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Clostridium Difficile (C.diff)

What is Clostridium difficile?

Clostridium difficile (C.diff) is a bacteria that lives in the gut of around 1 in 30 healthy adults and children. When it multiplies, C.diff produces spores that are present in the faeces, can survive for a long time in the environment and are resistant to ‘normal’ disinfectants. The normal bowel contains millions of different types of bacteria which help break down and digest our food.

There are lots of these ‘good’ bacteria, but also some bacteria, such as C.diff, which can cause ill-health. The ‘good’ bacteria usually help keep C.diff in check.

How do you catch C.diff?
A few people carry C.diff, but remain in good health. People can become infected with C.diff if they touch items or surfaces (such as beds and equipment) that have been contaminated with C.diff spores and then touch their mouths.

If the ‘good’ gut bacteria are not able to keep C.diff in check, or if the body’s resistance to infection is lowered, C.diff can multiply and produce spores and toxin. The toxin can cause inflammation of the bowel. This most often happens when people take antibiotics to treat other infections (the antibiotics kill off the ‘good’ gut bacteria), or if patients’ immunity is lowered by chronic or serious ill-health, surgery or drugs.

What are the symptoms of C.diff?
Bowel symptoms range from mild tummy upset to moderate loose stools to severe painful bloody diarrhoea. Other symptoms include fever, loss of appetite, nausea and abdominal pain.

How is C.diff diagnosed?
C.diff is diagnosed by testing for C.diff toxin in a poo sample.

Are some patients more likely to be made ill by C.diff?
Elderly patients, patients who have received antibiotics and those whose resistance is lowered by chronic or serious ill-health, surgery or drugs are more likely to be made ill by C.diff.

Can C.diff be treated?
Mild illness usually responds well to stopping antibiotics and preventing dehydration by taking plenty of fluids. In more severe illness, anti-C.diff antibiotics are added. Most patients will improve within a few days and the diarrhoea symptoms typically resolve within two weeks. Anti-diarrhoea medication may make C.diff diarrhoea worse and is not recommended.

Is it possible to get C.diff more than once?
C.diff infection usually responds well to treatment, but approximately 20% of patients will experience recurrence of diarrhoea symptoms up to several weeks after treatment has finished. A further course of anti-C.diff antibiotics will be effective in almost all patients and other specialist treatments are available.

If your diarrhoea returns after treatment for C.diff infection, it is important to restart treatment promptly. If you have been discharged home, you should visit your GP as soon as possible, taking a poo sample with you (sample containers can be obtained from your GP if you have not already got one).