Why do some people have recurring C Diff infections?

by admin on April 25, 2011

This is an area where research is ongoing, but here are some of the possible reasons.

1 They have been reinfected through another hospital contact and a cycle of sickness has started again

2 The drugs previously given subdued it but did not kill it. There is some evidence that some bacteria will ‘switch off’ and go dormant in their fight against vancocin. When the balance of the intestine is disturbed again by drug treatment for another illness the latent c diff is re-activated.

3 Little is known about the general prevelance of c difficile in the environment and community. Figures of 3-35% who might be ‘silent carriers’ are sometimes mentioned in the scientific literature. There is also a growing body of evidence that some are suffering c difficile infections without hospital contact. The possibility of community spread cannot be ruled out.

4 The intestine can sometimes be so disturbed by drug treatment, infection and illness that it struggles to get right. The controversial fecal transplant method does suggest that healthier fecal matter can restore the intestine to balance and break the cycle of illness



C Diff Basics
What is C Diff?
What are the symptoms of C Diff?
How do I know I have C Diff?
How is C Difficile treated?

Understanding Your C Difficile Infection
How does C Diff actually make you ill
Why do some people have recurring C Diff infection
How can C diff infection be prevented
What is the C Diff ‘fecal transplant’ therapy
Is C Difficile contagious?
What is C Difficile colitis
What are C Difficile toxins

C Difficile Drugs
A guide to Flagyl (Metronidazole)
New drug – Fidaxomicin
When Flagyl fails – Vancocin

  • Kathy

    I have C diff now. What can I eat? Everything goes right thrugh me.

  • Dave Roberts

    This from the http://www.uptodate.com/contents/patient-information-antibiotic-associated-diarrhea-clostridium-difficile site may help

    Diet — There is no particular food or group of foods that is best for a person with diarrhea. However, adequate nutrition is important during an episode of acute diarrhea. For patients without an appetite, it is acceptable to consume only liquids for a short period of time. Boiled starches and cereals (eg, potatoes, noodles, rice, wheat, and oats) with salt are recommended for people with watery diarrhea; crackers, bananas, soup, and boiled vegetables may also be eaten.

    A temporary type of lactose intolerance is common following diarrheal illness; this may last for several weeks to months. Thus, temporary avoidance of lactose-containing foods (eg, ice cream, milk and milk products) may be helpful.

  • Liz

    Can a pregnant woman give c-diff to her newborn after she returns home? She is getting better and the baby is due in 10 days how safe is it for her and other children?

    • admin

      She is more likely to infect others when she is still suffering. After it has stopped then there is a residual chance of infection from hard to eradicate spores but good personal hygiene should deal with that. It should be noted that many people are c diff carriers but suffer no ill effect unless they are unwell and have to have antibiotics. It is not an infection that automatically makes you ill

      Dave Roberts
      Cdifficile.org

  • Debbie Trainer

    I am on my second round of c-diff, acttually, I don’t even know if it went away the first time.My question is this…..I had my stomach removed in 2009 at the Cleveland Clinic due to perferations in my stomach(reaccuring ulcer disease), anyway my health is not all that great. I have trouble with my hemaglobin, i’m forever receiving blood, I had heart and lung failure last year, along with pnemonia, sepsis, blood loss(I came very close to dying) but this second round of c-diff is really bringing my health down. even though I have lomotil and immodiam ad I go 20-25 times, my stomach internal organs feel like they are being twisted, can’t sleep, I keep falling out( I will be on the toilet and wake up 2 hours later. I don’t know what to do , I’m scared. Could you possibly die from it? And when should I say- enough is enough and go to the hospital. HELP…..PLEASE!

    • admin

      I would urge you to go to the hospital. We are medical journalists, not doctors so we can’t give advice. But neither of the drugs you have been given are c diff drugs. If you have a proven c diff infection via a c diff test then they should be giving you another drug.

