Clostridium Difficile

Clostridium difficile, also known as C. difficile or C. diff, is a bacteria that can cause symptoms ranging from diarrhea to life-threatening inflammation of the colon.

C. difficile most commonly affects older adults in hospitals or in long-term care facilities and typically occurs after use of antibiotic medications.

At Virginia Mason, physicians specializing in infectious diseases and gastroenterology work closely to develop individualized care plans to effectively diagnose and treat C. difficile. For more information or to schedule an appointment with a Virginia Mason gastroenterologist, call (206) 223-2319.

Symptoms of C. Difficile

As C. difficile infection ranges from mild to life-threatening, symptoms vary greatly between individuals.

Symptoms of mild C. difficile:

  • Watery diarrhea (three or more times a day for several days)
  • Abdominal pain or tenderness

Symptoms of severe C. difficile:

  • Watery diarrhea (up to 15 times each day)
  • Severe abdominal pain
  • Loss of appetite
  • Fever
  • Blood or puss in the stool
  • Weight loss

Diagnosing C. Difficile

Your physician may suspect C. difficile if you have diarrhea and have recently taken antibiotics, or if diarrhea develops a few days after hospitalization. In such cases, you may undergo the following tests and procedures:

  • Stool tests — Toxins produced by C. difficile bacteria can usually be detected in a sample of your stool.
     
  • Colonoscopy — In rare instances, to help confirm a diagnosis of C. difficile, your physician may have you undergo a colonoscopy procedure using a colonoscope to view the colon and rectum.
     
  • Imaging tests — To confirm C. difficile, your physician may order an abdominal X-ray or a computerized tomography (CT) scan, which provides images of your colon.

Treating C. Difficile

If possible, the first step in treating C. difficile is to stop taking the antibiotic that triggered the infection. Depending on the severity of the infection, treatment may include:

  • Antibiotics — The standard treatment for C. difficile is giving the patient a different antibiotic, which keep the bacteria from growing, and helps to treat the diarrhea.
     
  • Surgery — For patients with severe pain, organ failure or inflammation of the lining of the abdominal wall, surgery to remove the diseased portion of the colon may be the only option.

Recurrent C. difficile infection:

Unfortunately, at least 20 percent of people with C. difficile experience symptoms again, with that number increasing after more than one recurrence. The recurrence of C. difficile happens either because the initial infection never left, or because they are infected with a different strain of the bacteria.

  • Fecal microbiota transplant (FMT) — Treatment for recurrent infection may include fecal microbiota transplant (FMT) or stool transplant. FMT works by restoring healthy intestinal bacteria by placing another person's (donor's) stool in your colon, using a colonoscope or nasogastric tube. Donor stools are carefully screened for parasites, viruses, bacteria and certain antibodies before being used for an FMT. Recent research has shown FMT to have higher than a 90 percent success rate for treating C. difficile infections.