Mucus in Diarrhea: Causes and Treatment Options - Gastroenterology and Hepatology

Diarrhea with mucus in the stool?

Hello, doctor.
Last Friday (February 11), I sought medical attention due to fever and mild diarrhea, and I was diagnosed with viral gastroenteritis.
After returning home, I did not take any antidiarrheal medication; I only took probiotics and antipyretics, along with dietary adjustments.
Yesterday (February 13), my fever subsided, but my diarrhea has worsened compared to the initial onset (once on Friday, six times on Saturday, twice on Sunday, and four times within three hours this morning; I have occasionally noticed mucus on the toilet paper).
I would like to ask: 1.
During my visit last Friday, I forgot to inform the doctor that I had just completed a six-week course of antibiotics (Ciprofloxacin 500 mg twice daily, from December 24 to February 4, due to suspected chronic prostatitis).
Does this increase my risk of Clostridioides difficile infection? 2.
Is my condition suitable for the use of KBT, Imodium, or Smecta? Or do you recommend any other types of antidiarrheal medications? Should I continue taking probiotics? 3.
If I need to go to a laboratory for testing, what specific tests would you recommend? (I prefer not to spend too much time in the hospital due to the pandemic.)

A-Zheng, 30~39 year old female. Ask Date: 2022/02/14

Dr. Chen Shidian reply Gastroenterology and Hepatology

Clostridium difficile infection cannot be ruled out; therefore, it is advisable to first check for red and white blood cells in the stool and assess inflammatory markers such as CRP in the blood.
If necessary, testing for C.
difficile toxins in the stool and performing a colonoscopy should be considered.

Reply Date: 2022/02/14

More Info

Understanding mucus in diarrhea can be quite complex, as it often indicates underlying gastrointestinal issues. In your case, the presence of mucus in your stool, especially after experiencing viral gastroenteritis, raises several important considerations.

1. Antibiotic Use and Risk of Clostridium difficile Infection: Given that you recently completed a six-week course of ciprofloxacin, you are indeed at a higher risk for developing a Clostridium difficile (C. diff) infection. Antibiotics can disrupt the normal gut flora, allowing C. diff, a bacterium that can cause severe diarrhea, to proliferate. Symptoms of a C. diff infection typically include watery diarrhea, abdominal pain, and sometimes fever. If your diarrhea persists or worsens, it would be prudent to consult your healthcare provider for further evaluation, including a stool test for C. diff.

2. Use of Antidiarrheal Medications: Regarding the use of medications like KBT (kaolin-pectin), Imodium (loperamide), or Smecta (diosmectite), caution is advised. While these medications can help reduce diarrhea, they may not be suitable if an infection is present, particularly in the case of C. diff, as they can worsen the condition by slowing down the clearance of the bacteria from the intestines. It's generally recommended to avoid antidiarrheal medications in cases of infectious diarrhea unless specifically advised by a healthcare provider. Probiotics, such as the ones you are currently taking, can be beneficial in restoring gut flora, so continuing them may be a good idea.

3. Recommended Tests: If you decide to seek further medical evaluation, there are several tests that could be beneficial. A stool culture can help identify any infectious agents, including C. diff. Additionally, a stool test for ova and parasites may be warranted if your symptoms persist, especially if there is a history of travel or exposure to contaminated food or water. A complete blood count (CBC) can also help assess for signs of infection or dehydration.

In summary, while mucus in diarrhea can be a common symptom of gastrointestinal distress, it is essential to consider the context of your recent antibiotic use and the potential for C. difficile infection. Avoiding antidiarrheal medications without medical guidance is advisable, and continuing probiotics may support your recovery. If symptoms persist or worsen, seeking further evaluation and testing is crucial to ensure appropriate management and treatment. Always consult with your healthcare provider for personalized advice tailored to your specific situation.

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