Tag Archives: c diff

A PATIENT ASKS ABOUT C DIFF, AND I RESPOND

BOOK ON HEALTHDOCTOR DOUG…..I’m hearing a lot about C diff infection, a type of diarrheal illness.   They say it is increasing and I want to know “how do I know if I have it & how can I prevent myself and family from getting it?”

–DK

 

I RESPOND:

C diff is shorthand for Clostridium Difficile, an type of bacteria that typically causes  an antibiotic-induced diarrhea, which is to say….it typically occurs in a person who has been on strong antibiotics.  It is severe diarrhea, extremely loose, and often associated with leakage and incontinence….it’s that overwhelming.  This differentiates it from diarrhea that can be induced by antibiotics as a common side effect of antibiotic irritation of the GI tract, which is more common.

Historically C diff was discovered in the 70’s by my professor Dr. John Bartlett, former head of Infectious Diseases at Johns Hopkins Hospital.  Since the 70’s this condition has become more common and widespread.  Where it formerly occurred only in hospital settings, we now see if often in the outpatient setting, without a hospital connection and sometimes without a previous antibiotic exposure.   A recent study suggested that patients who visit doctors and dentists have an increased risk of C diff, this connection is unclear.

Diagnosing C diff is done through a special stool test for the C diff toxin, a substance excreted by the C diff bacteria.  This test is imperfect and can be falsely negative, so treatment is often based on empiric considerations.

 

Treating C diff infection is rather straightforward, with two different antibiotics readily treating the condition.  Yes…there are cases that are very severe, but they often occur in very ill patients who are hospitalized.  Milder cases are more common in community acquired C diff, and Metronidazole or Vancomycin resolve this infection.  In addition, the probiotic Florastor (Sachromyces Boullardi) has been shown reduce the duration of C diff infection and to hasten resolution.  Extreme cases of C diff have been seen and might even require a transplant of ‘good bacteria’ to the colon, but I have never had to resort to such measures.

Preventing C diff is most important and involves:

Reducing exposure to unnecessary antibiotics

Reduce exposure to persons with C diff if you can, are using very good hand-washing technique if you caring for someone with this infection

Maintaining your general health, including taking care of your blood sugar if you are a diabetic

 

I do not routinely recommend probiotics for prevention of C diff, although there may be a role for Florastor in certain situations.

To read more about C diff, see my section on this topic in THE GUIDE at www.doctordougbooks.com     I include information on cost save ways to save money on the best treatment.

Also, if you’d rather, you can listen to my PODCAST ON C DIFF >>>>HERE<<<

 

 

FROZEN POO????

windyIn an effort to deliver ‘good bacteria’ to the bowels of people who have lost their normal bacterial flora, there are many different approaches  underway.   Delivering the fecal material via colonoscopy has generally been the method of choice, but given the challenges involved in rectal administration, many researchers are looking at oral routes using encapsulated microbiota.

A recent report using frozen fecal material in capsules has shown promise, with the idea that oral ingestion is a simple and quick means of replenishing the requisite bacteria.

Studying patients with difficult to treat antibiotic-induced diarrhea (called C diff diarrhea) these researchers at Massachusetts General Hospital were able to resolve the C diff infection in otherwise resistant patients using a frozen oral capsule technique.  Simple and efficient….read more>>>>HERE.

C DIFF….NEW AND OLD TRICKS

Poop_Pills_Gasp_t653C diff (Clostridium Difficile) is an intestinal infection that arises from overgrowth of this type of bacteria that crowds out the normal gut flora.  It occurs often after a person is treated with strong antibiotics that ‘wipe out’ their normal gut bacteria.

C diff results in severe diarrhea that is debilitating, particularly as it occurs as a complication of patients who are already receiving treatment for a serious medication condition….which is why they are on antibiotics in the first place.

There are many standard treatments for this condition,  but this article in the news from the LAS VEGAS SUN sheds new light on treatments that are coming soon.

Beyond ‘poop transplants, to repopulate the gut with normal bacteria, two other tricks to try right now….

Vancomycin liquid from a formulating pharmacy.  The cost of this medication is very inexpensive, compared to the pills from the chain pharmacy, where the costs are in the 100’s of dollars

Florastor probiotic.  This type of yeast, available at any Grocery/Pharmacy has the potential to prevent C diff by competing with it in your intestines.  Taken as a pill once daily it can be very effective.