Post-Infectious Chronic Constipation Following E. coli Infection

Initial Treatment Approach

Adequate dietary fiber consumption should be encouraged to promote beneficial short-chain fatty acid production by gut flora, as recommended by the American Gastroenterological Association 1
Stool bulking agents or laxatives can be used for proximal constipation, according to the European Society of Gastrointestinal Motility 2

Fecal Microbiota Transplantation (FMT) should be considered for constipation refractory to standard medical therapy, with a clinical cure rate of nearly 90% for recurrent C. difficile infection, as reported by the British Society of Gastroenterology 3
FMT may correct microbiota imbalance caused by severe E. coli infection and re-establish normal bowel function, as suggested by the World Gastroenterology Organisation 4
FMT should only be performed with appropriately screened donor stool, as recommended by the American Gastroenterological Association 5

Discontinue any unnecessary antibiotics, as antibiotic use can further disrupt the intestinal microbiota and perpetuate the constipation, according to the World Gastroenterology Organisation 1
Avoid proton pump inhibitors if not medically necessary, as there is clinical association between PPI use and gastrointestinal complications, as reported by the European Society of Gastrointestinal Motility 4
Do not use antiperistaltic agents or opiates, as these can worsen constipation and are contraindicated in infectious colitis scenarios, as recommended by the American College of Gastroenterology 6