Antibiotics if not responding to fluid resuscitation or if suspecting an infectious exacerbation of IBD e.g. Metronidazole 400mg three times daily (check local guidelines)
If C. diff then give Metronidazole po 400mg three times daily and/or Vancomycin 500mg orally four times daily
See local guidelines for grading severity of C.Diff and subsequent treatment strategy
Further management of diarrhoea
Flexible sigmoidoscopy and/or Colonoscopy with biopsies
Abdominal ultrasound
CT abdomen/pelvis
Faecal elastase
TTG antibodies + OGD if suspecting coeliac disease
Loperamide 2-4mg up to four times daily if refractory diarrhoea with no treatable cause found – MUST exclude obstruction before prescribing.
