Therapeutic implications of Clostridium difficile toxin during relapse of chronic inflammatory bowel disease

Clostridium difficile toxin was present in the stools of six patients with chronic inflammatory bowel disease during symptomatic relapse. Only two of these individuals had received antibiotics known to cause pseudomembranous colitis, and on proctoscopy none had pseudomembranes. In all patients disappearance of toxin, either with vancomycin therapy (five patients) or spontaneously (one patient), was associated with symptomatic improvement. Cl. difficile toxin may complicate chronic inflammatory bowel disease, and contribute to relapse in some patients.