This note is about my wife (not very computer friendly.) She had a subtotal colectomy with ileostomy almost 6 years ago for a C. diff infection that caused gangrene of the colon. They left her 12 cm of rectum and she then had her ileostomy closed to the rectum only to go on and have problems with bowel obstructions from adhesions and fistulas. The fistulas and obstructions have been controlled and although she had another ileostomy, that has now been taken down and her problem is worsening diarrhea. The loop ileostomy closure was 3 months ago. Now she is basically housebound having bowel movements anywhere from every 20 minutes to a few hours apart. If she doesn't set an alarm to wake up every hour during the night she will have an accident with uncontrolled bowel movement.

A complicating factor is that, for unknown reasons, even large doses of Lomotil or Imodium (12 to 15 tablets 4 times a day) don't slow it down at all. She has been on large doses of opiates to try to slow it down also with no effect. She has also tried bentyl with no improvement and we are currently trying donnatal but the jury is still out on that. I guess what we are looking for is some other ideas that may help her. She is obviously getting very depressed being stuck in the house 24/7.

If it were me, I'd assume this was a lingering C. diff infection and get on some Flagyl. If that didn't work, then Vancomycin. Many docs are under the impression that C. diff cannot colonize in the ileum. This has been proven wrong. Plus, she still has her rectum.

I'd do serial C. diff toxin studies, and still go on the antibiotics while waiting for the results.

Jan