What is Clostridium difficile colitis?
Clostridium difficile (also called C. difficile) 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. difficile colitis if you take
antibiotics. C. difficile also
can be passed from person to person. The infection is most common in people who
are taking antibiotics while in the hospital. It is especially common in older
people in hospitals and nursing homes.
Colitis caused by
C. difficile can be mild or serious. In rare cases, it
can cause death.
What causes it?
The large intestine normally
contains many good bacteria that keep it healthy and do not cause disease. If
you take antibiotics to kill bacteria that do cause disease, your medicine may
also kill the good bacteria. This may allow C. difficile
bacteria to grow in your large intestine and release harmful substances called
toxins. Experts also think that, in some cases, antibiotics may cause these
toxins to be released.
When the toxins are released, the colon
What are the symptoms?
C. difficile colitis may cause:
You also may have an abnormal heartbeat.
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
The illness may be so mild that you have some
diarrhea but no fever or cramps. In rare cases, a person who is very ill may
develop a hole, or perforation, in the intestine. A perforation is a medical
emergency and requires surgery.
How is it diagnosed?
Your doctor may think you
have C. difficile colitis if both of the following are true:
- You have symptoms of the illness.
- You are taking, or you recently took, antibiotics.
To confirm the diagnosis, a stool sample will be tested
to look for the toxins that C. difficile produces.
Also, your doctor may look at the colon through a lighted instrument
colonoscopy). In the most serious cases of
C. difficile colitis, patches of yellow and white tissue
may form on the inside of the colon.
How is it treated?
First, if possible, your doctor will have you stop taking the antibiotic that caused the infection. Your doctor may then treat
C. difficile colitis with an antibiotic other than the one
that caused the infection. You will likely take metronidazole or vancomycin by
If you have severe diarrhea, you also may be given fluids
dehydration and to make sure you have the right amount
of minerals (electrolytes) in your blood. Sometimes the infection comes back a
few days after you stop treatment. If this happens, you may be given another
In rare cases, a person might need surgery to remove
part of the intestines. This would happen only if you did not get better with
antibiotics and you developed a perforation in your intestines.