The D Words

[Josey Quinn 187]

First, a bit of advice: If you have symptoms that concern you, please call your doctor sooner rather than later.

After my VSG, as I transitioned from liquids and "mushies" to solid food during weeks four and five post-op, I thought my bowel movements would become more normal. They didn't. I had VSG rather than a gastric bypass, but since I had problems with dumping before surgery if I ate too much of the wrong foods, I thought it could be dumping syndrome. I started experimenting with my diet, hoping to eliminate any foods that were causing the supposed dumping.

Finally, I realized this wasn't dumping. It was unrelenting diarrhea. At the nine-week follow-up appointment with my surgeon earlier this week, I told him about it. He said I most likely have Clostridium difficile (C.diff) colitis, and he prescribed a targeted antibiotic. The C.diff overgrowth can be caused by the broad-spectrum antibiotics used after surgery.

I'm pretty miserable right now. My tiny tummy doesn't tolerate the antibiotics well, so I get nauseated every time I eat. My guts are still quite unhappy, so I can't stray far from the bathroom. I'm dehydrated because I'm having trouble drinking enough Water. I'm super tired. (Thank you for attending my little pity party.)

If I had called my surgeon a few weeks ago, I might have avoided some of this gastrointestinal misery. :-)

[Kindle 8,667]

I definitely feel your pain (and all the other unpleasantness). I got a C. diff infection about 5-6 weeks after my VSG. Mine was a result of the clindamycin my dentist put me on for a tooth abcess, but having a teeny tiny tummy definitely hindered my ability to stay hydrated.

You said you "most likely" have a C. diff infection. Did your doctor test for it? If not, I recommend the PCR test rather than the ELISA as the latter has a higher rate of false negatives. A positive confirmation may qualify you for any number of ongoing clinical trials for C. diff treatments. A was asked to participate in one, but the infectious disease center was located 60miles away and I just couldn't fit that much travel into my work schedule.

Here are the posts that describe what I went through and what I eventually had to do to clear the infection. Good luck, I sure hope you have an easier time than I did. Feel free to ask any questions as I became kind of a C. diff expert.

http://www.bariatricpal.com/topic/296042-possible-c-difficile-bummer/

http://www.bariatricpal.com/topic/297327-diarrhea-is-back/

http://www.bariatricpal.com/topic/300646-calling-all-poop-donors/

http://www.bariatricpal.com/topic/303173-fecal-transplant-scheduled/

[Kindle 8,667]

What antibiotic did he put you on? My first two rounds were metronidazole (flagyl) which made me extremely nauseous. I could barely eat or drink anything.....couldn't even swallow my own saliva some days. Thus, ending up needing IV fluids 3 times for dehydration. I was praying to the WLS gods that I would be perfectly happy to never lose another pound as long as the nausea would go away.

Ironically, that was the month I gained 3 pounds and stalled. As soon as I was switched to vancomycin I doubled my food and Water intake and lost 8 pounds in 1 week!

Keep us posted. Whine all you want. C diff sucks way worse than the preop diet, and that gets lots of whine time on here!

[Josey Quinn 187]

What antibiotic did he put you on? My first two rounds were metronidazole (flagyl) which made me extremely nauseous. I could barely eat or drink anything.....couldn't even swallow my own saliva some days. Thus, ending up needing IV fluids 3 times for dehydration. I was praying to the WLS gods that I would be perfectly happy to never lose another pound as long as the nausea would go away.

Ironically, that was the month I gained 3 pounds and stalled. As soon as I was switched to vancomycin I doubled my food and Water intake and lost 8 pounds in 1 week!

Keep us posted. Whine all you want. C diff sucks way worse than the preop diet, and that gets lots of whine time on here!

Thank you for letting me know about your experience with C.diff. My doctor put me on metronidazole. It definitely makes me nauseated. :-( I would much rather be in pain than be nauseated. In fact, I just got back from the clinic at CVS, where I was begging for more Zofran to get me through the weekend. I also picked up a probiotic with saccharomyces boulardii.

I'm trying really hard to keep eating and drinking Water, but I know I'm dehydrated. I was still losing half a pound a day until today. I have a feeling it's the beginning of a stall until I increase my intake again.

[Kindle 8,667]

I also did the saccharomyces boulardii and Probiotics. Look for the highest count, most multi-strain probiotic you can find. The best are going to be found in the refrigerated section of a good health/whole food store. Mine was 50billion CFU with 32 different strains. Take them at a different time than the metronidazole since the metro will immediately kill the probiotics if they are in contact with each other.

Hydration is SO hard. Try and make sipping your focus. Go back to all liquid diet with Protein shakes if you have to. Make everything you get in count towards hydration. The crazy thing is, though, the best 3 days out of my 2 1/2 month ordeal were the days I got IV fluids. I actually had several hours where I DIDNT have to try and drink anything. It was heaven.

[BarrySue 602]

Yipe. My heart goes out to you, OP, it's a painful and particularly unpleasant illness. As a nurse, C.Diff is the infectious disease I hate most (I would rather have a patient with the flu, TB, hepatitis, HIV, leprosy, bursting spontaneously into flames, ANYTHING but C.Diff). The hardest part about it is that it can survive for a long time on surfaces, transmits easily (hopefully none of your family or friends get it), and isn't killed by hand sanitizers, only good old fashioned scrubbing with soap and Water.

Unfortunately, hospitals are a common place to contract CD, as well as dentist offices. It's a risk for any medical procedure nowadays. Thanks for the perspective.