tag:blogger.com,1999:blog-2760353953251845523.post3398427119162465953..comments2024-02-10T02:14:39.898-05:00Comments on Buckeye Surgeon: Clostridial Difficile ColitisJeffrey Parks MD FACShttp://www.blogger.com/profile/15650563299849196122noreply@blogger.comBlogger7125tag:blogger.com,1999:blog-2760353953251845523.post-2347467246619338332010-04-16T10:21:27.245-04:002010-04-16T10:21:27.245-04:00HI I AM SO GLAD TO FIND THIS OHIO SURGEON. THAT TH...HI I AM SO GLAD TO FIND THIS OHIO SURGEON. THAT THINKS SOME EARLIER SURGICAL INTERVENTION IS GOOD. WE LIVE IN GA. MY HUSBAND HAD THE WEIGHT LOSS SURGERYOVER 2 YEARS AGO AND GOT C DIFF DURING THAT TIME. HE WAS IN SURGER 13 HOURS INSTEAD OF 4. HE HAS SINCE OCT. HAD C DIFF COLITIS MANDY TIMES AND IN HOSPITAL WAS IN IN OCT. ALMOST THE WHOLE MONTH. ON FLAGYL NOW STABLE BUT ONLY GAINED 2 LBS. FROM THE 40 HE LOSS WHEN HE HAD THE SICK SPELLS. HE IS FROM COLUMBUS,OH. HE IS GOING TO WEAN OFF FLAGYL INEND OF MAY WHEN WE COME TO OHIO THIS SUMMER WE WOULD LIKE TO VISIT THIS DR. THANK YOU DANNY AND DIANNA MYERS /DDZIGZAG@BELLSOUTH.NETdianna myersnoreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-46094170525419014432009-10-15T13:11:54.804-04:002009-10-15T13:11:54.804-04:00Hi. While I agree with your approach, I have conce...Hi. While I agree with your approach, I have concerns about your interpretation of the recent study. There may be reasons why a patient is on the medical vs. surgical service. Such a bias could explain the differences in outcomes just as readily as any difference in interventions between the 2 cohorts. You really need an RCT to answer the question, "does early surgical intervention improve outcome?" This will of course never be done given practicalities.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-81096018335190408072009-10-15T12:30:23.404-04:002009-10-15T12:30:23.404-04:00Buckeye, you are entitled to your interpretation o...Buckeye, you are entitled to your interpretation of history as I am to mine; my version is that c.diff colitis has probably been around even before the introduction of macrolides and the other great new antibiotics at our disposal. I still recall the flurry of lawsuits in the 70's that alleged Lincocin was the specific causative agent of the colitis and should be banned from the market.<br />So it is really not as recent a phenomenon as we often think, but one that we getting better at recognizing and treating earlier. And surgeons, who eventually have to deal with the worst cases are leading the way. Great post, keep up the good work. I really admire and envy your writing skills.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-69820794205754403392009-10-13T10:54:33.790-04:002009-10-13T10:54:33.790-04:00Hello Dr. Parks. I have a question regarding your...Hello Dr. Parks. I have a question regarding your post. (I went to the PubMed link but could only read the abstract since I don’t have a subscription.) By systemic toxicity do you mean bacteria and/or toxins in the bloodstream or a general immune system response (which I’ve seen referred to as a “cytokine storm”)? If it is the immune system response which is inflaming the colon and other organs, Dr. David Moskowitz in St. Louis (www.genomed.com) uses a therapy of high dose lipophilic ACE inhibitors to suppress this reaction in cases of various viral infections, such as SARS and West Nile Virus. I have been wondering for awhile if this would be effective against C. diff. colitis of the severity you have described.Unknownhttps://www.blogger.com/profile/07219671443257773212noreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-85411269987292501682009-10-13T09:57:24.546-04:002009-10-13T09:57:24.546-04:00Is that a Mr. Menckle's Diverticulum? Or an Ap...Is that a Mr. Menckle's Diverticulum? Or an Appendix that doesn't know its place?<br />And looks like either Free-Air or Pneumatos-is Whatever-is right next to it...<br />CUT!!!!!!!!!!!<br />Easy for me to say, I'm not a Surgeon. <br />But anything that gets patients away from those Quack-Flea-Witchdoctors has gotta be a good thing.<br />They'll bleed someone down to a Hemoglobin of "1" with all their friggin tests, thought Phlebotomy went out of style centuries ago.<br />And I think C dificile's God's way of tellin you you took to many Z-packs...<br /><br />Frank<br /><br />FrankAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-43571402244635659352009-10-13T08:59:07.943-04:002009-10-13T08:59:07.943-04:00Jeff,
I appreciate your aggressiveness with the...Jeff,<br /> I appreciate your aggressiveness with these patients and it appears that the surgical literature supports early surgical intervention. Unfortunetly i have a very hard time convincing some of the surgeons of this fact. It can be very frustrating. There are times i wish i could "cut"!HudsonMDhttps://www.blogger.com/profile/05955328271938173408noreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-49587683725168247782009-10-12T21:07:09.744-04:002009-10-12T21:07:09.744-04:00c diff is a terrible problem, and one that we'...c diff is a terrible problem, and one that we're responsible for creating through our own indiscriminate antibiotic use. <br /><br />there's great data out of europe and other countries to show that probiotics work to prevent c diff, decrease severity, and increase cure rates. <br /><br />with data like this everyone who gets an antibiotic should get a probiotic too. it should be like ldl and lipitor. too bad there is little financial incentive to promoting these cheap supplements. <br /><br />it's the same with fish oil, some good studies (in the nejm no less) show it *doubles* stent patency at three months. <br /><br />I'm not sure what my point is, just to say that there are some big problems that have simple, cheap interventions that have good benefit, and it's frustrating that they're not used. <br /><br />later,<br />radincradincnoreply@blogger.com