Clostridium difficile,
also known as C. difficile or C. diff, is a bacterium that can infect the
bowel and cause diarrhoea. The infection most commonly affects people who have
recently been treated with antibiotics, but can spread easily to
others. C. difficile infections are unpleasant and can
sometimes cause serious bowel problems, but they can usually be
treated with another course of antibiotics.
Symptoms of a C. difficile infection
Symptoms of a C. difficile infection usually
develop when you're taking antibiotics, or when you've finished taking them
within the last few weeks. The most common symptoms are:
- watery diarrhoea, which can be bloody
- painful
tummy cramps
- feeling
sick
- signs of dehydration, such as a dry mouth, headaches and peeing less often
than normal
- a
high temperature (fever) of above 38C (100.4F)
- loss
of appetite and weight loss.
In some cases, serious complications can
develop, such as damage to the bowel or severe dehydration, which may
cause drowsiness, confusion, a rapid heart rate and fainting.
Who is most at risk of C. difficile?
C. difficile mostly affects people who:
- have
been treated with broad-spectrum antibiotics (antibiotics that work
against several types of bacteria) or several different antibiotics
at the same time, or those taking long-term antibiotics
- have
had to stay in a healthcare setting, such as a hospital or care home,
for a long time
- are
over 65 years old
- have certain
underlying conditions, including inflammatory bowel disease (IBD), cancer or kidney disease
- have
a weakened immune system, which can be because of a condition such
as diabetes or a side effect of a
treatment such as chemotherapy or steroid medication
- are
taking a medication called a proton pump inhibitor (PPI) to reduce
the amount of stomach acid they produce
- have
had surgery on their digestive system.
Many C. difficile infections used to occur in
places where many people take antibiotics and are in close contact with each
other, such as hospitals and care homes. However, strict infection control measures have
helped to reduce this risk, and an increasing number of C. difficile
infections now occur outside these settings.
When to get medical advice
Visiting your doctor/ GP surgery with a possible C.
difficile infection can put others at risk, so it's best to call your GP
or NHS 111 if you are concerned or feel you need advice. Get medical advice if:
- you
have persistent diarrhoea after finishing a course
of antibiotics
- you
have bloody diarrhoea
- you
have diarrhoea and experience severe tummy pain, a high
fever, a rapid heart rate or fainting
- you
have symptoms of severe dehydration, such
as confusion, drowsiness, only passing small amounts of urine or no urine
at all.
Diarrhoea can be caused by a number of conditions
and is a common side effect of antibiotics, so having diarrhoea while
taking antibiotics doesn't necessarily mean you have a C. difficile
infection.
Your doctor may suggest sending off a sample of
your poo to confirm whether you have C. difficile. A blood test may also be carried out to
help determine how severe the infection is, and sometimes you may need tests or
scans in hospital to check if your bowel is damaged.
Treatment for C. difficile
Your GP will decide whether you need hospital
treatment (if you're not already in hospital). If the infection
is relatively mild, you may be treated at home. If you're in hospital, you might be moved to a
room of your own during treatment to reduce the risk of the infection spreading
to others. Treatment for C. difficile can include:
- stopping the
antibiotics thought to be causing the infection, if possible – in mild
cases, this may be the only treatment that's needed
- taking
a 10 to 14-day course of antibiotics that are known to kill C. difficile
bacteria
- rarely, serious infections
may require surgery to remove a damaged section of the bowel.
C. difficile infections usually respond well
to treatment, with most people making a full recovery in a week or two.
However, the symptoms come back in around 1 in 5 cases and treatment may need
to be repeated.
Looking after yourself at home
If you're well enough to be treated at home, the
following measures can help relieve your symptoms and prevent the
infection spreading:
- make
sure you finish the entire course of any antibiotics you're prescribed,
even if you're feeling better
- drink
plenty of fluids to avoid dehydration and eat plain foods such
as soup, rice, pasta and bread if you feel hungry
- take paracetamol for tummy pain or a
fever
- don't take anti-diarrhoeal
medication, as this can stop the infection being cleared from your body
- regularly
wash your hands and contaminated surfaces, objects or sheets.
- stay
at home until at least 48 hours after your last episode of diarrhoea.
Your doctor may contact you regularly to make sure
you're getting better. Call them if your symptoms return after treatment
finishes, as it may need to be repeated.
How you get C. difficile
C. difficile bacteria are found in the digestive
system of about 1 in every 30 healthy adults. The bacteria often live
harmlessly because the other bacteria normally found in the bowel keep it under
control. However, some antibiotics can interfere with the
balance of bacteria in the bowel, which can cause the C. difficile
bacteria to multiply and produce toxins that make the person ill.
When this happens, C. difficile can spread easily
to other people because the bacteria are passed out of the body in the person's
diarrhoea. Once out of the body, the bacteria turn into
resistant cells called spores. These can survive for long periods on hands,
surfaces (such as toilets), objects and clothing unless they're thoroughly
cleaned, and can infect someone else if they get into their mouth. Someone with a C. difficile infection is generally
considered to be infectious until at least 48 hours after their symptoms have
cleared up.
How to stop C. difficile spreading
C. difficile infections can be
passed on very easily. You can reduce your risk of picking it up or
spreading it by practising good hygiene, both at home and in healthcare
settings. The following measures can help:
- stay
at home until at least 48 hours after your symptoms have cleared up
- wash
your hands regularly with soap and water, particularly after going to the
toilet and before eating – use liquid rather than bar soap and
don't use flannels or nail brushes
- clean
contaminated surfaces – such as the toilet, flush handle, light
switches and door handles – with a bleach-based cleaner after
each use
- don't
share towels and flannels
- wash
contaminated clothes and sheets separately from other washing at the
highest possible temperature
- when
visiting someone in hospital, observe any visiting guidelines,
avoid taking any children under the age of 12, and wash your hands with
liquid soap and water when entering and leaving ward areas – don't
rely on alcohol hand gels, as they're not effective against C. difficile
- avoid
visiting hospital if you're feeling unwell or have recently had
diarrhoea.
Source: NHS Choices
