Clostridioides difficile colitis

Clostridioides difficile (also called C. diff) are bacteria that can cause swelling and irritation of the large intestine, or colon. This inflammation, known as colitis, can cause diarrhea, fever, and abdominal cramps.

You may get C. diff colitis if you take antibiotics. C. diff also can be passed from person to person. But 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.

Colitis caused by C. diff can be mild or serious. In rare cases, it can cause death.

Clostridioides difficile (C. diff) colitis may cause diarrhea, belly cramps, fever, or dehydration. You also may have an abnormal heartbeat, especially if you become dehydrated. Symptoms usually begin 4 to 10 days after you start taking antibiotics. But they might not start until a few weeks after you stop taking antibiotics.

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 illness. These may include:
  • Watery diarrhea (which may contain blood or pus).
  • Swelling, cramps, pain, or tenderness in the belly.
  • Fever.
  • Dehydration.

To confirm the diagnosis, a sample of your stool will be tested. The test will check for the bacteria by looking for its DNA. 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. In the most serious cases, the doctor may see patches of yellow and white tissue on the inside of the colon.

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.

• Your doctor may give you antibiotics to treat Clostridioides difficile (C. diff) colitis. If your doctor prescribes an antibiotic, you will be given a different antibiotic than the one that caused your infection. Take your antibiotics as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
• To prevent dehydration, drink plenty of fluids. Choose water and other clear liquids until you feel better. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.
• Eat small amounts of food when you feel like eating. This will help you to get enough nutrition.
• To prevent the spread of C. diff, practice good hygiene. Keep your hands clean by washing them well and often with soap and clean, running water. This is most important after you use the bathroom and before you make and eat food.
• After the diarrhea is better, you are much less likely to spread C. diff. But you still need to take extra care to keep your home clean.
  • Clean bathroom surfaces with a bleach solution to kill any C. diff spores. To dilute household bleach, follow the directions on the label.