Clostridium Difficile Infection

Clostridium difficile (C. diff) is a bacteria found in the intestinal tract or colon. Under certain conditions, it causes diarrhea and sometimes severe disease. The severe form of the disease is known as pseudomembranous colitis (often called C. diff colitis). This disease can damage the lining of the colon or cause the colon to become enlarged (toxic megacolon).

CAUSES

Your colon normally contains many different bacteria, including C. diff. The balance of bacteria in your colon can change during illness. This is especially true when you take antibiotic medicine. Taking antibiotics may allow the C. diff to grow, multiply excessively, and make a toxin that then causes illness. The elderly and people with certain medical conditions have a greater risk of getting C. diff infections.

SYMPTOMS

  • Watery diarrhea.

  • Fever.

  • Fatigue.

  • Loss of appetite.

  • Nausea.

  • Abdominal swelling, pain, or tenderness.

  • Dehydration.

DIAGNOSIS

Your symptoms may make your caregiver suspicious of a C. diff infection, especially if you have used antibiotics in the preceding weeks. However, there are only 2 ways to know for certain whether you have a C. diff infection:

  • A lab test that finds the toxin in your stool.

  • The specific appearance of an abnormality (pseudomembrane) in your colon. This can only be seen by doing a sigmoidoscopy or colonoscopy. These procedures involve passing an instrument through your rectum to look at the inside of your colon.

Your caregiver will help determine if these tests are necessary.

TREATMENT

  • Most people are successfully treated with 1 of 2 specific antibiotics, usually given by mouth. Other antibiotics you are receiving are stopped if possible.

  • Intravenous (IV) fluids and correction of electrolyte imbalance may be necessary.

  • Rarely, surgery may be needed to remove the infected part of the intestines.

  • Careful hand washing by you and your caregivers is important to prevent the spread of infection. In the hospital, your caregivers may also put on gowns and gloves to prevent the spread of the C. diff bacteria. Your room is also cleaned regularly with a hospital grade disinfectant.

HOME CARE INSTRUCTIONS

  • Drink enough fluids to keep your urine clear or pale yellow. Avoid milk, caffeine, and alcohol.

  • Ask your caregiver for specific rehydration instructions.

  • Try eating small, frequent meals rather than large meals.

  • Take your antibiotics as directed. Finish them even if you start to feel better.

  • Do not use medicines to slow diarrhea. This could delay healing or cause complications.

  • Wash your hands thoroughly after using the bathroom and before preparing food.

  • Make sure people who live with you wash their hands often, too.

SEEK MEDICAL CARE IF:

  • Diarrhea persists longer than expected or recurs after completing your course of antibiotic treatment for the C. diff infection.

  • You have trouble staying hydrated.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You develop a new fever.

  • You have increasing abdominal pain or tenderness.

  • There is blood in your stools, or your stools are dark black and tarry.

  • You cannot hold down food or liquids.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.