C-Diff Symptoms and Treatments

C-diff symptoms range from mild, self-limited diarrhea to severe abdominal pain with bloody, life-threatening diarrhea.

c-diff symptoms

C-diff may produce no symptoms at all in some, while hitting others with severe infections that can result in loss of the colon or even death.

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Scientists attribute C-diff’s spread to unnecessary and incorrect use of antibiotics, which can wipe out beneficial bacteria in the gut, opening an opportunity for C. difficile to infect the colon. While C-diff isn’t (yet) drug-resistant, stronger strains of this bacteria are emerging, and the CDC recently identified it as one of the country’s top three“urgent threat” microbes, meaning it is at risk of becoming a drug-resistant superbug which poses “an immediate public health threat that requires urgent and aggressive action.”[1]

Once C-diff colonizes the colon, it releases toxins that cause inflammation and damage to the colon’s mucosal lining. All this overuse of antibiotics is threatening doctors’ ability to combat infections, according to a 114-page book issued by the Centers for Disease Control. The report, written for the general public, offered the first comprehensive picture of drug resistance in the U.S.[1]

C-diff Symptoms

C-diff symptoms range from mild, self-limited diarrhea to severe abdominal pain with bloody, life-threatening diarrhea. Some people have no c-diff symptoms at all and are simply “carriers” of the bacteria, while others can develop severe infection that results in loss of the colon or death. Between 4 and 7 percent of those infected with C-diff die from the infection.

C-diff symptoms often include the following:

  • Mild to moderate watery diarrhea that is rarely bloody
  • Cramping abdominal pain
  • Anorexia
  • Malaise
  • Fever, especially in more severe cases

People with C-diff develop diarrhea during or shortly after starting antibiotics. However, 25 to 40 percent of people may not become symptomatic for as many as 10 weeks after completing antibiotic therapy.

Standard C-diff Treatment

Ironically, even though C-diff infection is almost always caused by antibiotics, the standard treatment for how to get rid of c-diff is another antibiotic. Depending on a number of factors, including how severe the infection is and how otherwise healthy the infected person is, another antibiotic may truly be necessary, even life-saving.

Currently, there are only two standard antibiotics that can be used for C-diff (vancomycin and metronidazole) and the success of metronidazole has been declining. It is also unfortunate that those infected are often left vulnerable to re-infection with C-diff because their repeated antibiotic use leaves their gut bacteria unable to fully recover. Up to 60 percent of patients have recurrent C-diff infections.

Natural Remedies for C-diff

A number of natural options for how to treat C-diff are also viable. In some cases, the use of natural therapies along with an antibiotic is the best option. Several human studies have shown that taking probiotic supplements is helpful for both treatment and prevention of C-diff infection and diarrhea. Probiotic supplements contain healthy colon bacteria, such as Lactobacillus acidophilus, Bifidobacterium bifidum, other strains of Lactobacilli, and a yeast named Saccharomyces boulardii.

Dr. Lynne McFarland, PhD, a researcher and professor at the VA Puget Sound Healthcare System and the University of Washington, in Seattle, Wash., has published a number of review papers on treatment of C-diff with probiotics. She describes a meta-analysis of six randomized controlled trials using probiotics combined with one of the two standard antibiotics to treat C-diff.[2] The results showed that probiotics, in general, significantly reduced the risk of C-diff infection.

  • In one of the trials that was analyzed, patients with C-diff randomly received either a combination treatment of the antibiotic vancomycin and the probiotic Saccharomyces boulardii (1 g/day for 4 weeks) or vancomycin and placebo.[2] Patients treated with the probiotic were significantly less likely to experience a recurrence of C-diff compared with those treated with vancomycin and placebo (16.7 percent vs. 50 percent recurrence rate, respectively).
  • In another study that was analyzed, patients taking antibiotics for various infections (not C-diff) received either a probiotic drink mix (Actimel drink by Danone, Paris, France) or a placebo drink along with their antibiotic.[2] None of those in the probiotic group contracted a C-diff infection, while 17 percent of those in the placebo group did.
  • In another study, hospitalized people being treated with antibiotics were randomly assigned to receive either one capsule of a probiotic supplement (containing L. acidophilus and B. bifidum) or a placebo per day for 20 days.[3] The number of people developing C-diff diarrhea was 60 percent lower in the probiotic group than in the placebo group.

Cure Recurring C-diff Using Probiotics Plus Other Natural Treatments

Mona Morstein, ND, a professor at Southwest College of Naturopathic Medicine & Health Sciences and a naturopathic physician who specializes in gastrointestinal diseases, has developed a two-month natural treatment protocol for patients with recurrent C-diff.

