Journal of General Practice

Inflammatory Bowel Disease and Clostridium difficile Infection: A Report from a Tertiary Care Center of North India

Abstract

Chetana Vaishnavi and Rakesh Kochhar

Clostridium difficile infection (CDI) is reported to be frequently associated with inflammatory bowel disease (IBD). Because of the common characteristics of the clinical appearance of CDI and IBD the diagnosis and treatment of the same becomes complicated. We analyzed the prevalence of CDI in patients with IBD along with their demographic and clinical profile from our meticulously maintained laboratory records. During analysis, the IBD patients (n=721; M:F=1.10:1) comprised of test group and an equal number of gender-matched patients with no indication of IBD was included as non-IBD controls. The demographic and clinical data as well as fecal C. difficile toxin status of all the patients were retrieved from laboratory records. The number of C. difficile positivity was more in the non-IBD group (20%) compared to IBD patients (16%) with non-significant difference (p<0.064). The patients in non-IBD group were relatively older (p<0.001) compared to those in IBD group. The duration of diarrhea in the IBD group was significantly longer (p<0.001) compared to the non-IBD group, but no significant difference (p>0.063) in the frequency of diarrhea between the two groups was observed. Blood in stool and abdominal pain symptoms were found to be significantly higher (p<0.001) among the IBD group whereas watery diarrhea and fever were significantly linked (p<0.001) with non-IBD group. Significant improvement was seen in most of the parameters during the time of follow-up. Though the prevalence of CDI in both IBD and non-IBD groups were almost comparable, clinical symptom and age of presentation varied in them.