Clostridium difficile

The average human digestive tract is home to as many as 1,000 species of

microorganisms.
Most of them are harmless -- or even helpful -- under normal circumstances. But
when something upsets the balance of these organisms in your gut, otherwise
harmless bacteria can grow out of control and make you sick.
One of the worst offenders is a bacterium called Clostridium difficile (C. difficile, or C.
diff). As the bacteria overgrow they release toxins that attack the lining of
theintestines, causing a condition called Clostridium difficile colitis.

Symptoms of C. diff
C. difficile infection can range from mild to life-threatening. Symptoms of mild cases
include watery diarrhea, three or more times a day for several days, with abdominal
pain or tenderness.
Symptoms of more severe C. diff infection include:

Watery diarrhea, up to 15 times each day

Severe abdominal pain
Loss of appetite
Fever
Blood or pus in the stool
Weight loss
In some cases, C. diff infection can lead to a hole in the intestines, which can be fatal
if not treated immediately.
C. diff can be diagnosed by stool specimens tested for the toxins. In some cases, a
colonoscopy may be needed for diagnosis and more tests ordered.

Risk Factors for C. diff

Although C. diff occasionally causes problems in healthy people, it is most likely to
affect patients in hospitals or long-term care facilities. Most have conditions that
require long-term treatment with antibiotics, which kill off other intestinal bacteria that
keep C. diff in check. While use of any antibiotic can potentially lead to C. Diff
overgrowth, it most commonly occurs with the use of an antibiotic that is broad-

spectrum, or able to kill a wide variety of bacteria. It also happens more often when
multiple antibiotics are needed to fight infection and when the antibiotics need to be
taken for a long period of time.

Other risk factors for C. diff infection include:

Surgery of the gastrointestinal (GI) tract

Diseases of the colon such as inflammatory bowel disease or colorectal cancer
A weakened immune system
Use of chemotherapy drugs
Previous C. diff infection
Advanced age -- 65 or older
Kidney disease
Use of drugs called proton-pump inhibitors, which lessen stomachacid

Treatments for C. diff

Doctors typically prescribe a 10-day course of one of the following oral
antibiotics: metronidazole (Flagyl), Dificid (fidaxomicin), or vancomycin(Vancocin).
Flagyl is usually tried first. Improvement usually happens within 72 hours after
starting antibiotics, but the diarrhea may return temporarily. Another round of
antibiotics is needed in about 25% of cases.
In addition to prescribed medications, treatment may include:

Probiotics. Available in most drug and health food stores without a prescription,
probiotics are "good" bacteria that colonize in the gut and may help keep C.
diff. infection from recurring if taken along with prescribed medicines.

Fluids. Drinking plenty of water and other fluids or getting intravenous fluids can help
guard against dehydration from diarrhea.
If you think you may have a C. diff infection, speak to your doctor before using an
anti-diarrhea medicine. Stopping the diarrhea could actually make the C. diff infection
worse.

Preventing C. diff Infection

Once a person has C. diff infection, the infection can spread to others.C. diff spores
are shed in the feces and can live on dry surfaces for a long time. A person who
touches one of those surfaces can pick up the infection.
Fortunately, infection can be prevented. If you are visiting a health care facility or are
in contact with someone who has the infection, good hygiene is vital.
Precautions:

Wash your hands with soap and water frequently. Do not rely just on alcohol-based
hand sanitizers.

Clean surfaces in bathrooms and kitchens regularly with chlorine bleach-based

products.
Wash soiled clothing with detergent and chlorine bleach.
If you are visiting someone in a health care facility, wash your hands before and after
your visit. If you use the restroom, wash your hands well to remove possible C.
diff spores.

Don't use antibiotics unless your doctor recommends them.