Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Does PPI Use Increases The Risk Of C Diff Associated Diarrhea?
Question: Hi,
I have taken proton pump inhibitors like rabeprazole and nexium in the past. I am currently prescribed omeprazole for mild GERD.
Is the risk of the complication diarrhea caused by clostridium difficile high with the taking of ppis and which of the above has least risk of side-effects. Would a two-week course have a high risk of causing side effects? Would it be more advisable to take other medications like zantac?
Thanks,
Regards
I have taken proton pump inhibitors like rabeprazole and nexium in the past. I am currently prescribed omeprazole for mild GERD.
Is the risk of the complication diarrhea caused by clostridium difficile high with the taking of ppis and which of the above has least risk of side-effects. Would a two-week course have a high risk of causing side effects? Would it be more advisable to take other medications like zantac?
Thanks,
Regards
Brief Answer:
Yes there is a risk of C diff infection
Detailed Answer:
Hi,
Thanks for posting your query.
I am Dr.R.K and I am pleased to assist you.
Yes, studies have shown that PPI use increases the risk of C diff associated diarrhea.
To prevent it, you can take PPI along with probiotics.
Both Rabeprazole and esomeprazole (Nexium) have similar efficacy and side effects.
PPI are very safe medications. A 2 week course may not produce any serious side effects. But I would recommend you to take a complete course of 4-8 weeks.
Zantac is also effective but less potent than PPI.
So you can go ahead with either Nexium or rabeprazole.
I hope that answers your question.
Let me know if I can assist you further.
Regards,
Dr.R.K.
Yes there is a risk of C diff infection
Detailed Answer:
Hi,
Thanks for posting your query.
I am Dr.R.K and I am pleased to assist you.
Yes, studies have shown that PPI use increases the risk of C diff associated diarrhea.
To prevent it, you can take PPI along with probiotics.
Both Rabeprazole and esomeprazole (Nexium) have similar efficacy and side effects.
PPI are very safe medications. A 2 week course may not produce any serious side effects. But I would recommend you to take a complete course of 4-8 weeks.
Zantac is also effective but less potent than PPI.
So you can go ahead with either Nexium or rabeprazole.
I hope that answers your question.
Let me know if I can assist you further.
Regards,
Dr.R.K.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks Dr. Kini,
In the case of C Diffi associated diarrhea, is this a long-term condition once it is acquired or can it be treated and goes away usually on its own?
I have also been given omeprazole. Is this also as effective as the other two? Are there any issues with taking two different ppis because I only have enough if two are combined.
Thanks,
Regards.
In the case of C Diffi associated diarrhea, is this a long-term condition once it is acquired or can it be treated and goes away usually on its own?
I have also been given omeprazole. Is this also as effective as the other two? Are there any issues with taking two different ppis because I only have enough if two are combined.
Thanks,
Regards.
Brief Answer:
C diff can be treated
Detailed Answer:
Hi,
Thanks for getting back to me with more questions.
C diff infection can be treated with medications like metronidazole, rifaximin and probiotics. No it does not go on its own.
Yes omeprazole is equally effective.
There are six PPIs available- Omeprazole, Lansoprazole, Pantoprazole, Rabeprazole, Esomeprazole and Ilaprazole. Ilaprazole has a longer duration of action. Other than that all these have similar efficacy and same side effects.
No issues if you take two different PPIs.
I hope that answers your question.
Let me know if I can assist you further.
Regards,
Dr.R.K
C diff can be treated
Detailed Answer:
Hi,
Thanks for getting back to me with more questions.
C diff infection can be treated with medications like metronidazole, rifaximin and probiotics. No it does not go on its own.
Yes omeprazole is equally effective.
There are six PPIs available- Omeprazole, Lansoprazole, Pantoprazole, Rabeprazole, Esomeprazole and Ilaprazole. Ilaprazole has a longer duration of action. Other than that all these have similar efficacy and same side effects.
No issues if you take two different PPIs.
I hope that answers your question.
Let me know if I can assist you further.
Regards,
Dr.R.K
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks Dr. Kini,
I forgot to mention that I have recently been on a course of ciprofloxacin two weeks ago, which I understand can also cause c diff infection. Would it be better to start ppis later if there is no urgency.
Also, I have a dry cough which has become worse over about 3 weeks, which occurs mostly when trying to speak. Can this condition be caused by gastric reflux and would it be better to look through the throat with a scope?
Thanks,
Regards.
I forgot to mention that I have recently been on a course of ciprofloxacin two weeks ago, which I understand can also cause c diff infection. Would it be better to start ppis later if there is no urgency.
Also, I have a dry cough which has become worse over about 3 weeks, which occurs mostly when trying to speak. Can this condition be caused by gastric reflux and would it be better to look through the throat with a scope?
Thanks,
Regards.
Brief Answer:
Yes
Detailed Answer:
Hi,
Though cirpofloxacin can cause C diff infection, it need not always cause it and if you do not have any bowel symptoms there is no issues starting PPI if there is a need for it. But there is no harm starting it later if there is no urgency.
For the second question, yes acid reflux is one of the causes. A chest x ray may be done as the first test since the cough is for more than 3 weeks now. If it is normal and if you do not have history of asthma and if you are not taking medications for hypertension (ACEI), then the cough is more likely to be due to acid reflux.
There is however no need for endoscopy and you can continue taking PPI.
I hope that answers your question.
Let me know if I can assist you further.
Regards,
Dr.R.K
Yes
Detailed Answer:
Hi,
Though cirpofloxacin can cause C diff infection, it need not always cause it and if you do not have any bowel symptoms there is no issues starting PPI if there is a need for it. But there is no harm starting it later if there is no urgency.
For the second question, yes acid reflux is one of the causes. A chest x ray may be done as the first test since the cough is for more than 3 weeks now. If it is normal and if you do not have history of asthma and if you are not taking medications for hypertension (ACEI), then the cough is more likely to be due to acid reflux.
There is however no need for endoscopy and you can continue taking PPI.
I hope that answers your question.
Let me know if I can assist you further.
Regards,
Dr.R.K
Note: For further follow up on digestive issues share your reports here and Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