      C Diff can make people very ill who are already unwell. Get help now

      Dave Roberts
      cdifficile.org

  • Jane Perry

    I developed Cdiff as a result of taking Augmentin. Treated for 10 days with Metronidazole. 3 days after completing the regimen I relapsed. My doctor uncertain on how to proceed sent me to the ER. They gave me IV fluids including a gram of Vancomycin. Sent me home with a 4 week script for Metronidazole. After 2 days on regimen I am feeling much better.

    Since my doctor is unclear on course of treatment I have questions that she cannot answer. Here is my main question. After I complete the 4 weeks of Metronidazole would a stool sample reveal the presence of Cdiff or not?

    I am a 60 year old female previously in excellent health, normal weight, no smoking, physically fit, taking no medications. I took the antibiotic Augmentin as a result of a dog bite.

    Thank you for any insight into this nasty condition.

    • admin

      The only way that they will know that the c diff has been dealt with is via a stool sample. It may not have been totally flushed from your body but may have come back under the control of the other bacteria that usually keep it in check

      Dave
      cdifficile.org

  • http://@rr sherri fenstermaker

    Please help me find some information about staff infection? “

  • unlucky

    Hi i just had my large bowel removed after getting sick with cdiff. i was on antibiotics and by the time i got to the hospital i had blood poisoning/sepsis and my stomach was swollen although i seemed okay i do not remember anything now. I had flu symptoms for a week then called a ambulance.They got family to sign a paper to remove my large bowel. i woke up two and half weeks later from coma and found i had a ileostomy. I guess i had internal bleeding so they did two surgerys back to back. I had edema and my organs were shutting down. Breathing and kidney troubles and mega colon along with pseudomembranous colitis. I almost died..I now have about eight inches of my large bowel left and they plan on doing a reversal. My question is ..its been about eight weeks since the operation and cdiff and now i have had several troubling episodes with stuff coming from my rectum. Supposedly my large bowel is no longer attached to anything. Yet the first episode looked like packing..white and hard two inches thick and long the second episode looked like a piece of my bowel…or a piece of beef…now i have a pudding substance that looks like carmel pudding coming out. Could this be cdiff back again? I talked to the doctor and he doesnt think it is likely but he also didnt think i had it the first time and told me it was the flu so i didnt seek help until i was deathly sick. I do not want to lose my bowel that i have left or i wont be able to do a reversal. I have also had chills and hot spells but could be menopause symptoms. Pain issues and stomach aches in morning and after eating. I heard relapse of cdiff is rare..but i am very concerned ..any ideas on what could be going on ? thanks..

  • Marianne T.

    My mother-in-law has been hospitalized after a bout of c-diff. They were going to release her (she is 91 yrs. old) but did another test and she still has the c-diff. I am currently on chemo. She lives with us. Should she be in a nursing facility while she is still be treated. I really don’t think she should come home as I my immune system is
    not the best. My side effects from the chemo is IBS for a few days after my treatment.

    • Infection Watch

      You are at risk because of your own need to take medicine which may disturb your intestine. If after care for her is not possible then hand hygiene for your family will be key. Regular washing especially after helping or ading her will ber vital. Was your hands for at least 30 seconds under running water

      dave
      cdifficile.org

  • Carrie

    This is my third time with dificid for C-diff. I am also taking the VSL#3 probiotics. I have had a 3 week course of dificid. I am very scared to quit as the next step is a fecal transplant. Are there patients that just maintain on dificid? What symptoms should I look for that would come back first? Are there now donor capsules that one can take for the C-diff instead of a FT? Where is the US on the vaccine for C-diff?

    • Infection Watch

      Dificid has a strong reputation for halting repeat attacks. We are not aware that prolonged courses of any C Diff drug are reccomended. The donor capsule idea is being explored at this time as is the vaccine. Neither have been through the full tesing process

      Dave
      cdifficile.org

  • Ashley

    I am a 24 yr old female. I had strep 6 times in a row and was treated with different antibiotics each time. A few days ago I noticed mucus in my stool. It was not lose at all just a regular BM. I went to the doctor and they took a stool sample. Came back with c diff. gave me 500 mg flagyl 3 times a day for 14 days. I have not cramping and no lose stool. I feel fine. Could this been a false positive and is there such thing as minor c diff?? In really nervous thinking that I’m going to get toxic mega colon or something serious and not even know. I didn’t even know I had c diff!!

