What Is C. Diff?
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Medically reviewed by Jay N. Yepuri, MD
Clostridiodes difficile, which is commonly called C. diff or C. difficile, is a bacteria that can cause symptoms ranging from mild illness to severe, watery diarrhea. The bacteria causes an estimated 500 million infections in the United States every year. The condition commonly occurs after taking antibiotics that kill healthy bacteria in the gut or staying at a hospital.
The most common C. diff symptoms are watery diarrhea that lasts more than three days and doesn't have another known cause. However, you can also experience symptoms such as nausea, stomach pain, and fever. Treatment options include antibiotics and supportive care to prevent dehydration and other C. diff complications.
Types
There are three types of C. diff infections: non-severe, severe, and fulminant.
Non-severe: Non-severe C. diff infections do not cause significant increases in white blood cell counts or severe illness that would require hospital admission.
Severe: Severe C. diff infections cause your white blood cell counts to go higher than 15,000 cells/microliter, decreases your albumin (protein) levels, and increases your creatinine levels (a measure of kidney function).
Fulminant: Fulminant C. diff is the most severe type and can lead to complications such as hypotension (low blood pressure), shock, ileus (no muscle contractions in the intestines), and megacolon (severe colon dilation).
Fulminant C. diff infections can be life-threatening and require immediate medical attention.
C. Diff Symptoms
Some people may carry C. diff bacteria in their body without experiencing symptoms while others can get sick after being exposed to C. diff. The most common C. diff symptom is watery diarrhea that usually lasts more than three days. However, you may also experience other symptoms, which include:
Appetite loss
Fever
Nausea
Stomach pain
Severe Symptoms
Some people can become seriously ill with C. diff. Severe and potentially life-threatening symptoms include:
Circulatory shock, or severely low blood pressure due to dehydration
Low albumin (a blood protein) levels, leading to hand, ankle, and foot swelling
Swollen abdomen that may feel hard to the touch
The condition can also cause severe complications, including colon perforation (tear or hole in the colon), severe infection, and kidney failure.
Causes
The Clostridioides difficile bacteria causes C. diff infections. This bacteria produces toxins called toxin A and toxin B that can cause a more serious infection type than other common causes of diarrhea, such as norovirus. The bacteria also makes spores, which are difficult for the body to destroy.
Taking antibiotics can lead to C. diff infections. This is especially true for the antibiotics clindamycin, cephalosporins, ciprofloxacin, and levofloxacin. These antibiotics can destroy normal protective bacteria in the colon, which allows C. diff bacteria to grow more easily.
C. diff bacteria are a common cause of nosocomial infections. These are infections you can get when you are in the hospital or a healthcare environment.
Risk Factors
The main risk factor for C. diff is if you have recently taken antibiotics. The antibiotics kill off bacteria that cause illness as well as healthy bacteria that prevent infections.
Other C. diff risk factors include:
Being age 65 or older
Being immunocompromised, such as having a medical condition like HIV/AIDS, cancer, or a history of organ transplant
Having had a recent hospital stay
History of previous C. diff infection
Staying or living in a nursing home
Diagnosis
A healthcare provider will consider your symptoms when diagnosing you with C. diff. They may ask you if you have recently taken antibiotics and when your symptoms began.
Your healthcare provider will likely ask you to provide a stool sample. They will send this sample to a laboratory to test for the presence of C. diff bacteria. The laboratory will perform at least two out of three possible C. diff tests to confirm the condition: GSH, Toxin EIA, or Toxin B PCR. If the test is positive, your healthcare provider will likely prescribe antibiotic medications to cure the infection.
Additional tests may determine how severe your C. diff infection is. Examples include:
Imaging studies: Imaging tests such as an X-ray or ultrasound can help a healthcare provider determine if your colon is swollen or filled with air.
Blood tests: Blood tests for white blood cells, albumin levels, or C-reactive protein (a sign of inflammation).
Endoscopy: A doctor—likely a gastroenterologist—may perform an endoscopy, a test that involves inserting a thin, flexible instrument that has a camera on the end of it to examine the colon's appearance and potentially take a biopsy (tissue sample) of the intestinal lining.
Related:What Should a Medical Scan Cost?
C. Diff Treatment
The main goal for C. diff treatment is to destroy the bacteria causing your symptoms. A secondary goal is to reduce discomfort, dehydration, and other C. diff symptoms that occur until you get better.
Your healthcare provider will likely prescribe an antibiotic to cure your C. diff infection. Antibiotics used to treat C. diff include vancomycin and fidaxomicin.
If you are very ill, your healthcare provider may admit you to the hospital. In addition to treating you with antibiotics, you may receive fluids and medicines to support your blood pressure until you get better.
Unfortunately, many people with C. diff experience a recurrence within two to eight weeks after they first had the condition. If the condition keeps coming back, your healthcare provider may recommend a fecal microbiota transplant. This involves transplanting fecal matter from a healthy donor to your intestine. The transplanted material can help to restore healthy bacteria to your digestive tract to help your body fight off C. diff.
Prevention
C. diff can be very contagious. To keep from getting it or spreading it to others, take the following precautions:
Washing your hands with soap and water after going to the bathroom.
Using a separate bathroom from relatives or friends if you have diarrhea. Disinfect the toilet seat with a bleach-based solution and other surfaces after you have been ill.
Shower regularly, bathing with soap.
You must wash your hands with soap and water (not hand sanitizer) to effectively get rid of C. diff spores.
Related Conditions
In addition to infectious conditions that require antibiotics, there are some other medical conditions that increase your risk for C. diff. Examples of these conditions include:
Inflammatory bowel disease, which includes Crohn's disease and ulcerative colitis, although healthcare providers aren't sure why these two conditions commonly occur together
History of gastrointestinal surgery, which can affect your body's natural balance of C. diff-fighting bacteria
Being immunocompromised, such as having cancer or a history of organ transplant and taking immunosuppressants, which can mean your body has a harder time fighting off infections
Living With C. Diff
Antibiotics are effective at treating between 80 and 90% of C. diff cases. If you experience recurrent C. diff infections, fecal transplant is effective in more than 90% of patients. Seeking treatment if you think you may have a C. diff infection is important to preventing further complications from occurring because there are treatments available.
Frequently Asked Questions
What are the long-term effects of C. diff?
Ideally, C. diff will go away with antibiotic treatment. If you have a recurrent infection, you may need additional treatments, but your symptoms should go away.
Is C. Diff contagious?
Yes, C. Diff is highly contagious and difficult to get rid of. This is because the bacteria produces spores that must be removed with soap and water on your hands and bleach-containing solutions on other surfaces.
Will C. Diff go away on its own?
C. diff infections that cause symptoms will not go away on their own. They require antibiotics to kill the C. diff bacteria.
How long does it take to get rid of C. diff?
Most people will treat C. diff with antibiotics for 10 days. If your C. diff comes back, your healthcare provider may have you take antibiotics for as long as eight weeks.
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