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

C. diff infection
C. diff infection


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.

Healthcare Associated Infections – Britons will go a long way to avoid them – A guest post from MindMetre Research

As regular readers of the blog will know we has been covering the topics of superbugs and the related issue of MRSA here at PatientTalk.Org.

So we are delighted to share this guest post from MindMetre Research which tells us more about a recent study the contacted in the UK looking at attitudes toward hospital provision and infection.

They share “How far would you go to avoid being treated in a hospital with a poor record for antibiotic-resistant Healthcare Associated Infections (HCAIs), or ‘superbugs’? The answer – “up to a hundred miles” – according to almost half of British citizens.

Latest research on the subject from MindMetre seeks to calibrate the likelihood of British citizens to insist on treatment at an alternative hospital if their local provider had a below average record of HCAI reduction, along with the distance they would be prepared to go to get treatment in a safer environment.

The findings from the MindMetre study were definitive and clear:
· 76% of citizens say that if they learned that their hospital was a low performer on HCAI reduction, they would insist their GP referred them to a hospital with a better record;
· 83% would be happy to travel 20 miles to be treated in a hospital with a better HCAI reduction record than their local hospital;
· 62% would be happy to travel 50 miles for treatment;
· And 48% would be happy to travel 100 miles in the same situation.

Paul Lindsell, Managing Director at MindMetre Research, comments, “In the new structure of the NHS, with acute clinical services commissioned by GP-managed Clinical Commissioning Groups (CCG), patient mobility has become a clear and present reality. Patients, in partnership with their GP, can choose to be treated at an Acute Trust of their choice, with the associated funds following the patient. CCGs are clearly charged with the mandate to improve patient outcomes, and so offering this level of patient choice is systemically built in to the new NHS structure.”

“Acute Trusts have done a great job addressing very specific HCAIs, notably MRSA and C.difficile, but there is a rising tide of other infections, and the problem needs to be addressed holistically.”

“This research note clearly demonstrates that Acute Trusts need to take their initiatives to reduce HCAIs even more seriously if they are to avoid patients opting to be treated at a hospital with a better record, with funds following the patient.” ”

Research Methodology
Fieldwork was conducted by MindMetre Research between May and July 2014, in person and via online questionnaires, amongst a nationally representative sample of 2,003 British citizens (age, gender, region, social class). Margin of error: – +/- 1.78%

About MindMetre
MindMetre, part of the Lindsell Marketing Group, is a leading consumer and business analyst. The organisation has been investigating trends in a number of fields and sectors since the late-1990s, including health & medicine, finance, central & local government and internet technology. Research programmes are regularly conducted across the globe, embracing geographies from the Americas to the Far East. In the healthcare sector, MindMetre is particularly known for its series on healthcare financing, beginning in the early 2000s. All MindMetre research activity strictly protects the privacy and confidentiality of respondents.