    • Infection Watch

      A paper has come out in the last few days which notes that sensitive tests may be showing up very mild c diff which will resolve without treatment.

      You are a prime candidate for c diff however given the amount of antibiotics that you have had to take.

      You are likely to be low risk for a major c diff infection given you otherwise healthy state

      Remain watchful and finish the treatment but do not be too alarmed

      Dave
      cdifficile.org

      • Mal Nagle

        I am an 81year old healthy woman I had a “Citrobacter Koseri” urinary infection, on Augmentin for 10 days.
        4 weeks later urine still showed “Citrobacter Koseri” 10 more days of Augmentin.
        Had severe diarrhea for 3 days- 1st stool specimen showed cdiff. Started Flagyl
        2nd day Stool specimen was negative for cdiff only on had 4 doses on medication.
        Still on Flagyl course of 10 days.
        Questioned doctor about 2nd specimen being negative and was told I still have the infection even though it was negative is this possible?

        • Infection Watch

          c difficile test false negative

          If you google the above phrase you will find several leads as to why the test may have been negative but you could still be infected.

          Hope that helps

          Dave
          cdifficile.org

  • Jessica

    When I was around 7 months pregnant I ended up getting c diff and was treated. It went away and I didn’t have any problems for about six months. when all of the sudden I felt like I had c diff again. After a day of having all the same symptoms of c diff it went away and I was fine. I have this problem every couple of months or so. This all started around 2 years ago. It is extremely painful and prevents me from doing anything for a full day and night. So I was wondering if it is possible that I am still suffering from c diff

    • Infection Watch

      Hard to say without a test of your stool at the time of illness. Given the short duration maybe not.

      Dave
      cdifficile.org

  • Garnet Oltmann

    I had cdiff and was hospitalized for 28 days. Had to be transported home from NC to FL via ICU Jet. Went to rehab center for two weeks and left with a negative test for cdiff. Tested positive after a few weeks. Have taken dificid for ten days. Was lucky to get this drug for no charge. ($3200 for ten day prescription). Have been tested and have cdiff. NO symtoms. Gastro doctor tells he will not prescribe any treatment unless I show signs of active cdiff. He is concerned about giving me antibotics as he states your sytem can build up a resistance to them. I feel fine………….however, am concerned about being a cdiff carrier and having active cdiff again. I was so sick with this I don’t remember anything for the first 3 weeks in the hospital. My bottom was so RAW if took weeks and constant care before I became pain free. I take probotics. I am still concerned and don’t know if I should consult another doctor.

    • Infection Watch

      Dificid is thought to be more effective at killing c diff in the intestine. So you are less likely to have another episode. He is also right about the antibiotics. They may spark another episode if taken beyond the time needed to stop the diarrhea.

      The choice is yours but the doctor seems to be on firm ground

      Dave
      cdifficile.org

  • george

    I been diagnosed with c diff it was a very long painful four days of being in the er treated for other things and discharged before my Dr saw me and tested me thank god .my question is I been having the painful non stop diarrhea and vomiting I started flagyl and although I’m extremely happy not to be living in the bathroom my concern is I haven’t had a bm in 2 days of any kind and my belly when I eat feels like I ate rocks should I be concerned or is everything trying to right itself Ty

  • Sara

    For the past 7 months, once a month for a 24 hour time period, I have had horrible watery diarrhea where I go nearly every 30 minutes to an hour. I have no appetite and can barely drink anything because everything just goes straight through me. But then, the next day I’m perfectly fine. Could this be a side effect from my birth control that I take, because the past 2 months it happened on the EXACT day 3 days after I started my new pack. But I have been on this pill for 1 year now and I wasn’t effected the other 5 months. Could this be C diff or something else?

