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C. diff is a nickname for a bacterium whose full name is Clostridioides difficile (klos-TRID-e-OY-dees dif-uh-SEEL). This bacterium can infect your colon (large intestine), causing diarrhea and other symptoms.
Bacterial infections in your colon are common, and most aren’t serious. But C. diff infection can be more aggressive and harmful to your colon. It can cause severe colitis, known as pseudomembranous colitis.
The most common symptom, and usually the first to appear, is watery diarrhea. A mild infection will cause diarrhea at least three times a day, often with some abdominal cramping or tenderness.
As C. diff infection becomes more severe, diarrhea increases. It may occur as much as 10 to 15 times a day. You may notice traces of blood in your poop (stool). You may also develop other symptoms, such as:
C. diff symptoms may resemble food poisoning or stomach flu at first, but they don't go away as easily. If you're taking antibiotics, it's possible to mistake C. diff diarrhea for a normal side effect of the antibiotics.
It’s also important to note that C. diff infection can occur without diarrhea. Some people with C. diff may have other health conditions or medications affecting their bowels, which may prevent diarrhea.
What does C. diff poop look like?
C. diff diarrhea is typically mushy or porridge-like, but not completely liquid. Sometimes it has a green tint, though other bacterial infections can also cause this. Occasionally, it contains blood, mucus or pus.
What does C. diff poop smell like?
Many people have noticed a distinctive odor with C. diff diarrhea. They describe it as unusually strong and oddly sweet. This smell may be because C. diff increases the levels of bile acids in your poop.
You may already have C. diff in your gut at birth, or may acquire it by accidentally ingesting it. It lives in the intestines of humans and other animals and spreads through their poop into the environment.
Researchers estimate that about 5% of the population has C. difficile in their colon without signs or symptoms of infection. You can have C. diff under control, but still carry and spread it to others.
How does C. diff spread?
C. difficile reproduces by releasing spores. These spores live in the environment, especially where infected people and animals live. They can enter your gastrointestinal (GI) tract through your mouth.
Why is C. diff so contagious?
C. diff spores are very hard to kill, both inside and outside of your intestines. They’re resistant to heat, acid and many antibiotics and disinfectants. They can also survive for months on surfaces.
A healthy immune system normally protects your gut from C. diff infection by keeping C. diff levels under control. If they grow out of control, it’s because something has compromised your gut immunity.
The most common cause is:
Medical conditions that may reduce your defenses against C. diff infection include:
Other risk factors associated with C. diff infection include:
Sometimes it isn’t clear what allowed C. diff to take over. While many factors can affect your gut immunity, it’s important to know that infection can occur even if you don’t have any known risk factors.
Complications can occur with more severe infections. How severe your infection becomes will depend on several factors, including the strain of the bacteria you have and how strong your immune system is.
People who have more risk factors for getting a C. diff infection in the first place may be more at risk of a severe infection. They may also have repeat infections, which cause more damage over time.
Common complications include:
As toxic damage in your colon progresses, you may have further complications, including:
Treatment for C. diff infection is progressive, based on how severe it is. If you developed a C. diff infection while taking antibiotics, your provider might begin by simply stopping those medications.
For some people, this is enough. Their natural gut immunity returns and overcomes the infection. If this doesn’t happen, your provider will prescribe one of the antibiotics known to be effective against C. diff.
Antibiotics to treat C. diff include:
If you have a mild infection, you’ll take the prescription home with you. Most people will begin to improve in a few days. If your infection is more severe, you might need to check in to the hospital.
In the hospital, your provider might give you antibiotics through an IV, along with fluids to prevent dehydration. In some cases, they might deliver medications directly into your colon as an enema.
Complicated C. diff infection
If you have severe complications, you might need intensive care. In rare cases, providers recommend emergency surgery to remove the source of the infection in your colon. This is called colectomy.
If you’ve recovered, but you continue to have repeat infections after treatment, your options are:
If your healthcare provider suspects C. diff infection based on your symptoms, they’ll take a sample of your poop and send it to a lab. The lab will test it for evidence of the toxins C. diff produces.
If you test positive for infection, your healthcare provider may conduct further tests to find out how severe the infection is. These may include blood tests and imaging tests that look inside your colon.