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Clostridium difficile Colitis in a Patient With Abdominal Distention, Pain, and Severe Constipation
1is a Staff Hospitalist at George E. Wahlen VAMC. is a Gastroenterology Fellow at the University of Utah School of Medicine, and Dr. Cowan is an Assistant Professor at the University of Utah Hospital Department of Internal Medicine, both in Salt Lake City.
Summary
Constipation in patients using opioids may signal an underlying infectious disease. Healthcare providers should consider infections when diagnosing opioid-induced constipation.
Area of Science:
- Medical Case Study
- Infectious Disease
- Gastroenterology
Background:
- Opioid medications are frequently prescribed for pain management.
- Opioid-induced constipation (OIC) is a common and challenging side effect.
- Differential diagnosis of constipation in patients on opioids can be complex.
Purpose of the Study:
- To highlight the importance of considering infectious etiologies in patients presenting with constipation while on opioid therapy.
- To emphasize the need for a thorough diagnostic workup beyond typical OIC management.
Main Methods:
- Presentation of a clinical case involving a patient experiencing constipation.
- Review of diagnostic procedures undertaken to identify the cause of constipation.
- Analysis of the patient's response to treatment after identifying an infectious cause.
Main Results:
- The patient's constipation was ultimately attributed to an underlying infectious process.
- Standard OIC treatments were ineffective until the infectious cause was addressed.
- Successful management of the infection led to resolution of constipation.
Conclusions:
- Infectious diseases should be included in the differential diagnosis for constipation in patients receiving opioid therapy.
- Prompt identification and treatment of underlying infections are crucial for managing refractory constipation in this patient population.
- This case underscores the potential for serious underlying conditions to manifest as common opioid side effects.
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