  • http://cdifficile.org Robyn

    I was hospitalized 3 months ago for diverticulitis and put on flagyl and augmentin after getting out for 10 days. After a week of not feeling much better, my doctor prescribed another round of flagyl and cipro for 10 days. Things seemed to clear up for the most part, however, a month later I felt like I had another flare up and the doctor gave me another 10 day round of flagyl and cipro. Still not feeling well after that, my doctor gave me yet another round of flagyl and cipro. About halfway through that round I had a CT that said I had mild diverticulosys with no sign of diverticulitis or abcis. I then had a bad reaction to the contrast from the CT and passed a kidney stone two days later. I then went and saw a new doctor who did a full blood, urine, and stool tests and come to find out that I had c. diff. My new doctor assumes it is from taking too much antibiotics and not enough probiotics. He put me on vancomyicin for 10 days, and about halfway through I started feeling much better. I have now been off for a week and my diarrhea is feeling more loose (not watery), and getting mild cramping on and off throughout the day.
    My question is how long should I have diarrhea after getting off vancomyicin? Is this normal?

    • admin

      Vanco is the second drug when Flaygl fails. But Dificid is thought to be the one that halts c diff rather than just dampening it down.

      dave
      cdifficile.org

  • Tamera

    I got c.diff about 15 years ago while taking an antibiotic for a sinus infection and was prescribed Flagyl. The Flagyl made the c.diff worse, so the doctor told me to stop all medications. After 3 weeks of bed rest and losing 10 pounds, I seemed to come back to health (I was young and healthier). Two months ago I had an endoscopy for recurrent reflux and stomach pain. Turns out I have acute Gastritis and was prescribed Prilosec 20mg daily. 10 days ago my stomach began hurting and the battle with c.diff begins again. My GI doc told me to stop the Prilosec, but doesn’t seem concerned about the diahrrea and cramping. I am concerned because I have pain under my ribs and in my sides- I don’t remember experiencing this in the past. Is this normal with c.diff? If it turns out I am a carrier, will I ALWAYS have c.diff? Thank you for your thoughts on the subject.

    • admin

      The new drug, Dificid, seems to have a much better track record at halting C Diff rather than just suppressing it. Has the doctor confirmed your recent situation with a test?

      Dave
      cdifficile.org

      • Tamera

        I have never been given an official test for C Diff, but when I was prescribed the Flagyl years ago, the advice nurse told me that’s what I had. As a follow up to the recent bout- I went on the BRAT style diet for two weeks (my main diet was yogurt, rice, poached eggs, grilled plain chicken (organic), saltine crackers, boiled asparagus and carrots, chicken noodle soup, bananas and Kefir). After about 10 days I added Flora (super acidophilus), and I must say it has made a monumental difference. I have normal BM’s now (for the first time in 2 years!), but I do still feel inflammation in my stomach and intestines. My acid reflux has been reduced so dramatically I’m astonished. However, I definitely still have inflammation and hope to get a CT scan of my intestines at some point. If the symptoms of my C Diff have subsided, do you think it wise to request a test for C Diff at this point? I am wondering about the “colonization” factor, and which test would be adequate for a proper diagnosis at this point. Thank you for your time.

        • admin

          You really need a test to confirm without a doubt that it is c diff causing your problems. Without that there are no definitive answers

          dave
          cdifficile.org

          • Tamera

            Is there any way to naturally rid the body of the c.diff through diet and supplements?

  • Rosette shumacher

    My 21/2 yr old grandson was diagnosed with CDif he is on round number three of medication he has lost too much weight and is now only 20 lbs I am very concerned that maybe his gastro Dr. Is not treating him correctly iis there a top specialist in the New York area that you can recommend? His diareah is completely watery even though he is on medication this is freaking me out. I can literally see he is all bones Any information would be greatly appreciated
    Rose

    • admin

      We are based in Europe so are not aware of key doctors in the USA. What medication is he on

      Dave
      cdifficile.org

  • Jane Perry

    This reply is for Tamara. I did test positive for Cdiff 3 times. One mistake that I (and my doctor) made was testing right after a round of 4 weeks on flagyl. I tested negative then and we thought I was out of the woods. However about 10 days later I relapsed. If you do not have symptoms then the Cdiff is hibernating — so don’t waste your time, money and dignity on the test unless you have symptoms.

