C.difficile – The Symptoms of a C. diff infection

C. diff infection
C. diff infection

Introduction

Clostridium difficile, also known as C. difficile or C. diff, is a bacterium that can infect the bowel and cause diarrhoea.

The infection most commonly affects people who have recently been treated with antibiotics, but can spread easily to others.

C. difficile infections are unpleasant and can sometimes cause serious bowel problems, but they can usually be treated with another course of antibiotics.

 

Symptoms of a C. difficile infection

Symptoms of a C. difficile infection usually develop when you’re taking antibiotics, or when you’ve finished taking them within the last few weeks.

The most common symptoms are:

  • watery diarrhoea, which can be bloody
  • painful tummy cramps
  • feeling sick
  • signs of dehydration, such as a dry mouthheadaches and peeing less often than normal
  • a high temperature (fever) of above 38C (100.4F)
  • loss of appetite and weight loss

In some cases, serious complications can develop, such as damage to the bowel or severe dehydration, which may cause drowsiness, confusion, a rapid heart rate and fainting.

Who’s most at risk of C. difficile?

C. difficile mostly affects people who:

  • have been treated with broad-spectrum antibiotics (antibiotics that work against several types of bacteria) or several different antibiotics at the same time, or those taking long-term antibiotics
  • have had to stay in a healthcare setting, such as a hospital or care home, for a long time
  • are over 65 years old
  • have certain underlying conditions, including inflammatory bowel disease (IBD)cancer or kidney disease
  • have a weakened immune system, which can be because of a condition such as diabetes or a side effect of a treatment such as chemotherapy or steroid medication
  • are taking a medication called a proton pump inhibitor (PPI) to reduce the amount of stomach acid they produce
  • have had surgery on their digestive system

Many C. difficile infections used to occur in places where many people take antibiotics and are in close contact with each other, such as hospitals and care homes.

However, strict infection control measures have helped to reduce this risk, and an increasing number of C. difficile infections now occur outside these settings.

When to get medical advice

Visiting your GP surgery with a possible C. difficile infection can put others at risk, so it’s best to call your GP or NHS 111 if you’re concerned or feel you need advice.

Get medical advice if:

  • you have persistent diarrhoea after finishing a course of antibiotics
  • you have bloody diarrhoea
  • you have diarrhoea and experience severe tummy pain, a high fever, a rapid heart rate or fainting
  • you have symptoms of severe dehydration, such as confusion, drowsiness, only passing small amounts of urine or no urine at all

Diarrhoea can be caused by a number of conditions and is a common side effect of antibiotics, so having diarrhoea while taking antibiotics doesn’t necessarily mean you have a C. difficile infection.

Your GP may suggest sending off a sample of your poo to confirm whether you have C. difficile. A blood test may also be carried out to help determine how severe the infection is, and sometimes you may need tests or scans in hospital to check if your bowel is damaged.

Treatment for C. difficile

Your GP will decide whether you need hospital treatment (if you’re not already in hospital). If the infection is relatively mild, you may be treated at home.

If you’re in hospital, you might be moved to a room of your own during treatment to reduce the risk of the infection spreading to others.

Treatment for C. difficile can include:

  • stopping the antibiotics thought to be causing the infection, if possible – in mild cases, this may be the only treatment that’s needed
  • taking a 10 to 14-day course of antibiotics that are known to kill C. difficile bacteria
  • rarely, serious infections may require surgery to remove a damaged section of the bowel

C. difficile infections usually respond well to treatment, with most people making a full recovery in a week or two. However, the symptoms come back in around 1 in 5 cases and treatment may need to be repeated.

Looking after yourself at home

If you’re well enough to be treated at home, the following measures can help relieve your symptoms and prevent the infection spreading:

  • make sure you finish the entire course of any antibiotics you’re prescribed, even if you’re feeling better
  • drink plenty of fluids to avoid dehydration and eat plain foods such as soup, rice, pasta and bread if you feel hungry
  • take paracetamol for tummy pain or a fever
  • don’t take anti-diarrhoeal medication, as this can stop the infection being cleared from your body
  • regularly wash your hands and contaminated surfaces, objects or sheets (see How to stop C. difficile spreading)
  • stay at home until at least 48 hours after your last episode of diarrhoea

Your GP may contact you regularly to make sure you’re getting better. Call them if your symptoms return after treatment finishes, as it may need to be repeated.

How you get C. difficile

C. difficile bacteria are found in the digestive system of about 1 in every 30 healthy adults. The bacteria often live harmlessly because the other bacteria normally found in the bowel keep it under control.

