what is c-diff?

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ontrose84
New Member


Date Joined Oct 2009
Total Posts : 2
   Posted 10/3/2009 6:21 PM (GMT -7)   
I'm just wondering what this c-diff thing is that people keep mentioning.  I have had crohn's disease for 3 years and have recently had a really bad flare up that landed me in the emergency room with pain, nausea, weird gurgling noises and diarrhea.  All they did was to pump me full of  pain drugs and said that my blood test didn't show any inflammation so I could go home.  I was also in the hospital for food allergies about 2 months ago, it turns out that I can no longer eat sour cream.  If anyone has any suggestions that would be most helpful.   confused
Diagnosed with Crohn's 2007.
Bowel re-section for Crohn's 2007
Treatment for Crohn's: Pentasa 2g twice daily
Treatment for Anxiety: Lexapro 20mg once daily
 

Post Edited (ontrose84) : 10/3/2009 7:29:32 PM (GMT-6)


Keeper
Veteran Member


Date Joined Jun 2008
Total Posts : 1058
   Posted 10/3/2009 8:14 PM (GMT -7)   
C diff stands for Clostridium difficile - a bacteria that is a minor intestinal bacteria. It becomes a problem often as a result of antibiotic treatment since it is very antibiotic resistant and will multiply as other bacteria are killed by the antibiotics. When it has grown to occupy a large part of the bowel's bacteria population, it causes D and pain in the gut - generally like a flare, but not due to the usual Crohn's causes. It does not go away when treated as if it were Crohn's, and the usual steroids/immune suppressants will only make the problem worse.

It is treated by stronger antibiotics and by using probiotics like Florastor and Culturelle which compete with it for food sources in the gut.

PV
Veteran Member


Date Joined May 2006
Total Posts : 1177
   Posted 10/4/2009 6:50 AM (GMT -7)   
As Keeper says, c-diff is clostridium difficile. It normally happens when people are on antibiotics, and these antibiotics upset the normal flora of the gut, allowing c-difficile to take root. C-diff is a spore forming bacteria that can live on surfaces for months, and once you ingest these spores, they can lie in wait for an opportune moment in your gut to take hold. Also, untreated c-diff can result in a severe infection that causes pseudomembranous colitis. C-difficile infection is characterized normally by large watery bowel movements, with lots of frequency, and a very distinctive smell.

However, antibiotics are not the only way to end up with a c-diff infection. My husband has been on no antibiotics, but has now had a c-diff infection twice! They say that people with IBD like Crohn's and UC are more susceptible to infection with c-diff, because IBD is a disease that affects the flora of the gut. So, when you have IBD, you can get c-diff even without exposure to antibiotics.

If you suspect you have c-diff, you should be tested for it (stool test), which is simple enough. The test is usually a toxin test that tests the stool for both Tox A and Tox B (make sure that it tests for both toxins). If the test is positive, you can assume that the test is correct, because it has high specificity. However, if the test is negative, and you still have symptoms, get 2 more stool tests, because the test isn't very sensitive, ie. you can get false negatives. The rule of thumb is that if you have 3 negative stool tests from stool taken on different days, then you can assume you don't have a c-diff infection and look for other causes. Also, if you have a c-diff infection, and your infection is severe enough, a colonoscopy will reveal pseudomembranous colitis.

However, it is uncommon to get c-diff without antibiotics - my husband has just been (un)lucky (twice) :-)

It sounds like you need further examination - blood tests for inflammation are not always accurate. It sounds like you need to be tested for any infections, and if no infections are found, treated for a flare up of Crohn's disease, with something stronger than pentasa. A steroid taper perhaps. Go see your GI as soon as you can, so you don't suffer with this for too much longer.

PV
Husband with Crohn's
Diagnosed March 2003 Ulcerative Proctitis
Diagnosed March 2008 Crohn's & C-diff, hospitalized 45 days
Canasa, Lialda, Remicade, VSL#3, Florastor
In Remission since June 2008
Stopped vancomycin for c-diff Jan 1 2009
C-diff free, until Sep 2, 2009
Fighting c-diff, I guess for life

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