November 22, 2023

Gut Check: Clostridium difficile

Clostridioides difficile, commonly known as C. diff, is a bacterium that can cause infections in the colon, leading to a range of symptoms that can be uncomfortable and, in some cases, serious. There are an estimated half a million infections in the United States each year ¹.

About 1 in 6 patients who get C. diff will get it again in the subsequent 2-8 weeks ¹. If you or a loved one has been diagnosed with a C. diff infection, it’s essential to understand the condition, its causes, and the steps you can take to manage and prevent it.

What is C. diff?

C. diff is a bacterium that naturally resides in the gut of many people without causing harm. However, certain factors can disrupt the balance of the gut microbiota, allowing C. diff to multiply and produce toxins that can damage the colon’s lining. This disruption often occurs after taking antibiotics, which can kill both harmful and beneficial bacteria in the gut. People are 7 to 10 times more likely to get C. diff while on antibiotics and during the month after ².
Other C. diff risk factors include ²:

  • older age (65 and older)
  • recent stay at a hospital or nursing home
  • a weakened immune system, such as people with HIV/AIDS, cancer, or organ transplant patients taking immunosuppressive drugs
  • previous infection with C. diff or known exposure to the germs

You can still get C. diff even if you have none of these risk factors.


Symptoms might develop within a few days after you begin taking antibiotics and might include:

  • Severe, persistent diarrhea
  • Unformed stool
  • Fever
  • Stomach tenderness or pain
  • Loss of appetite
  • Nausea

It is important to note that symptoms of C. diff (especially diarrhea) are often severe. Rare but severe complications of C. diff include dehydration, inflammation of the colon (colitis), serious intestinal conditions such as toxic megacolon, and sepsis ².


If you suspect a C. diff infection or have been diagnosed with one, it’s essential to seek medical attention promptly. Treatment often involves antibiotics specifically targeted at C. diff, such as fidaxomicin or vancomycin. Be sure to complete the full course of antibiotics as prescribed by your healthcare provider. Because of the high rate of reinfection, effective prevention measures are incredibly important in recovering from a C. diff infection.


When C. diff germs are outside the body, they become spores. These spores are an inactive form of the germ and have a protective coating allowing them to live for months or sometimes years on surfaces and in the soil. The germs become active again when these spores are swallowed and reach the intestines. Healthy people will often not be infected even if the spores reach their intestines, but if your immune system is weakened or you’ve recently taken antibiotics, you could get sick ³. Preventing C. diff infections can be challenging but not impossible. Here are some tips to reduce your risk:

  • Good Hand Hygiene: Regularly wash your hands with soap and water, especially before eating and after using the restroom.
  • Proper Antibiotic Use: Only take antibiotics when prescribed by a healthcare professional and follow their instructions precisely.
  • Isolation: If you have C. diff, follow isolation precautions to prevent spreading the infection to others.
  • Environmental Cleaning: Ensure that surfaces in your home or healthcare facilities are regularly cleaned and disinfected.

Most people recover from C. diff infections with appropriate treatment. However, some individuals may experience recurrent infections, which can be more challenging to manage. If you have concerns about your recovery or experience persistent symptoms, consult your healthcare provider for guidance.

For more information

C. diff infections can be uncomfortable and concerning, but with proper medical care and prevention measures, you can effectively manage and recover from this condition. Always remember that early detection and timely treatment are essential for a better outcome. For more information about C. diff, visit the CDC’s website.

¹ Centers for Disease Control and Prevention. (2022, September 07). What is C. diff? U.S. Department of Health and Human Services.
² Centers for Disease Control and Prevention. (2022, June 27). Your risk of C. diff. U.S. Department of Health and Human Services.
³ Centers for Disease Control and Prevention. (2021, July 20). Prevent the spread of C. diff. U.S. Department of Health and Human Services.