However, some antibiotics can interfere with the balance of bacteria in the bowel, which can cause the C. difficile bacteria to multiply and produce toxins that make the person ill.

When this happens, C. difficile can spread easily to other people because the bacteria are passed out of the body in the person’s diarrhoea.

Once out of the body, the bacteria turn into resistant cells called spores. These can survive for long periods on hands, surfaces (such as toilets), objects and clothing unless they’re thoroughly cleaned, and can infect someone else if they get into their mouth.

Someone with a C. difficile infection is generally considered to be infectious until at least 48 hours after their symptoms have cleared up.

How to stop C. difficile spreading

C. difficile infections can be passed on very easily. You can reduce your risk of picking it up or spreading it by practising good hygiene, both at home and in healthcare settings.

The following measures can help:

  • stay at home until at least 48 hours after your symptoms have cleared up
  • wash your hands regularly with soap and water, particularly after going to the toilet and before eating – use liquid rather than bar soap and don’t use flannels or nail brushes
  • clean contaminated surfaces – such as the toilet, flush handle, light switches and door handles – with a bleach-based cleaner after each use
  • don’t share towels and flannels
  • wash contaminated clothes and sheets separately from other washing at the highest possible temperature
  • when visiting someone in hospital, observe any visiting guidelines, avoid taking any children under the age of 12, and wash your hands with liquid soap and water when entering and leaving ward areas – don’t rely on alcohol hand gels, as they’re not effective against C. difficile
  • avoid visiting hospital if you’re feeling unwell or have recently had diarrhoea

Read more about preventing germs from spreading.

New Year Health Top 5 Tips from Dr Hilary Jones

Dr Hilary Jones dispels our coughing confusions
Dr Hilary Jones dispels our coughing confusions

So Christmas festivities are over for another year, while all the excitement and adrenaline of New Year’s Eve is fading fast as we return to work.

And with some forecasters projecting lows of -2° C by the 19th January*, common cold season is well and truly upon us.

Research released recently by Unicough showed that 98% of adults say that they typically develop a cough following a cold or a chest infection, with 40% of people thinking they have become more prone to coughing as they’ve gotten older.

So how can you avoid falling victim to one of the 200+ viruses that can cause a cold this January? TV’s Dr Hilary Jones joins us now with Top 5 tips for staying healthy in the New Year.

10 Winter Illnesses and Tops Tips on how to get rid of them

Winter illness
Winter illness

10 winter illnesses

Some health problems, such as asthma, sore throat and cold sores, are triggered or worsened by cold weather. Here’s how to help your body deal with cold weather ailments.

Colds

You can help prevent colds by washing your hands regularly. This destroys bugs that you may have picked up from touching surfaces used by other people, such as light switches and door handles.

Read this guide to how to wash your hands properly.

It’s also important to keep the house and any household items such as cups, glasses and towels clean, especially if someone in your house is ill.

Top tip: If you get a cold, use disposable tissues instead of cloth handkerchiefs to avoid constantly reinfecting your own hands.

Read five surprising facts about the common cold.

Sore throat

Sore throats are common in winter and are almost always caused by viral infections. There’s some evidence that changes in temperature, such as going from a warm, centrally heated room to the icy outdoors, can also affect the throat.

Top tip: One quick and easy remedy for a sore throat is to gargle with warm salty water. It won’t heal the infection, but it has anti-inflammatory properties and can have a soothing effect. Dissolve one teaspoon of salt in a glass of part-cooled boiled water.

Asthma

Cold air is a major trigger of asthma symptoms such as wheezing and shortness of breath. People with asthma should be especially careful in winter.

Top tip: Stay indoors on very cold, windy days. If you do go out, wear a scarf over your nose and mouth. Be extra vigilant about taking your regular medications, and keep rescue inhalers close by and in a warm place.

Get five tips to avoid cold-related asthma attacks.

Norovirus

Also known as the winter vomiting bug, norovirus is an extremely infectious stomach bug. It can strike all year round, but is more common in winter and in places such as hotels and schools. The illness is unpleasant, but it’s usually over within a couple of days.

Top tip: When people are ill with vomiting and diarrhoea, it’s important to drink plenty of fluids to prevent dehydration. Young children and the elderly are especially at risk. By drinking oral rehydration fluids (available from pharmacies), you can reduce the risk of dehydration.

Read about how to prevent food poisoning.

Painful joints

Many people with arthritis say their joints become more painful in winter, though it’s not clear why this is the case. Only joint symptoms such as pain and stiffness are affected by the weather. There’s no evidence that changes in the weather cause joint damage.