    I did find that when I relapsed the occurance was not as harsh as previous episodes.

    A comment on vancomyacin — I had to pay $1680 for a two week course — I have no prescription coverage. After I relapsed again I found out that you can get a liquid form of vancomyacin from a compounding pharmacy. That cost me $133 for a two week course. Do the math.

    Once more thing — you should be taking probiotics. I was told by a pharmacist that the specific culture to get is Saccharomyces boulardii.

    • Tamera

      Thank you for the information Jane. I have the Saccharomyces boulardi but am not taking it because I want to speak with my primary MD and chiropractor. I used to get yeast infections and thrush a lot, and there is a slight risk factor for fungemia for some people who take Saccharomyces boulardi. Have you heard about this? I am very pleased with the response my body has to Flora and kefir, but if neither of those actually rid the body of the c.diff bacteria, I’d hate to think the c.diff is just hibernating. Is there no natural way to overcome it?

  • Gayl

    I am 29 and in pretty good health overall. I was diagnosed with c diff after having my meds changed ftom arythromican to clyndomician for strep that wasn’t going away. I just finished my 10 day prescription of metronidazole on Saturday and by Sunday afternoon I started having symptoms again. Much milder symptoms than before with no fever a milder stomach pain and no diarrhea. I am however making increasingly more frequent trips to the bathroom with more tissue and blood in my stool than my first bout with c diff. This worries we and I wonder if I should wait until my dr can see me, or head straight to the er?

    • admin

      We cannot give medical advice, only information. We would suggest however that you seek help now. Blood discharges are never a good sign

      Dave
      cdifficile.org

  • unlucky

    Well i guess now the doctor is saying or calling this my third relapse with cdiff since january ..i got out of the hospital minus my large bowel in feb…And i was on a ten day treatment in march and again in may with vancomycin. Now they did a biopsy and a scope which showed nothing….just inflamation but my understanding is a scope does not show cdiff . Does anyone know if this is correct? I am now on vancomycin via enemias for the summer . I am scheduled to be put back together after the summer is over and i am very worried the cdiff will take off again since it almost killed me the first time….

    • admin

      The scope is likely to show the damage being done by c diff, including inflammation. Only a test can confirm that c diff is the cause. Ask them about fidaxomicin as this seems better at stopping c diff coming back.

      Dave
      cdifficile.org

      • unlucky

        thank you i will ask them. The scope showed imflamation. And by test do you mean test on the stuff i am passing?
        Also is there any means of getting good bacteria levels back up in my bowel and system before going in for a reattachment surgery in two months? this is what i am afraid of the most that when they go to reattach the cdiff takes off and this time finishes the job and kills me. It almost did the first time.

        • admin

          Yes – they will need to test the fecal matter. Given that you are having surgery again the use of fidaxomicin to clear your current infection if it is proved to be c diff by a test would help stabilise you before the next surgery.

          You may also find this helpful

          This from the http://www.uptodate.com/contents/patient-information-antibiotic-associated-diarrhea-clostridium-difficile site may help

          Diet — There is no particular food or group of foods that is best for a person with diarrhea. However, adequate nutrition is important during an episode of acute diarrhea. For patients without an appetite, it is acceptable to consume only liquids for a short period of time. Boiled starches and cereals (eg, potatoes, noodles, rice, wheat, and oats) with salt are recommended for people with watery diarrhea; crackers, bananas, soup, and boiled vegetables may also be eaten.

          A temporary type of lactose intolerance is common following diarrheal illness; this may last for several weeks to months. Thus, temporary avoidance of lactose-containing foods (eg, ice cream, milk and milk products) may be helpful.

          Dave
          cdifficile.org

  • Nina

    Hi I had cdiff for 4 weeks, was treated with Vanco for 14 days, I finished it 4 days ago, now I got UTI, and my doc wants me to take cipro for 3 days!!!! I am so afraid of cdiff coming right back! Should I take it or hold off for few more days, try something else….? Thanks

    • admin

      Was the doctor aware of the the c diff. Is it the same one? We would not encourage you to self medicate re the UTI and ignore his/her advice. You may need to go back and ask some questions.

