C. Diff

What is C. diff?

C. diff (Clostridioides difficile, also called Clostridium difficile in the past) is a common bacterial infection that can develop in your digestive system. In some cases, it’s serious or even life-threatening.

Clostridioides difficile infections usually happen after you take antibiotics to treat another infection. Along with destroying the dangerous bacteria that are causing your infection, the antibiotics may also disrupt the healthy bacteria that live in your large intestine (colon). When levels of healthy bacteria get low, C. diff can take over.

These infections often set in during a stay in a hospital or health care facility, but you can be infected even if you haven’t been in those settings. Knowing what causes infections and how they spread can help keep you and your loved ones healthy.

Concerned about symptoms? Schedule an appointment today.

Causes and risk factors of C. diff

C. diff bacteria live on surfaces and food and in soil and can survive for months or years. In health care settings, C. diff can spread through contaminated surfaces, equipment or person-to-person contact.

Most common cleaning products and alcohol-based hand sanitizers don’t get rid of C. diff — you need thorough handwashing and special cleaning protocols.

If you’re healthy, you probably won’t get sick from C. diff even if the germs reach your intestines. But if you take antibiotics, the balance of bacteria in your intestines can change and C. diff may multiply. When that happens, C. diff creates toxins that damage your intestine and cause inflammation. 

These factors put you at higher risk for C. diff infection:

• Recently taking a course of antibiotics or using antibiotics regularly. C. diff infections are seven to ten times more common in people taking antibiotics or who have taken them in the past month. Antibiotics most often linked to C. diff infections include cephalosporins, clindamycin, fluoroquinolones and penicillins.
• Being age 65 or older, since your immune system gets weaker as you age.
• Recently staying in a hospital, nursing home, long-term care facility or other health care setting. That’s because people who have C. diff are likely to get care in those places.
• Having a weakened immune system from cancer, HIV/AIDS, organ transplant, immunosuppressive medications or other causes.
• Having inflammatory bowel disease, colorectal cancer or chronic kidney disease.
• Surgery on the digestive tract.
• Taking a proton pump inhibitor to reduce stomach acid.
• Being exposed to or infected with C. diff in the past.

Signs and symptoms of C. diff

C. diff symptoms usually begin a few days after you start taking antibiotics, but it’s possible for them to start up to three months later. Signs and symptoms of infection may include:

• Watery diarrhea (It’s common to have diarrhea when you’re taking an antibiotic. With C. diff, you’re likely to have diarrhea more than twice a day for a few days.)
• A change in the odor of your stool
• Belly pain or cramping
• Fever
• Loss of appetite
• Nausea

If you experience any of these symptoms, see a health care provider right away, especially if you’re taking or recently took antibiotics. 

In severe cases, C. diff can cause more intense symptoms, including:

• Diarrhea 10 to 15 times a day
• Dehydration
• Fast heart rate
• Blood or pus in the stool
• Kidney failure
• Weight loss
• Fluid leaking from the colon into the abdomen
• Reactive arthritis, with joint pain and swelling
• Pseudomembranous colitis, where plaques form on the colon lining
• Hole in the large intestine (bowel perforation)
• Toxic megacolon, a rare condition where the colon swells dangerously (If the colon bursts, bacteria can enter the bloodstream.)
• Sepsis

Need expert advice? Contact Banner Health now.

C. diff diagnosis and treatment 

To diagnose C. diff, your health care provider will test a stool sample to see if it contains C. diff toxins or bacteria. If your provider suspects a severe infection, they may also perform imaging tests like a CT scan or X-ray to check for inflammation or complications in your colon.

Your provider may recommend a sigmoidoscopy or colonoscopy to check inside your colon, but most of the time these tests aren’t needed for diagnosis.

Your provider will recommend the best treatment based on your symptoms and how severe they are. Options include:

• Stopping the antibiotic you’re taking, if possible.
• Prescription antibiotics such as vancomycin (Firvanq Kit), fidaxomicin (Dificid) and sometimes metronidazole (Flagyl) for 10 days or more to target and eliminate C. diff.
• Drinking plenty of fluids.
• Intravenous (IV) fluids to prevent dehydration and replace electrolytes if your symptoms are severe.
• Gradually reintroducing food to allow your intestines to recover.
• In rare cases, surgery to remove damaged sections of the intestine.

Tips for preventing C. diff from spreading

If you have a C. diff infection, you could spread it to others. C. diff can be highly contagious. These tips reduce the risk of spread:

• Wash your hands thoroughly with soap and water every time you use the bathroom and before you eat. Hand sanitizer does not kill C. diff.
• If possible, use a separate bathroom from your family members, especially if you have diarrhea or active symptoms.
• Take showers and wash with soap to get germs off your skin.
• Disinfect high-touch surfaces like doorknobs, light switches, refrigerator handles and electronics regularly with a solution of one part bleach to nine parts water.
• Wash bedding, towels and clothing, especially underwear, with hot water and chlorine bleach (if bleach is safe for the material). Wear gloves if you’re handling soiled items. Wash your hands thoroughly after handling laundry.

Recovering and preventing reinfection

You’ll probably recover from C. diff in about two weeks. When your symptoms clear up, you can go back to your regular activities. But even after you feel better, C. diff bacteria can still be in your body. Take extra care with handwashing and cleaning so you don’t get infected again.

According to the Centers for Disease Control and Prevention (CDC), around one in six people who recover from C. diff may get infected again within two to eight weeks. To help prevent C. diff infections from coming back:

• Follow your health care provider’s advice on probiotics or other supplements that may help gut health.
• Keep following the tips listed above to prevent C. diff from spreading.
• Avoid using antibiotics in the future unless they are necessary.

If you get reinfected, your provider might recommend:

• Different antibiotics than those you’ve already taken.
• An antibody therapy called bezlotoxumab (Zinplava).
• Probiotics, which are foods or supplements that contain good bacteria.
• Fecal microbiota transplant (FMT), where you have a donor’s stool that contains healthy bacteria placed in your colon.

Getting care

At Banner Health, we provide specialized care for C. diff infections. We focus on personalized treatment plans, advanced infection prevention and resources to support you throughout your recovery. 

Our health care providers have the expertise and tools to diagnose, treat and help prevent C. diff and they support you with guidance and compassionate care.

• Concerned about C. diff? Schedule an appointment today.
• Need help managing a C. diff infection? Contact Banner Health now.