What is it?

Clostridioides difficile is a bacterium that causes an infection of the large intestine (colon). Symptoms can range from diarrhea to life-threatening damage to the colon.
Illness from C. difficile typically occurs after use of antibiotic medications. It most commonly affects older adults in hospitals or in long-term care facilities.

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Signs & symptoms

The most common signs and symptoms of mild to moderate C. difficile infection are:
* Watery diarrhea three or more times a day for more than one day
* Mild abdominal cramping and tenderness

Severe infection
People who have a severe C. difficile infection tend to become dehydrated and may need to be hospitalized. C. difficile can cause the colon to become inflamed and sometimes form patches of raw tissue that can bleed or produce pus. Signs and symptoms of severe infection include:
* Watery diarrhea as often as 10 to 15 times a day
* Abdominal cramping and pain, which may be severe
* Rapid heart rate
* Dehydration
* Fever
* Nausea
* Increased white blood cell count
* Kidney failure
* Loss of appetite
* Swollen abdomen
* Weight loss
* Blood or pus in the stool
C. difficile infection that is severe and sudden, an uncommon condition, may also cause intestinal inflammation leading to enlargement of the colon (also called toxic megacolon) and sepsis. Sepsis is a life-threatening condition that occurs when the body's response to an infection damages its own tissues. People who have these conditions are admitted to the intensive care unit.


A diagnosis of C. difficile infection is based on the presence of:
* Diarrhea
* Other signs and symptoms of C. difficile infection
* Presence of C. difficile in a stool sample
People who have regular, formed stools should not be tested for C. difficile infection. Recent use of antibiotics is not required for making a diagnosis of C. difficile infection.

Colon examination
In rare instances, to help confirm a diagnosis of C. difficile infection and look for alternative causes of the symptoms, the doctor may examine the inside of the colon. This test (flexible sigmoidoscopy or colonoscopy) involves inserting a flexible tube with a small camera on one end into the colon to look for areas of inflammation or abnormal tissue.

Imaging tests
If the doctor is concerned about possible complications of C. difficile infection, he or she may order an abdominal X-ray or a computerized tomography (CT) scan, which provides images of the colon. The scan can detect the presence of complications such as:
* Thickening of the colon wall
* Enlargement of the bowel
* A hole (perforation) in the lining of your colon.


Treatments are used only if a person has signs or symptoms of infection. People who carry the bacteria- but are not sick- are not treated.
Antibiotics- If C. difficile infection is related to an antibiotic you're taking, the doctor will likely discontinue use of that drug. In many cases, however, an antibiotic treatment is critical for treating another infectious condition. The doctor may prescribe a different antibiotic that is less likely to contribute to diarrhea related to C. difficile infection.
Antibiotics are the mainstay to treat C. difficile infection. Commonly used antibiotics include:
* Vancomycin
* Fidaxomicin
* Metronidazole (Flagyl) may be used in combination with vancomycin to treat serious C. difficile infection.

Surgery- Surgery to remove the diseased portion of the colon may be necessary in some cases, including:
* Severe pain
* Organ failure
* Toxic megacolon
* Inflammation of the lining of the abdominal wall

☝️ This is not a substitute for professional medical advice. Please consult with your physician before making any medical decision.

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