C. Diff

What is C. diff? 

C. diff (Clostridioides difficile infection, sometimes still called Clostridium difficile) is a bacterial infection that affects the digestive system, especially the large intestine (colon). It can cause severe diarrhea, inflammation of the colon and, in some cases, life-threatening complications. 

C. diff infections most often happen after someone takes antibiotics for another infection. Antibiotics can destroy harmful bacteria but they can also disrupt the balance of healthy bacteria in the gut. When this balance changes, C. diff bacteria can multiply and release toxins that damage the colon. 

C. diff infections are often linked to hospitals or other health care facilities, but people can also develop them in the community. Knowing how C. diff spreads and recognizing symptoms early can help prevent complications. 

Concerned about symptoms of C. diff? Schedule an appointment with a Banner Health provider. 

How do you get a C. diff infection? 

C. diff bacteria exist in the environment and can survive for long periods as spores. These spores can live on surfaces, food, soil and medical equipment for months or even years. 

In health care settings, C. diff commonly spreads through: 

• Contaminated surfaces such as bed rails, toilets or medical equipment 
• Contact with contaminated hands 
• Person-to-person transmission 

Unlike many other germs, C. diff spores are resistant to most common disinfectants. Alcohol-based hand sanitizers do not kill C. diff. Proper handwashing with soap and water and special cleaning protocols are required to remove the bacteria. 

If your digestive system has healthy bacteria, these microbes usually prevent C. diff from growing. But when antibiotics disturb this balance, C. diff can grow quickly and produce toxins that inflame and damage the colon. 

Who is at risk for C. diff infection? 

Anyone can develop C. diff, but certain factors increase your risk. 

Common risk factors include: 

• Recent antibiotic use. C. diff infections are 7 to 10 times more common in people currently taking antibiotics or who have taken them within the past month. 
• Certain antibiotics, including cephalosporins, clindamycin, fluoroquinolones and penicillins 
• Age 65 or older 
• Recent hospitalization or residence in a nursing home or long-term care facility 
• Weakened immune system, including people with cancer, HIV/AIDS, organ transplants or those taking immunosuppressive medications 
• Digestive diseases such as inflammatory bowel disease or colorectal cancer 
• Chronic kidney disease 
• Recent gastrointestinal surgery 
• Use of proton pump inhibitors (PPIs) to reduce stomach acid 
• Previous C. diff infection 

What are the symptoms of C. diff? 

Symptoms of C. diff infection usually start within a few days of taking antibiotics, but they can appear up to three months later. 

Common symptoms of C. diff include: 

• Watery diarrhea several times a day 
• A strong or unusual odor in stool 
• Belly pain or cramping 
• Fever 
• Loss of appetite 
• Nausea 

Many people experience mild diarrhea when taking antibiotics, but persistent diarrhea for several days may signal a C. diff infection. 

If you develop these symptoms while taking antibiotics or shortly afterward, contact a health care provider. 

Severe C. diff symptoms to watch for 

Some C. diff infections become severe and can lead to dangerous complications. 

Signs of severe infection may include: 

• Diarrhea 10 to 15 times per day 
• Severe dehydration 
• Rapid heart rate 
• Blood or pus in stool 
• Kidney failure 
• Weight loss 
• Fluid leaking from the colon into the abdomen 
• Joint pain and swelling from reactive arthritis 

Rare but serious complications include: 

• Pseudomembranous colitis, where inflammatory plaques form on the colon lining 
• Bowel perforation, a hole in the colon wall 
• Toxic megacolon, a dangerous swelling of the colon 
• Sepsis, a life-threatening infection that spreads through the bloodstream 

Seek medical care immediately if you experience severe symptoms. 

How is C. diff diagnosed? 

Health care providers typically diagnose C. diff infection by testing a stool sample for C. diff toxins or bacteria. 

If a severe infection is suspected, additional tests may be used, including: 

• CT scan or abdominal X-ray to check for colon inflammation or complications 
• Blood tests to evaluate infection and dehydration 

In rare cases, a provider may recommend a sigmoidoscopy or colonoscopy to examine the colon, but these procedures are usually not required to confirm diagnosis. 

C. diff treatment options 

Treatment for C. diff depends on how severe the infection is and whether it is a first infection or a recurrence. 

Common treatments include: 

Stopping the antibiotic 

If possible, your provider may stop the antibiotic that triggered the infection. This may allow healthy bacteria in the gut to recover. 

Antibiotics that treat C. diff 

Medications that target C. diff bacteria include: 

• Vancomycin (Firvanq Kit) 
• Fidaxomicin (Dificid) 
• Sometimes metronidazole (Flagyl) 

These treatments usually last 10 days or longer. 

Fluids and electrolyte replacement 

Severe diarrhea can lead to dehydration. Drinking fluids or receiving intravenous (IV) fluids may help restore hydration and electrolyte balance. 

Gradual return to eating 

Your provider may recommend slowly reintroducing foods as your digestive system recovers. 

Surgery 

In rare cases involving serious complications, surgery may be required to remove severely damaged portions of the colon. 

How to prevent C. diff from spreading 

C. diff spreads easily, especially when someone has active diarrhea. Taking precautions can help prevent transmission to others. 

Prevention steps include: 

• Washing hands thoroughly with soap and water after using the bathroom and before eating 
• Using a separate bathroom if possible during active infection 
• Showering regularly to remove bacteria from the skin 
• Cleaning high-touch surfaces such as doorknobs, light switches and electronics with a bleach solution (1 part bleach to 9 parts water) 
• Washing bedding, towels and clothing in hot water with chlorine bleach when safe 
• Wearing gloves when handling soiled laundry 

Alcohol-based hand sanitizer does not kill C. diff spores. 

How to recover from and prevent C. diff reinfection 

Most people recover from C. diff infection in about two weeks, although recovery time can vary depending on the severity of the infection. 

Even after symptoms improve, C. diff bacteria may remain in the body. Continued attention to hygiene and prevention steps is important. 

About 1 in 6 people experience recurrent C. diff infection within two to eight weeks. 

Ways to help reduce recurrence include: 

• Following your provider’s advice about probiotics or gut health support 
• Continuing careful handwashing and surface cleaning 
• Avoiding unnecessary antibiotic use in the future 

What if C. diff comes back? 

Some people experience recurrent C. diff infections. 

If the infection returns, treatment options may include: 

• A different antibiotic than previously used 
• Bezlotoxumab (Zinplava), an antibody therapy that helps prevent recurrence 
• Probiotics that may support healthy gut bacteria 
• Fecal microbiota transplant (FMT), which restores healthy bacteria by transferring stool from a screened donor into the colon 

FMT is often recommended for people who have multiple recurrent infections. 

Expert care for C. diff at Banner Health 

At Banner Health, our specialists provide expert diagnosis and treatment for C. diff infections. We focus on personalized care, advanced infection prevention strategies and long-term recovery support. 

Our care teams can help you: 

• Identify the cause of digestive symptoms 
• Access advanced diagnostic testing 
• Receive effective treatments for C. diff infection 
• Reduce the risk of recurrence and complications 

Concerned about C. diff symptoms? Schedule an appointment with a Banner Health provider today.