Clostridium Difficile Colitis

What is Clostridium difficile colitis?

Clostridium difficile (C. difficile) is a bacterium found commonly in soil, air, water and stools. C.difficile infection causes inflammation of the colon (large bowel), besides other problems. This is not a common infection and is typically linked to hospital admission.

What are its main signs and symptoms?

• When C. difficile affects the colon, it causes inflammation of the colon lining, leading to fever.
• Symptoms also include abdominal pain or cramps.
• The other symptoms include diarrhoea, with multiple episodes of watery stools in a day. Noticing blood while passing stools is common.
• Diarrhoea results in dehydration and mineral imbalance in the body.
• In severe cases, if the colon ruptures and the infection spreads to other parts of the body, it can be life-threatening.

What are its main causes?

• The commonest cause of C. difficile colitis is recent treatment with antibiotics. When a person takes antibiotics, the balance of bacteria in the colon is disturbed, leading to an increase in the number of C. difficile bacteria.
• Amoxicillin, cephalosporins, penicillin and erythromycin are some antibiotics that cause colitis.
• It is not necessary that every person who has the bacteria will develop colitis. The bacteria may already be present in the intestine and cause no symptoms at all. People can just be carriers of the organism.
• It could also be a hospital-acquired infection.

How is it diagnosed and treated?

To make a diagnosis, the physician obtains a thorough history including medications taken by the patient in the recent past.

• White cell count increases in such infections and is reflected in blood tests.
• There are special stool tests which detect the toxins produced by C. difficile and confirm the diagnosis.
• Colonoscopy and sigmoidoscopy are tests by which the physician can examine the condition of the colon.

The primary treatment is to stop the antibiotics causing the infection. Antibiotics like metronidazole are effective against C. difficile infection.

• To correct dehydration and electrolyte imbalance, fluids are administered.
• If a relapse occurs because of incomplete elimination of the bacteria, then a stronger dose of antibiotics is given or different medicines are prescribed. It is important to identify the antibiotics which will completely eliminate the organism from the body.

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2. Center for Disease Control and Prevention [internet], Atlanta (GA): US Department of Health and Human Services; What is C. diff?
3. MedlinePlus Medical Encyclopedia: US National Library of Medicine; Clostridium Difficile Infections
4. Clinical Trials. Study of CB-183,315 in Participants With Clostridium Difficile Infection. U.S. National Library of Medicine. [internet].
5. Health Link. Clostridium Difficile Colitis. British Columbia. [internet].