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What Is The Correlation Between TPN And Clostridium Difficile Infection?

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Posted on Fri, 22 Jan 2016
Question: My son who is TPN dependent has elevated GGT & ALT numbers. He recently (6 wks) had C-Diff-is there a correlation?
doctor
Answered by Dr. Vivek Chail (1 hour later)
Brief Answer:
There is a correlation between TPN and C difficile infection

Detailed Answer:
Hi XXXX,
Thanks for writing in to us.

I have read through your query in detail.
Please find my observations below.

1. TPN elements are digested completely in the small intestine.

2. Therefore the food never reaches the large bowel and the large bowel has limited function in digestion.

3. In the large bowel there is no dietary fiber, fructose and resistant starch which causes resulting deprivation of the nutrients to the colonic bacteria.

4. Therefore there is suppression of the good bacteria in the colon and this creates the conditions favorable for multiplication of C difficile.

5. There is a correlation between TPN and increased C difficile infection.

Hope your query is answered.
Please do write back if you have any doubts.

Regards,
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Vivek Chail (11 hours later)
My son is not symptomatic of CDL now - however, his GGT & alt enzymes continue to climb weekly. I know GGT relates to bilious - he has no gallbladder, is it possible the CDL damaged his liver?
doctor
Answered by Dr. Vivek Chail (27 minutes later)
Brief Answer:
If patient is not having liver symptoms then C difficile in liver unlikely

Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.

1. Liver enzymes including GGT can increase in many conditions including post gall bladder surgery and in infection by C difficile.

2. Infection in liver due to C difficile is suspected when the patient has pain and discomfort in the liver region with fever and toxic features. If your son does not have any liver symptoms then it is less likely to be the C difficile affecting liver enzymes.

3. If doubt persists then an ultrasound scan abdomen can be done to have a detailed evaluation of the liver.

Hope your query is answered.
Please do write back if you have any doubts.

Regards,
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Vivek Chail

Radiologist

Practicing since :2002

Answered : 6874 Questions

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What Is The Correlation Between TPN And Clostridium Difficile Infection?

Brief Answer: There is a correlation between TPN and C difficile infection Detailed Answer: Hi XXXX, Thanks for writing in to us. I have read through your query in detail. Please find my observations below. 1. TPN elements are digested completely in the small intestine. 2. Therefore the food never reaches the large bowel and the large bowel has limited function in digestion. 3. In the large bowel there is no dietary fiber, fructose and resistant starch which causes resulting deprivation of the nutrients to the colonic bacteria. 4. Therefore there is suppression of the good bacteria in the colon and this creates the conditions favorable for multiplication of C difficile. 5. There is a correlation between TPN and increased C difficile infection. Hope your query is answered. Please do write back if you have any doubts. Regards,