What is Clostridioides difficile (C. diff) colitis?
Clostridioides difficile (also called C. diff) are bacteria that can cause the large intestine, or colon, to swell and get inflamed. This inflammation, known as colitis, can cause belly cramps, watery diarrhea, nausea, vomiting, and fever.
The infection is most common in people who are taking antibiotics or have taken them recently. It is also common in older people who are in hospitals and nursing homes and in people who are getting chemotherapy for cancer. C. diff also can be passed from person to person.
Colitis caused by C. diff can be mild or severe.
What causes it?
The large intestine has many good bacteria that keep it healthy and don't cause problems. If you take antibiotics to kill bacteria that do cause an infection, that medicine may also kill the good bacteria. This may allow Clostridioides difficile (C. diff) bacteria to grow in your large intestine. The bacteria can release harmful substances called toxins.
When the toxins are released, the colon becomes inflamed.
People who take medicines that reduce stomach acid, such as esomeprazole (Nexium), lansoprazole (Prevacid), and omeprazole (Prilosec), also have a greater risk of getting a C. diff infection. Your doctor can help you decide which medicines to keep or change.
What are the symptoms?
Clostridioides difficile (C. diff) colitis may cause belly cramps, watery diarrhea, nausea, vomiting, and fever. Symptoms can be mild or severe. Symptoms usually begin 4 to 10 days after you start taking antibiotics. But they may start on the first day or up to a few weeks after you stop taking antibiotics.
How is it diagnosed?
Your doctor may think you have Clostridioides difficile (C. diff) colitis if both of the following are true:
- You are taking, or you recently took, antibiotics.
- You have symptoms of the infection. These may include:
- Watery diarrhea (which may contain blood or pus).
- Swelling, cramps, pain, or tenderness in the belly.
- A fever.
To confirm the diagnosis, a sample of your stool will be tested. The test will check for the C. diff bacteria. Another test may be done to look for the toxins that C. diff produces.
Your doctor may look at the inside of your colon through a thin, lighted tube called a colonoscope.
How is it treated?
If possible, your doctor will have you stop taking the antibiotic that caused the infection. Your doctor may then treat Clostridioides difficile (C. diff) colitis with an antibiotic other than the one that caused the infection.
If you have severe diarrhea, you also may be given fluids to prevent dehydration and to make sure you have the right amount of minerals (electrolytes) in your blood. Or you will be given medicine to control diarrhea.
If C. diff is severe or comes back a few times, fecal transplant may be done. This treatment places stool from a donor into the colon of a person who has C. diff infection. The good bacteria in the donor stool help heal the colon.
