I have a relative with an external collection bag who is doing rather poorly. From what I’ve been able to gather he had infections from C. diff and E. coli. Another relative made the comment, “They don’t know what caused the infection.”
I had just assumed that a person with an ostomy bag would be more susceptible to those types of infections. Or is there any increased risk?
Not that I’m aware and not that I found on a very quick scan of the literature prior to posting this.
Clostridium difficile colitis occurs when the C. Diff is allowed ‘free reign’ in the large bowel because (previously administered) antibiotics have eliminated much of the bacterial competition. That implies that C. Diff is already present in people’s bowels before the antibiotic was given. In fact, about three percent of apparently healthy individuals have it in their intestine and up to half of people hospitalized for significant illness have it in theirs. In other words, one acquires it during hospitalization. So long as there are the usual other bacteria (both species and numbers) present, the C. Diff remains suppressed and no disease develops. If antibiotics are given, C. Diff colitis can occur, as mentioned, as a result of the loss of bacterial competition.
Recognized risk factors for C Diff colitis in addition to antibiotic use are old age, severe illness with hospitalization, chemotherapy (those drugs have antibiotic properties!), and possibly suppression of stomach acid secretion by drugs such as Prilosec (i.e. PPIs). But, again, having an ostomy is not known to be a risk factor.