Clostridium difficile, also known as C. difficile or just or C. diff, is a serious bacterial infection that causes a range of gastrointestinal illnesses from diarrhea to a potentially fatal form of colon inflammation called colitis.
This bacterium is ubiquitous in the environment, but as an opportunistic pathogen, it tends to affect people who are already ill or have a weakened immune system, making it a common infection in healthcare settings.
Clostridium difficile spreads via spores that are difficult to eradicate with normal cleaning and can survive up to two years on hard surfaces like floors, tables and toilet seats. When ingested, the bacteria infects the host's intestinal tract where in large numbers, it produces toxins that can damage the mucosal lining, causing potentially life-threatening sickness, especially in the elderly and infirm.
What is Clostridium Difficile Colitis?
It’s a form of intestinal inflammation caused specifically by C. diff bacteria and is often referred to as Antibiotic-associated Colitis because it frequently occurs after the beneficial bacteria in the colon are destroyed after treatment with antibiotics for another type of infection.
C. diff normally exists in the human body at low levels without causing disease, but when the good bacteria that keep it under control are destroyed, pathogens like C. diff can multiply rapidly and grow out of control.
Cases of C. diff can occur out in the community, but are most common in healthcare facilities like hospitals and nursing homes. Spores spread readily through direct contact with infected persons or contaminated objects like dishware, clothing, and door handles, making it difficult to control in crowded environments with large, high-risk populations.
What are the Symptoms of Clostridium Difficile Colitis?
There are many different symptoms that may be experienced. Early symptoms vary from mild to severe and include:
- Abdominal pain
- Low-grade fever
- Loss of appetite
- Temporary weight loss
For some, symptoms stay mild, but as the infection progresses, the toxins released by C. diff bacteria can cause ulcers in the intestinal tract, including the colon, causing blood, pus or mucus to appear in stools. In its most severe form, C. diff colitis causes watery diarrhea so extreme that it can lead to dehydration and potentially life-threatening electrolyte abnormalities.
Symptoms of colitis can appear as quickly as a day or two after starting antibiotics or as late as weeks after a course of treatment is completed, but remember that not all cases are related to antibiotic use. In children, the elderly and those already struggling with illness, symptoms may appear quicker and be much more severe. A history of intestinal disorders, such as Crohn’s Disease, inflammatory bowel disease, diverticulitis, or colon cancer increases the risk of developing full-blown colitis from C. diff.
What are the Treatments for Clostridium Difficile Colitis?
The first line of treatment for C. diff is antibiotics. For mild cases, an oral antibiotic is typically prescribed. If symptoms are severe, intravenous antibiotics may be chosen. C. diff bacteria are beginning to show the same resistance to treatment as other bacteria and occasionally, combinations of drugs may be needed.
In the most severe cases, the colon may be so damaged that antibiotics alone will not be effective. In these cases, a portion of it may need to be surgically removed.
In addition to other therapy, supportive care is critical. The most profound and potentially deadly effects of Clostridium Difficile Colitis occur because of fluid loss due to diarrhea and poor appetite. Intravenous fluid and electrolyte replacement can be life-saving. Other helpful treatments include the use of probiotic supplements including yogurt to replenish good bacteria in the gut and analgesics to help to relieve pain.
For recurrent cases, a cutting-edge fecal transplant from a normal colon can restore a healthy microbiome.
In the end, the best treatment is actually prevention. Avoiding a condition is better than fixing it after all. For C. diff prevention:
- Avoid unnecessary antibiotic use.
- If antibiotics are needed, begin a probiotic supplement or daily serving of yogurt with active cultures the same day.
- Strict hand washing with soap is the best protection. Hand sanitizer is ineffective against C. diff spores.
With prompt treatment and supportive care, most people recover uneventfully from C. diff. Consult a doctor for diarrhea that last more than three days or is accompanied by abdominal pain and fever.