C. Diff. (Clostridioides difficile)

What is C. diff.?

Clostridioides difficile (C. diff.) is a type of bacteria that can live in the intestines without causing problems. It also lives in the environment, such as soil, water, and animal feces.

If the balance of bacteria in your gut changes—often after taking antibiotics—C. diff. can grow out of control. It releases toxins that irritate and damage the colon, causing infection.

C. diff. was formerly known as Clostridium difficile. Many people and doctors still use this older name.

Symptoms of C. diff.

C. diff. infection can range from mild to severe.

Mild symptoms:

• Watery diarrhea (3 or more times a day for several days)
• Stomach pain or tenderness

Severe symptoms:

• Very frequent diarrhea (up to 15 times a day)
• Severe stomach pain
• Nausea or loss of appetite
• Low-grade fever
• Blood or pus in stool

Call your doctor if symptoms start after taking an antibiotic or last longer than 3 days.

What causes a C. diff. infection?

The main risk factor is antibiotic use, especially long-term or broad-spectrum antibiotics. These medicines can disrupt the normal balance of bacteria in your gut.

Other risk factors include:

• Age 65 or older
• Recent hospitalization or nursing home stay
• Gastrointestinal surgery
• Inflammatory bowel disease or colon cancer
• Weakened immune system
• Prior C. diff. infection

Healthy people rarely get C. diff. infections.

How is C. diff. diagnosed?

Your doctor will test a stool sample to confirm C. diff. infection. Imaging tests such as X-rays or CT scans may be used to check for colon damage.

Some people carry C. diff. without symptoms. This is called colonization. A positive test plus symptoms indicates active infection.

Can a C. diff. infection be prevented or avoided?

C. diff. spreads easily from person to person and survives on surfaces. You can lower your risk by:

• Washing your hands with soap and water
• Using bleach-based cleaners on surfaces
• Wearing disposable gloves when caring for someone with C. diff.
• Washing soiled laundry with bleach
• Avoiding antibiotics unless prescribed by your doctor

If you have C. diff., clean surfaces you touch with a bleach-based product and wash your hands often to protect others. About 1 in 5 people who have C. diff. will get it again.

C. diff. treatment

If you were taking antibiotics when symptoms began, your doctor may stop that medicine. For mild cases, symptoms often improve within a few days.

For more severe cases, doctors prescribe antibiotics proven to treat C. diff., such as vancomycin or fidaxomicin. Some people need a second round of treatment.

While you recover:

• Drink plenty of fluids
• Avoid dairy and high-fiber foods until symptoms improve
• Ask your doctor before using antidiarrhea medicine

In rare cases, C. diff. may lead to serious complications such as sepsis or a puncture in the intestines.

Living with C. diff.

C. diff. infection can return, especially in people who are older or have weak immune systems. Some probiotics may help reduce the chance of another infection—ask your doctor before taking supplements.