Clostridium Difficile (C. Diff)

Our colons contain millions of good bacteria that protect us from infection. By taking antibiotics, many of these defenses are killed and opportunity arises for Clostridium difficile, also known as C. diff.

C. diff is a bacterium that causes half a million illnesses every year in the United States. It causes diarrhea and colitis and can lead to serious complications if left untreated, including death.

C. diff is found in many parts of our ecosystem, including soil, water, animal waste, and in some foods, like processed meats. Some even naturally carry the bacteria in the colon without any symptoms. 

Spores are passed through feces and spread to surfaces, food, and objects when infected individuals don’t wash their hands well enough. If you come into contact with the spores, it’s possible you may ingest them unknowingly. Once ingested, C. diff produces a toxin that wreaks havoc on the intestinal lining.

The major risk factors for this illness are antibiotic use and admission to a hospital.

Symptoms of C. diff vary in intensity from very mild to severe life-threatening conditions, which include loose stools and mild abdominal cramps to profuse diarrhea and severe abdominal pain. Other symptoms include fever, nausea, vomiting, and poor appetite. Blood may also be found in diarrhea.

C. difficile can lead to several complications. Profuse diarrhea may predispose to dehydration and even kidney injury. With severe infection, the large intestine can become very lazy and unable to move air and stools. This scenario can lead to over-distention of the colon (toxic megacolon) and possibly even rupture (perforation). If left untreated, C. diff complications can lead to death.

Treating C. difficile usually involves 10 to 14 days of antibiotics. Severe illness not responding to medical treatment may require surgery, which includes removal of the colon. Unfortunately, the risk of re-infection is quite high, approaching one in five patients. Studies have suggested that certain probiotics may have a role in preventing recurrence.

Know Your Risks

• If you’re on antibiotics, you have a higher risk of infection.
• Germs spread easily in hospitals and persist on many surfaces, facilitating transmission. Adequate cleaning of surfaces and hand washing is imperative, as traditional alcohol gels are not as effective against the bacteria like C. diff.
• Older age, recent surgery, inflammatory bowel disease (IBD), and patients undergoing chemotherapy are also factors that increase risk of infection.