What is Clostridioides difficile (C. diff) colitis?

Clostridioides difficile (also called C. diff) 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.

C. diff infection is most common in people who are taking antibiotics or have taken them recently. When you take an antibiotic to kill bad bacteria, the medicine may also kill the good bacteria. Without the good bacteria, bad bacteria like C. diff can take over. C. diff can also be passed from person to person. It is also common in older people who are in hospitals and nursing homes and in people who are getting chemotherapy for cancer, but it can happen in healthy people, too.

Colitis caused by C. diff can be mild or serious. In rare cases, it can cause death.

How is it diagnosed?

Your doctor may think you have Clostridioides difficile (C. diff) colitis if both of the following are true:

• You are taking, or you recently took, antibiotics.
• You have symptoms of the illness. These may include:
  • Watery diarrhea (which may contain blood or mucus).
  • Swelling, cramps, pain, or tenderness in the belly.
  • Fever.
  • Dehydration.

To confirm the diagnosis, a sample of your stool will be tested. The test will check for the bacteria by looking for its DNA. Another test may be done to look for the toxins that C. diff produces.

Your doctor may look at the inside of your colon through a thin, lighted tube called a colonoscope. In the most serious cases, the doctor may see patches of yellow and white tissue on the inside of the colon.

How does C. diff get passed to other people?

Clostridioides difficile (C. diff) can be passed from person to person. It can also be passed from person to object to person. It's important that your infection does not spread to other people. Preventing the spread of C. diff is a top health concern in hospitals and long-term care facilities.

If you have a C. diff infection, you can spread it if you don't wash your hands well enough with soap and water after you use the toilet. Anything you touch, like a door handle, bed rail, or phone, can then carry the bacteria. C. diff can live on objects for a very long time.

The infection spreads to other people when they touch an object that has C. diff on it and then use their hands to eat or rub their faces.

Health care workers can pass C. diff from room to room in a hospital or a long-term care facility. Visitors can also spread it.

How can you avoid spreading C. diff infection?

When you have Clostridioides difficile (C. diff), you and everyone around you must take special care to avoid spreading it. You must use extra care after you use the toilet.

The best way to prevent spreading the infection is to wash your hands well and often. This is most important after you use the toilet and before you make and eat food.

• Wash your hands with running water and soap for at least 20 seconds.
• Pay special attention to your wrists, the backs of your hands, between your fingers, and under your fingernails.
• Don't touch the faucet with your hand. Use a paper towel to turn off the water.

Don't use an alcohol-based hand sanitizer instead of washing your hands with soap and water. Sanitizer will not kill C. diff.

If you start having diarrhea again, call your doctor or nurse advice line right away. Your doctor will arrange for more tests or a referral for fecal microbiota transplant (FMT) if your C. diff infection keeps coming back. If your diarrhea has gone away after you have finished your antibiotic treatment, you do not need to be tested for C. diff again.