      There are also different strains of C Diff. If you have had a milder one they may feel that the Vanco will have done the trick

      Dave
      cdifficile.org

  • Carol

    Hello. I am an otherwise healthy 44 year-old woman. I came down with C diff about 3 months ago and I have no idea from where. It cleared up after a round of flagyl. Now I feel that it may be coming back. I started having mucus in my stool for the past week. Then last night my stomach started feeling “funny”. It feels just like it had in the 2 weeks before the diarrhea started 3 months ago. Can they test for C diff without the diarrhea being there yet? I feel like a ticking time bomb just waiting for it to start again. Thank you!

    • admin

      It may have come back but only a test will indicate – they can do this whether you have diarrhea or not. It will probably test positive but there is a threshold where the c diff is not merely present but active. You may need a stronger drug.

      Dave
      cdifficile.org

  • Sonny Brown

    My 30 year old daughter was diagnosed with C diff 10 years ago. I’m not sure what she was treated with. But since that time she has had bouts of severe diarahha off and on throughout the past decade. She has had all the routine test
    Colonoscopy, endoscosy, biopsy…. but has never been retested for C diff. (I only just read about this in USA Today last week and it sparked my attention.) So… now I’m wondering if she has additional bouts of C diff., but it is too complex a case for our local (we live in rural, small town) to uncover. Can you recommend the leading hospitals or experts we might see? I’m ready to do ANYTHING to help her… it has really stopped her life in many ways. Thank you so much for this helpful site! Sonny

    • admin

      Use the search box on our site to look for mentions of your state. this may throw up some good treatment centres. Let me know if this doesn’t show up a suitable match

      Dave
      cdifficile.org

  • Tammee

    I contracted C-Diff from hospital during surgery this year. I’ve been very sick and Vancomycin was the last resort treatment. I was treated at home. It has been 6 weeks and I am still suffering. What else can I do to help myself?

  • amber

    hi i have had c diff for about 5 months now. it has been the longest 5 months of my life. i have been on a course of flagyl for 14 days, that did not clear it up. they waited a period of 2 weeks or so to retest and i was positive again. they tried to prescribe me vanco but i do not have prescription coverage and could not get it. the diffcid manufacturer sent me a supply of diffcid for no charge. i took that for 10 days waited to retest again. Again the test came back positive. i was experiencing a large amount of pain in my lower abdomen they took me in for xray and bloodwork to make sure nothing perforated, everything was okay. i was told to go to er. i did, and they said they couldn’t admit me beacuse my blood test numbers were low but not low enough. they sent me home with another prescription for flagyl, that did not work the first time. i have had constant diarrhea throughout htis entire time, anything i eat goes right through me and gives me horrible stomach pains. i’m scared to eat becuase of these pains and trips to the bathroom. My hair has begun to fall out, and i have experienced weight loss. i am at my wits end. Where can i turn? i just want to feel better, this has been going on for so long now, i am desperate, and scared. i have read that this can be fatal, and cause other serious problems. i am hoping to hear back from you with any insight that you may have. thank you in advance for your time.

    • Infection Watch

      It is rare for Dificid not to help halt the infection. You may want to google fecal transplant and the name of your state or city. His will stop it in most cases within 24 hours

      Dave
      Cdifficile.org

  • Pat

    I have had 3 bouts with C-diff – one worse than the last one. I had a knee replacement prior to the last bout and came down with it 3 days after I came home from surgery. All seems to be going well now. My last bout with in August, 2012. My question is Since I had C-diff the last time I have had this gnawing sensation in my stomach and can’t seem to get rid of it. Is there anything I can eat or take to get rid of this. Food seems to help but I have gained about 6 pounds and I don’t want to continue on this road. Any help would be appreciated..

    • admin

      You need proper medical advice but it may be acid reflux which is not uncommon. The drugs for it provoke C Diff reactions however. The gnawing sensation may be the lesser of two evils

      Dave
      cdifficile.org

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