. I thought it was part of the recovery, thinking each day it would get better. I didn't say anything for 2 weeks (I know, I'm an idiot), and I just stopped eating. At two weeks I questioned the surgeon whether this was normal recovery and he said no, that it sounded like cdiff. They took a stool sample, and the test was positive for cdiff. But the result was not returned for another week, so I had watery diarrhea with small carmel colored flecks in it for 3 weeks. Lost 12 lbs. My surgeon put me on vancomycin for 10 days. My stools never returned to normal, never firm formed stools, just mostly loose, but, again, I was told this was all part of the colon surgery recovery now complicated by cdiff. I simply did not educate myself at this point (regrettably). Over the twelve days that followed the last dose of vancomycin my stools, which never returned to normal, steadlily increased in loosness and began smelling like cdiff, so I called my surgeon. He recommended another test and in the meantime he would put me on another course of vancomycin. I asked if there was something else becasue I thought the vancomycin was causing prostatitis type issues. He did not think that was possible but I persisted so he prescribed 10 days of metronidazole. The results came back four days later as "positive PCR, but negative toxin." He thought it might be false negative because of my descripton of the stool looseness and smell, so he had me I finish the metronidazole. Toward the end of the metronidazole, my stools showed a little improvement (if partially formed and semi firm are improvements), but they fluctuated between that and very loose. Afer I finished the metronidazole, the stools steadily loosend and four days after the end of the metronidazole they started to become watery and by eight days after the metronidazole I was going every hour or two and they all were watery diarrhea with only flecks. My surgeon put me on a 14 day course of vancomycin and said he would talk to an ID regarding seeing me and discussing a taper at the end of the 14 day course. The ID said they did not need to see me because they would just do the same as the surgeon –put me on vancomycin (though they told him only a 10 day course) and they would not see me until I failed vancomycin twice, at which time they would consider either a third round of vancomycin or possibly fidaxomicin. My surgeon later talked to them and they apparently agreed on a taper at the end of this 14 day course. I am in the second week of the taper. (1st week 2 125mg a day; 2nd week 1 125 mg a day; 3rd and 4th week 1 125 mg every other day).

Jump to this post

I feel for you going through cdiff definitely is a life changing. I am now 5 months post antibiotic and still not fully recovered I don’t think will ever go back to previous cdiff. Luckily I only had one relapse but they are not fun. I am still terrified until now eveytime I get diarrhea I got tested for toxin 2 times and negative. I still cannot gain the weight I lost originally 14 lbs. I eat eat but cannot gain. I heard good things about fidaxomicin so you need to insist if your symptoms don’t improve. Please keep us posted.

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@dilly69

I'm finding that l'm getting weaker and now have fissures from extreme diarrhea, so painful

Jump to this post

I feel for you. Are you still dealing with cdiff now? What was the interval between your relapses?

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2 weeks was my longest between episodes. I keep getting UTI'S which require antibiotics. Just a viscous cycle

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I feel bad for you. So do you still have Cdiff? Or just dealing with UTI? My heart goes out to you

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Still have Cdiff

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Did the doctor recommend Fecal transplant? Or did you try taking dificid?

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Just vancomycin so far. Waiting to hear from the Gastroenterologist on next step. I'm sure they'll figure something out, we usually have to wait a month to see a specialist in BC.

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Good luck and hope you hear from the specialist soon. Keep us posted.

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