Watery diarrhea up to 15 times per dayDehydrationSwollen abdomen, with severe cramping and painElevated heart rateFeverStool containing blood or pusNauseaLoss of appetite or weight lossLiver or kidney failureIncreased white blood cell count
Although people with no known risk factors can get a C. diff infection, certain things increase your risk, including the heavy use of antibiotics for the treatment of long-term infections. These antibiotics can disrupt the normal makeup of the gut microbiome — the community of microbes living in the intestines — allowing C. diff to grow out of control and cause an infection.
clindamycin (Cleocin HCL)ampicillin (Omnipen), amoxicillin (Amoxil), and other penicillinsCephalosporinsFluoroquinolones
In addition, the use of proton pump inhibitors (PPIs), a type of medicine that reduces stomach acid and treats acid reflux, also may increase your risk of C. diff infection. Blood tests can reveal high levels of white blood cells, a sign of infection, including C. diff. A colonoscopy allows your doctor to assess the entire colon and rectum, while a sigmoidoscopy provides images of the rectum and the lower part of the colon. Both tests can indicate whether inflammation is present, a telltale sign of a C. diff infection, among other infections or inflammatory disorders. They also allow your doctor to collect tissue samples from your colon, if needed, to further test them for bacteria.
Prognosis of C. Diff
Some C. diff infections can become fatal in certain patients if not treated promptly, because of severe dehydration or damage to the colon or intestines.
You’re older than 65You’re taking antibiotics for another condition while being treated with antibiotics for C. diffYou have a severe underlying medical condition, including chronic kidney failure, inflammatory bowel disease, or chronic liver disease
Antibiotics (different antibiotics from the ones that triggered the C. diff)SurgeryChronic, recurrent C. diff–infected patients may pursue a new treatment called fecal transplant
Medication Options for C. Diff
While it may sound counterintuitive (since antibiotics cause C. diff), the initial treatment for an infection usually requires taking one of three antibiotics that remain effective against the bacteria. These drugs include, yet are not limited to:
vancomycin (Firvanq)fidaxomicin (Dificid)metronidazole (Flagyl)
Oral vancomycin is typically the first-line antibiotic for the treatment of C. diff, while fidaxomicin (which can be cost-prohibitive) may be reserved for those with severe symptoms.
Surgery for C. Diff
For people who have severe pain, organ failure, toxic megacolon, or inflammation of the lining of the abdominal wall, surgery to remove the affected portion of the colon may be the only option.
In people with recurrent C. diff, despite medication management, a fecal microbiota transplant (FMT) may be an option. In this procedure, the stool of a healthy person is transplanted into the colon of a person with C. diff infection.
Alternative and Complementary Therapies for C. Diff
Talk to your doctor before using probiotics or any other OTC products to treat your C. diff.
Prevention of C. Diff
Take your C. diff medication exactly as instructed by your doctorWash your hands with soap and water after going to the bathroom, before preparing or eating food, and when they’re dirty — and encourage family to do the sameClean bathroom and kitchen surfaces regularly with household detergents or disinfectantsTell your doctor right away if your diarrhea returns after treatment
In some cases of C. diff infection, dehydration occurs so rapidly that kidney function deteriorates, leading to kidney failure. In addition, toxic megacolon is a rare condition that can develop after C. diff infection. If your colon is unable to expel gas and stool, it can become greatly distended, potentially causing it to rupture and allow bacteria to seep into your abdominal cavity (a condition called peritonitis). Toxic megacolon requires emergency surgery and can be fatal if left untreated. A bowel perforation, or hole in your large intestine, is a rare complication that results from extensive damage to the lining of the organ following toxic megacolon.
Traveler’s diarrheaDehydrationCholera
Unlike C. diff, traveler’s diarrhea is rarely life-threatening, but it can be unpleasant. Dehydration also causes dry mouth, fatigue, dizziness, headache, and muscle cramps. You may also urinate less often than you normally do or have dark urine. Most cases of dehydration are mild, and resolved by drinking lots of fluids. But severe cases may require intravenous fluids administered by a health professional. Finally, cholera is a bacterial intestinal infection that spreads through contaminated water, particularly in regions with poor sanitation. Like C. diff, it can also cause severe diarrhea and dehydration. The CDC, a trusted source for Everyday Health editors, has a comprehensive online section on C. diff, with the most current info, from treatment and prevention to life after C. diff. Mayo Clinic For clear, up-to-date, and detailed coverage of C. diff, visit the Mayo Clinic’s website. You can also look into participating in the clinical trials they’re conducting, which investigate new treatments and interventions for C. diff. C. Diff Foundation This volunteer, nonprofit advocacy organization raises awareness about C. diff and provides resources for those who have the infection and those who’ve survived it, including nutritional tips and a TeleSupport program. Association for Professionals in Infection Control and Epidemiology (APIC) APIC is an association for healthcare professionals that aims to prevent the spread of infection, in particular healthcare-associated infections like C. diff. Their website offers in-depth info for providers and public health workers but also has resources for patients. Additional reporting by Brian P. Dunleavy.
