Clostridium Difficile Colitis

Clostridium difficile colitis is a common cause of infectious diarrhea which is caused by bacteria called clostridium difficile, often called C. diff. It frequently affects older adults and is a common hospital or long term care facility acquired infection. The infection is most commonly associated with antibiotic use however infections have been reported in young and healthy individuals in the community without any exposure to antibiotics or healthcare facilities.


In addition to antibiotics, acid reducing medications also called proton pump inhibitors can increase the risk of C. diff infection. Other conditions such as a weakened immune system due to a disease or medications and conditions such as colon cancer or inflammatory bowel disease (crohn’s and ulcerative colitis) also increase the risk of C. diff colitis.


Symptoms of the C. difficile infection may range from none at all to severe diarrhea and dehydration needing hospitalization. Some individuals carry the bacteria in their colon without showing any signs of the infection. Others may have mild symptoms including watery diarrhea 3 or more times a day and crampy lower abdominal pain. Severe cases may result in profuse diarrhea causing dehydration and leading to hospitalization. Fever, nausea, rapid heart rate, poor appetite and blood in stool may be seen with severe cases as well. A swollen or distended abdomen, kidney failure or very high white cell counts can be indicative of worsening disease needing urgent intervention. A stool test is necessary for diagnosing the condition.


While antibiotic use can cause C. diff colitis, the treatment for the most part involves use of appropriate antibiotics. Approved antibiotics include:

  • Metronidazole.
  • Vancomycin.
  • Fidaxomicin.

Recurrence after infection with C. difficile is not uncommon. Chance of recurrence can be up to 20% after the first infection with increasing risk of recurrence with each subsequent infection. Frequent recurrence is felt to be due to lack of adequate populations of other bacteria in the colon. Often the only treatment the infection responds to is repopulation of the colon with another person’s stool also known as fecal microbiota transplant (FMT). It is done by instillation of healthy donor stool during a colonoscopy after it is screened for infections and parasites.


C. diff colitis, also known as Clostridium difficile colitis, is an infection with the bacterium Clostridium difficile (C. diff). It is characterized by inflammation of the colon, or large intestine, and can cause symptoms such as diarrhea, abdominal pain, and fever.

Symptoms of C. diff colitis can include diarrhea (which may be watery and foul-smelling), abdominal pain, cramping, fever, loss of appetite, and weight loss. Some people may also experience rectal bleeding or a feeling of incomplete bowel evacuation.

C. diff colitis is typically caused by an infection with the bacterium Clostridium difficile. This bacterium is found in the environment and can be transmitted through contact with contaminated surfaces or objects. People who have recently been hospitalized or taken antibiotics are at increased risk of developing C. diff colitis.

C. diff colitis is usually diagnosed based on the patient’s symptoms and a stool sample test to detect the presence of C. diff bacteria. Further testing, such as a colonoscopy or CT scan, may be necessary to assess the extent of the inflammation and rule out other potential causes of the symptoms.

Treatment for C. diff colitis usually involves antibiotics to kill the C. diff bacteria and stop the infection. In severe cases, hospitalization may be necessary to manage dehydration and other complications. In some cases, surgery may be necessary to remove infected or damaged tissue.

There is no sure way to prevent C. diff colitis, but certain measures may reduce the risk of developing the disease. These include practicing good hygiene (such as washing hands frequently), avoiding unnecessary use of antibiotics, and taking steps to prevent the spread of infection (such as using gloves and masks when caring for someone with C. diff).

C. diff bacteria can be transmitted through contact with contaminated surfaces or objects, such as bed linens or toilet seats. It can also be transmitted person-to-person, especially in settings such as hospitals or nursing homes.

People who have recently been hospitalized or taken antibiotics are at increased risk of developing C. diff infection. Older adults and people with weakened immune systems are also at higher risk.

Complications of C. diff infection can include dehydration, sepsis (a serious infection of the bloodstream), and toxic megacolon (a condition in which the colon becomes significantly dilated and inflamed). In severe cases, C. diff infection can be life-threatening.

C. diff infection can recur in some people, especially if they have underlying health conditions or continue to take medications that increase the risk of infection. It is important to follow the treatment plan recommended by your healthcare provider to reduce the risk of recurrence.

Currently, there is no vaccine for C. diff infection. Prevention strategies include practicing good hygiene, avoiding unnecessary use of antibiotics, and taking steps to prevent the spread of infection in healthcare settings.