Clostridium Difficile (C. Diff)

Medically Reviewed by Minesh Khatri, MD on November 14, 2022
5 min read

Clostridium difficile (C. diff) is a type of bacteria that can cause colitis, a serious inflammation of the colon. Infections from C. diff often start after you've been taking antibiotics. It can sometimes be life-threatening.


When you have C. diff, the symptoms can range from mild to severe.

Mild symptoms can include problems like:

  • Watery diarrhea that happens three to four times a day for several days
  • Stomach pain, cramping, or tenderness

In more serious infections, there may be blood or pus in the stool. This can happen because C. diff can cause the colon -- also called the large intestine -- to get inflamed. When this happens, tissue in the colon can bleed or make pus. Other symptoms of a serious infection include:

If your C. diff infection is severe, you could get severe intestinal inflammation. Your colon could also get enlarged and you could develop an extreme response to infection called sepsis. All of these problems are serious and could send you to the hospital.

If your diarrhea from C. diff is very severe, get medical help quickly. Severe diarrhea can lead to life-threatening dehydration.

C. diff exists all around us. It's in the air, water, soil, and in the feces of humans and animals.

C. diff bacteria that are outside the body turn into spores that can live on surfaces for weeks or months. These spores are not "active," but they can turn active after you swallow them and they get into your intestines. Some people have the bacteria in their intestines and never have any symptoms. But for others, the bacteria make toxins that attack the intestines.

A new strain of C. diff bacteria makes larger amounts of toxins. These types are hard to treat with medications.

C. diff bacteria spread in health care facilities, like hospitals or nursing homes, where workers are more likely to come into contact with it and then with patients or residents.

You can also become infected if you touch clothing, sheets, or other surfaces that have come in contact with feces and then touch your mouth or nose.

Older adults in health care facilities are most at risk, especially if they're taking antibiotics. That's because the human body contains thousands of different types of bacteria -- some good, some bad. If the antibiotics kill enough healthy bacteria, the ones that cause C. diff could grow unchecked and make you sick.

The antibiotics that are most linked to a risk of C. diff infection are:

An increasing number of younger people also develop C. diff infections, even without taking antibiotics or being in a hospital. Failure to wash your hands thoroughly after being exposed to the bacteria can lead to infection.

You also have higher odds of getting C. diff if you have:

Women have higher chances of getting C. diff than men. You're also more at risk for the disease if you're 65 or older. And your odds of C. diff go up the more times you've had the disease before.

If a C. diff infection isn't treated quickly, you could become dehydrated due to severe diarrhea. This loss of fluids might also affect your:

A C. diff infection also can lead to rare problems such as:

  • Toxic megacolon. Your colon dilates and can't release gas or stool. This could cause it to swell and rupture. It can be life-threatening without emergency surgery.
  • Bowel perforation. This is a hole in your large intestines that allows dangerous bacteria to escape. It can lead to a dangerous infection called peritonitis.

If your doctor suspects you have this infection, they'll probably order one or more stool tests. They include:

  • Enzyme immunoassay
  • Polymerase chain reaction
  • Cell cytotoxicity assay

If your doctor suspects serious problems with your colon, they might order X-rays or a CT scan of your intestines. In rare cases, your doctor may examine your colon with procedures such as a flexible sigmoidoscopy or colonoscopy.

Antibiotics may have triggered your infection, but some types of these drugs target C. diff. They include:

Talk with your doctor about the side effects of these antibiotics.

It's important to replace fluids that you lost from diarrhea. Drink plenty of fluids that have water, salt, and sugar, such as broth and fruit juices.

If there's been damage to your intestines, you may need surgery to remove the affected areas.

Sometimes, a C. diff infection can come back. Doctors sometimes recommend a treatment to help repopulate the colon with healthy bacteria. It's often done by putting another person's stool in your colon using a device called a colonoscope. The procedure is called fecal microbiota transplant (FMT).

Donors are screened carefully to make sure they're not passing along infections or parasites.

If you're in a hospital or long-term health care facility, you can do several things to protect yourself from C. diff. For example:

  • Ask your health care professionals to wash their hands thoroughly before and after caring for you.
  • Request that all medical equipment be sanitized before being brought into your room.
  • Wash your hands with soap and water after using the bathroom and before eating.

Another way to help prevent C. diff is to not take unnecessary antibiotics. Talk this over with your doctor and see if there are other treatment options. And don't take antibiotics without a doctor's OK.

Many C. diff infections are mild and short-lived, but others can be quite serious. Take precautions, and don't hesitate to seek medical help if you have symptoms.