Hi Dr. Nick | Issue 08

Hi Dr. Nick | Issue 08

Coughs, colds and clostridium colitis

Hi everybody,

Winter is coming. The white walkers are approaching, the Lannisters are sending their regards, and everybody you’ve grown attached to is being killed in the most gut wrenching of ways. Fuck you, George R. R. Martin. As winter approaches, not only do we see an increase in the number of manly tears shed over Game of Thrones (R.I.P. Renly), we also see an increase in the number of colds on campus.

Colds aren’t actually caused by cold weather; they’re caused by viruses. You can stand at the South Pole in your best town clothes (see-through tights and a dress that barely covers your cervix) and you won’t develop a cold unless you’ve got one of those viruses. The cold weather does, however, make you more likely to catch those bugs.

Cooler temperatures make it more difficult for your nose and airways to clear mucous causing moist, runny noses that shed and spray infected snot droplets everywhere. The low temperatures also makes us more likely to stay indoors with the windows and doors closed to keep the cold out and the stagnant, dank, snotty-dropletty air in. So, all those times you were told to “come inside or you’ll catch a cold,” you should have done the opposite and caught hypothermia instead.

With huge numbers of sick people around, GPs get huge numbers of requests for antibiotics. Antibiotics are brilliant if you need them, but they don’t have any effect on viruses and they’re definitely not risk-free.

Antibiotics work by disrupting certain bacteria-only enzymes that are vital to keep bacteria alive and replicating. Here’s where it gets tricky, however, because we carry a lot of bacteria that are essential for good health. For every human cell in your body, you have at least ten bacterial cells. Every time you take a shit, around 60 per cent of the poo is bacteria. Without the right types of bacteria in your body, you’re at a greater risk of everything from heart attacks, to cancer, to violently soiling yourself on a daily basis.

Unlike people from Christchurch, antibiotics don’t discriminate. They are mindless chemicals that target bacterial enzymes. If a “good” bacteria uses that enzyme, it will be wiped out too. People taking antibiotics will often get a bit of diarrhoea caused by losing some of the good gut bacteria that protect the gut. There’s a particularly worrying form of antibiotic-associated diarrhoea that is caused by a particularly nasty bug called Clostridium Difficile. C. Diff. isn’t affected by many of our first line antibiotics and absolutely thrives the moment those good bacteria are killed off. 14,000 Americans die every year from it, so we’re not just talking about a bit of the trots.

If that’s not worrying enough, there’s also the issue of antibiotic resistance. Pretty soon, antibiotics will be useless to us. Bacteria are clever: any bug that comes in contact with any bug that has come into contact with an antibiotic will develop resistance to it. Super bugs currently exist that are completely immune to antibiotics, which is fucking scary. If you never want to have sex again, Google super gonorrhoea.

Antibiotics are brilliant and can be life saving when you need them. But they have risks, particularly when taken inappropriately. When you see a doc and they say that you don’t need antibiotics, it’s because they think they either won’t work or won’t make enough of a difference to your recovery to justify the risks. And when you are given antibiotics, make sure to follow the instructions correctly as the courses we prescribe are designed to minimise the risks of resistance and side effects.
This article first appeared in Issue 8, 2014.
Posted 4:31pm Sunday 13th April 2014 by Dr. Nick.