Clostridium difficile is also known as clostridium difficile colitis, antibiotic-associated colitis, c difficile, and c diff. It is a gram positive, spore forming anaerobic bacillus that is not normally a part of the adult colonic flora found in the intestines. When there is an imbalance in the intestinal bacteria, c diff is allowed to flourish and take over. Bacteria are necessary in the intestines to digest food, fight off foreign "bad" bacteria and keep the body healthy.

Our bodies have a lot of "good" and necessary bacteria. The intestines also have some "bad" or dangerous bacteria. Clostridium difficile is a "bad" bacteria. Fortunately, when the body is healthy and the patient is not taking antibiotics, the millions of good bacteria in the intestinal system keep the c - diff under control and in smaller numbers. However, when the patient takes an antibiotic, the levels of good bacteria are reduced down (killed off) to a smaller number. If the c diff infection is strong and doesn't get killed by the antibiotic along with the good bacteria, then it is possible that the c diff will overpopulate inside the intestine or colon. When this happens, the individual may get the illness called clostridium difficile colitis.

When there is an imbalance of bacteria and c diff takes over, it creates two main types of toxins that affect the body and result in the symptoms of the actual disease. The toxins attack the intestinal wall and if left untreated, may cause ulcerations. Symptoms may include diarrhea and cramping, especially in the beginning. The later stages are commonly flu-like symptoms of weakness, dehydration, fever, nausea, vomiting and in advanced stages - blood in the stool/feces. If a patient is left untreated, death is possible. This is rare. It has been reported that clostridium difficile is mostly only contagious from other people through the fecal-oral route. Meaning the only way a person can receive c diff toxins into the intestinal track, is by direct contact with the fecal matter of an infected person. This doesn't necessarily mean direct human contact is necessary or even touching the feces of another person. What is does mean is that if a person somehow touches a microscopic specimen of fecal matter that is infected with c diff, it is possible that the microscopic specimen could enter the body and find it's way into the intestinal track.

Antibiotic usage is usually the initial cause of this disease. Additionally, antibiotics are usually the cause of recurrent cases of c diff. Ironically - two very powerful anerobic antibiotics are used to treat the disease! Certain broad-spectrum antibiotics used to treat various infections often destroy healthy bacteria in the intestinal tract. When this healthy bacteria, used to digest food and fight varous infections, dies off other "unhealthy" bacteria can flourish. Anerobic antibiotics are speficially deisgned to attack the more dangerous organisms that flourish when healthy bacteria is suppressed or absent.

Diagnosing c diff begins with sending a stool sample to the lab. A gastroenterologist generally handles the treatment of c diff. The gastroenterologist may perform a colonoscopy to assess the damage to the intestines and the presence of the c diff or pseudomembraneous colitis.  Some family practice and internal medicine physicians are equiped to treat c diff. However, stubborn cases should be treated by a specialist. Some physicians may unknowingly aggravated the condition by misdiagnosing or prescribing an antibiotic or other medication that encourages c diff overpopulation. For example, a doctor may prescribe an anti-diarrheal medication. The body produces diarrhea for a reason: to get rid of the bad stuff. Diarhea is like putting your body's natural cleansing system in high gear to get rid of toxins. However, prolonged diarrhea may cause dehydration and death. So, go see a doctor! Often patients are hospitalized in order to receive IV fluids to fight the dehydration that comes from such a high volume of diarrhea (up to 20 or more stools in a day in some cases).

C diff is generally treated with Flagyl or Vancocin and for most patients it resolves in 2 to 3 weeks. Only in about 20% of cases does the illness progress or reoccur. C diff produces spores when attacked by antibiotics making it more difficult to contain and treat. 

The c diff spores can live in the open air or in dirt for up to two years. Normal disinfectants have been shown ineffective against the spores. This means that even if c diff bacteria is killed, the spores may still be present. When the leftover spores detect an attack from conventional antibiotics, the spores are unmasked and they start producing the c diff bacteria all over again. This is why patients appear to have gotten over the symptoms of c diff while on the antibiotics but then by the time the course of the medication has been completed, the c diff infection comes right back again. 

C diff spores can live on a counter top unseen by the human eye for up to 6 months and cannot be killed by bleach or soap or antibacterial wash. The only way to get rid of the spore is to wash it off the hands, or sponge, or rag down the drain (or flushed down the toilet) where it will eventually die. If a spore is left dormant in a hospital room, bathroom, hotel room, etc. it could be passed on to another human who comes in contact with the spore. This is why it is so important to WASH YOUR HANDS! When you visit someone in a hospital or nursing home facility (the most common places where c diff is contracted), wash your hands. A wet wipe or dissolving antibacterial hand wash will not kill the spores. There are strict guidelines that the CDC requires to rid a hospital room has been occupied by an infected patient.

To avoid spreading c diff thoroughly clean all toilets, utensils and fixtures (wearing rubber gloves) while in the same house or ward to avoid cross-contamination. In addition, people should always wash their hands while preparing food regardless of if they have c diff or not. While using these simple precautions, normally it is rare to spread c diff and there is no need for hysteria or paranoia about catching it. Many people live with an infected person for months, or even years, in the same house and do not catch it. Also, even if a person comes in contact with a spore and it is able to enter the mouth and find it's way to the intestinal track, it does not mean the individual will actually become symptomatic. Many people live their entire lives with dormant spores in the their intestinal track and never know it. This is because the balance of intestinal bacteria keeps the spores under control not allowing them to flourish and take over the intestinal track.

If you are suffering from c diff right now, no matter what your treatment, stop eating refined sugar, canned food, processed food, wheat and dairy products and start drinking plain bottled water (with electrolytes added if available), taking refrigerated acidophilus, eating steamed fresh vegetables and try some plain soy yogurt, and brown rice. These things will help the diarrhea stop and the normal diet can be resumed once the negative stool tests confirms the infection is gone.