Top tip: Many people get a little depressed during the winter months, and this can make them perceive pain more acutely. Everything feels worse, including medical conditions. Daily exercise can boost a person’s mental and physical state. Swimming is ideal as it’s easy on the joints.

Read about how to get started with swimming for fitness.

Cold sores

Most of us recognise that cold sores are a sign that we’re run down or under stress. While there’s no cure for cold sores, you can reduce the chances of getting one by looking after yourself through winter.

Top tip: Every day, do things that make you feel less stressed, such as having a hot bath, going for a walk in the park, or watching one of your favourite films.

Read about the top 10 stress busters.

Heart attacks

Heart attacks are more common in winter. This may be because cold snaps increase blood pressure and put more strain on the heart. Your heart also has to work harder to maintain body heat when it’s cold.

Top tip: Stay warm in your home. Heat the main rooms you use to at least 18C and use a hot water bottle or electric blanket to keep warm in bed. Wrap up warm when you go out and wear a hat, scarf and gloves.

More tips on how to keep warm and well.

Cold hands

Raynaud’s phenomenon is a common condition that makes your fingers and toes change colour and become very painful in cold weather. Fingers can go white, then blue, then red, and throb and tingle. It’s a sign of poor circulation in the small blood vessels of the hands and feet. In severe cases, medication can help, but most people live with their symptoms.

Top tip: Don’t smoke or drink caffeine (they can both worsen symptoms) and always wear warm gloves, socks and shoes when going out in cold weather.

Get advice on how to stop smoking.

Dry skin

Dry skin is a common condition and is often worse during the winter, when environmental humidity is low.

Moisturising is essential during winter. Contrary to popular belief, moisturising lotions and creams aren’t absorbed by the skin. Instead, they act as a sealant to stop the skin’s natural moisture evaporating away.

The best time to apply moisturiser is after a bath or shower while your skin is still moist, and again at bedtime.

Top tip: Have warm, rather than hot, showers. Water that is too hot makes skin feel more dry and itchy. Hot water will also make your hair look dull and dry.

Flu

Flu is a major killer of vulnerable people. People aged 65 and over and people with long-term health conditions, including diabetes and kidney disease, are particularly at risk.

The best way to prevent getting flu is to have the flu jab (or flu nasal spray for children aged 2 to 18). The flu vaccine gives good protection against flu and lasts for one year.

Top tip: Find out if you’re at risk of getting flu by asking your GP, or read our article on who should have the flu jab. If you’re in a high-risk group, see your GP to get the vaccination.

Now, read about how to stay well in very cold weather.

Coughing confusion… Scientists unravel treatment myths Find out more from Dr Hilary Jones

Dr Hilary Jones dispels our coughing confusions
Dr Hilary Jones dispels our coughing confusions

New consumer insight shows more than half (56%) of adults ‘usually’ get a cough following a cold or chest infection, with one in five (20%) ‘always’ developing one

 

58% of people think you need to get the right cough mixture for the type of cough

 

Another study debunks the myth that different coughs require different medicines – all coughs are driven by the same underlying mechanism, cough reflex hypersensitivity

Research revealed today shows that 98% of adults say that they typically develop a cough following a cold or a chest infection.

In a recent clinical trial, the largest recent study on OTC products conducted in the UK, shows that one new medicine on the market helps to reduce cough frequency and night time disruption.

While 40% of people think they have become more prone to coughing as they’ve gotten older, 44% still don’t ask their pharmacist or GP for advice when buying cough medicine.

86% of people surveyed by UNICOUGH believe there are different types of cough, with 56% thinking you need the right cough mixture for the type of cough you have.

Yet in a recent publication in the Clinical Pharmacist, Professor Morice establishes that the traditional classification of “wet” and “dry” coughs are outdated.  In fact all coughs are caused by the same mechanism – cough reflex hypersensitivity.

And despite 84% of us thinking it’s important that all cough medicines have undergone clinical trials to prove their effectiveness, the experts involved in the study warn, “Much of the over-the-counter therapy currently recommended is based on custom and practice and is not supported by clinical studies of sufficient quality to meet the standards of modern evidence-based medicine”.

So what should you be using to treat your coughs during the chilly months, and beyond?

To find out more Emilee Senchyna interviewed TV’s Dr Hilary Jones

Zika Virus Disease: 8 things you need to know right away

Zika Virus Disease: 8 things you need to know right away

Zika Virus Disease: 8 things you need to know right away

From Visually.