Indications and Relative Utility of Lower Endoscopy in the Management of Clostridium difficile Infection
Background. Diagnosis and management of Clostridium difficile infection (CDI) rely upon clinical assessments and diagnostic studies. Among diagnostic tests, lower gastrointestinal (GI) endoscopy in the setting of CDI remains controversial. Objective. To describe the role of lower endoscopy in CDI...
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| Format: | Article |
| Language: | English |
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Wiley
2011-01-01
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| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2011/626582 |
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| author | Nora E. Burkart Mary R. Kwaan Christopher Shepela Robert D. Madoff Yan Wang David A. Rothenberger Genevieve B. Melton |
| author_facet | Nora E. Burkart Mary R. Kwaan Christopher Shepela Robert D. Madoff Yan Wang David A. Rothenberger Genevieve B. Melton |
| author_sort | Nora E. Burkart |
| collection | DOAJ |
| description | Background. Diagnosis and management of Clostridium difficile infection (CDI) rely upon clinical assessments and diagnostic studies. Among diagnostic tests, lower gastrointestinal (GI) endoscopy in the setting of CDI remains controversial. Objective. To describe the role of lower endoscopy in CDI management. Methods. Retrospective study of lower endoscopies in CDI at four metropolitan hospitals, July 2005 through December 2007. Results. Of 1760 CDI inpatients, 45 lower endoscopies were performed on 43 patients. Most common indications were ruling out other etiologies (42%), inconclusive stool studies (36%), and worsening course (11%). Most endoscopies (73%) had positive findings, including pseudomembranous colitis (49%) and nonspecific colitis (24%). Biopsies were performed in 31 cases, more with nonspecific colitis (10/11, 92%) compared to pseudomembranous colitis (14/22, 64%). Conclusion. While not recommended as a primary screening tool, lower GI endoscopy can add valuable information in CDI when other colonic pathologies may exist, studies are inconclusive, or clinical status worsens. |
| format | Article |
| id | doaj-art-80885dfdf4374cf6a1190d2aec2fdce6 |
| institution | Kabale University |
| issn | 1687-6121 1687-630X |
| language | English |
| publishDate | 2011-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Gastroenterology Research and Practice |
| spelling | doaj-art-80885dfdf4374cf6a1190d2aec2fdce62025-02-03T01:01:03ZengWileyGastroenterology Research and Practice1687-61211687-630X2011-01-01201110.1155/2011/626582626582Indications and Relative Utility of Lower Endoscopy in the Management of Clostridium difficile InfectionNora E. Burkart0Mary R. Kwaan1Christopher Shepela2Robert D. Madoff3Yan Wang4David A. Rothenberger5Genevieve B. Melton6Division of Colon and Rectal Surgery, Department of Surgery, University of Minnesota, 420 Delaware Street SE, Mayo Mail Code 450, Minneapolis, MN 55455, USADivision of Colon and Rectal Surgery, Department of Surgery, University of Minnesota, 420 Delaware Street SE, Mayo Mail Code 450, Minneapolis, MN 55455, USADivision of Gastroenterology, Department of Medicine, University of Minnesota, Minneapolis, MN 55455, USADivision of Colon and Rectal Surgery, Department of Surgery, University of Minnesota, 420 Delaware Street SE, Mayo Mail Code 450, Minneapolis, MN 55455, USAInstitute for Health Informatics, Academic Health Center, University of Minnesota, Minneapolis, MN 55455, USADivision of Colon and Rectal Surgery, Department of Surgery, University of Minnesota, 420 Delaware Street SE, Mayo Mail Code 450, Minneapolis, MN 55455, USADivision of Colon and Rectal Surgery, Department of Surgery, University of Minnesota, 420 Delaware Street SE, Mayo Mail Code 450, Minneapolis, MN 55455, USABackground. Diagnosis and management of Clostridium difficile infection (CDI) rely upon clinical assessments and diagnostic studies. Among diagnostic tests, lower gastrointestinal (GI) endoscopy in the setting of CDI remains controversial. Objective. To describe the role of lower endoscopy in CDI management. Methods. Retrospective study of lower endoscopies in CDI at four metropolitan hospitals, July 2005 through December 2007. Results. Of 1760 CDI inpatients, 45 lower endoscopies were performed on 43 patients. Most common indications were ruling out other etiologies (42%), inconclusive stool studies (36%), and worsening course (11%). Most endoscopies (73%) had positive findings, including pseudomembranous colitis (49%) and nonspecific colitis (24%). Biopsies were performed in 31 cases, more with nonspecific colitis (10/11, 92%) compared to pseudomembranous colitis (14/22, 64%). Conclusion. While not recommended as a primary screening tool, lower GI endoscopy can add valuable information in CDI when other colonic pathologies may exist, studies are inconclusive, or clinical status worsens.http://dx.doi.org/10.1155/2011/626582 |
| spellingShingle | Nora E. Burkart Mary R. Kwaan Christopher Shepela Robert D. Madoff Yan Wang David A. Rothenberger Genevieve B. Melton Indications and Relative Utility of Lower Endoscopy in the Management of Clostridium difficile Infection Gastroenterology Research and Practice |
| title | Indications and Relative Utility of Lower Endoscopy in the Management of Clostridium difficile Infection |
| title_full | Indications and Relative Utility of Lower Endoscopy in the Management of Clostridium difficile Infection |
| title_fullStr | Indications and Relative Utility of Lower Endoscopy in the Management of Clostridium difficile Infection |
| title_full_unstemmed | Indications and Relative Utility of Lower Endoscopy in the Management of Clostridium difficile Infection |
| title_short | Indications and Relative Utility of Lower Endoscopy in the Management of Clostridium difficile Infection |
| title_sort | indications and relative utility of lower endoscopy in the management of clostridium difficile infection |
| url | http://dx.doi.org/10.1155/2011/626582 |
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