  1. Natural antimicrobials. Certain herbs and nutrients have the ability to kill bacteria and treat bacterial infections. Dr. Morstein uses an encapsulated blend of caprylic acid, quebracho tannins, berberine sulfate, garlic, and uva ursi. She may also use allicin capsules (allicin is a component of garlic extract) and/or freeze-dried uva ursi capsules.
  2. Probiotics. As discussed above, probiotics have been proven to be effective for prevention of antibiotic-associated diarrhea and to be useful with other antimicrobials for treatment of C. difficile disease. Dr. Morstein recommends a mixture of Lactobacillus, Bifidobacillus, and Saccharomyces boulardii (200 billion live bacteria a day).
  3. Small bowel healing. C-diff doesn’t affect the colon only. It has been associated with significant damage to the small intestine, leading to leaky gut. Dr. Morstein therefore also helps her patients strengthen the lining of the small intestine for some months, continuing even after the stools are back to normal. She believes this is a vital component to fully heal patients with post–C. difficile diarrhea. You can find a treatment protocol for healing the small intestine and leaky gut here.
  4. Removal of gluten and dairy. Although removal of gluten is not necessarily supported by medical studies, Dr. Morstein has observed that some of her patients develop an intolerance to gluten after repeated antibiotics and C-diff infection. If her patients’ bowel movements are markedly improved but not completely back to normal, she may recommend full avoidance of gluten. Because the damaged small intestine may not be able to produce enough of the enzyme lactase in order to digest dairy, she also considers eliminating it if other natural treatment for c-diff and a basic healthy diet are not fully reversing patients’ symptoms. (Find a list of dairy substitutes here.)
  5. Hygiene. To avoid spreading the bacteria or re-infecting yourself, excellent hygiene is recommended. This includes frequent hand-washing, especially before eating and after using the toilet; frequent cleaning/disinfection, especially in bathrooms; and fingernail cutting.

Additional C-diff Natural Treatment

Along with recommending the two-month protocol above, Dr. Morstein addresses C-diff natural remedies such as the patient’s basic diet to remove irritating, pro-inflammatory, unhealthy foods. She also recommends lifestyle treatments—getting good sleep every night, for example, and maintaining more peace of mind in stressful situations. In addition, she recommends a good multivitamin and a fish oil supplement. With these home remedies for C-diff, you can beat this nasty bug once and for all.

For related reading, please visit these posts:

[1] CDC. Antibiotic resistance threats in the U.S., 2013.
[2] CurrOpinGastroenterol. 2009 Jan;25(1):24-35.
[3] Can J Infect Dis Med Microbiol. 2006 Sep-Oct; 17(5): 291–295.
[4] Nat Doc News Rev. Jan 9, 2012.

Originally published in 2013, this article is regularly updated.

As a service to our readers, University Health News offers a vast archive of free digital content. Please note the date published or last update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

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  • This information is very informative and thorough. Thank you for writing this article about C-diff symptoms & treatment! It’s hard to find natural remedies for these types of conditions elsewhere.

  • Editor’s Note: We received the following comment over email and are posting here with the writer’s permission:

    The article, C-Diff Symptoms and Treatments, says, “Currently,
    there are only two standard antibiotics that can be used for C-diff
    (vancomycin and metronidazole) and the success of metronidazole has been
    declining.” There is a third, which has been available since about 2012:
    Dificid (fidaxomicin) stays about 98% in the intestines and targets C-diff
    without wiping out all the friendly bacteria. It is more effective than
    Vancomycin. It is also a great deal more expensive (somewhere around $2,000
    or $3,000, but with insurance, we “only” paid $654 the first time and
    $366.88 the second).. Still, it’s a heck of a lot cheaper than going to the
    hospital. My dad was concerned about Vancomycin side effects (including
    deafness and tinnitus, which he already has, so he didn’t want to get any
    worse), so he started with Flagyl and then Dificid. The first 10 days of
    Dificid made him feel MUCH better, but 5 days later he started getting sick
    again, so he is currently taking another
    10-day round. Whether the first round was successful and he subsequently
    got reinfected or the first round didn’t quite get it all, we don’t know.
    But he had a much better effect from it than he had from Flagyl.

  • We appreciate this discussion on a new and possibly better antibiotic for C. diff. However, re-infections continue to be a major problem. Furthermore, even if C. diff infection is completely eradicated by standard care (antibiotics), many patients are still left with lingering diarrhea. All the antibiotics used—those that led to the C. diff infection in the first place and those used to treat it—can cause other bacterial infections aside from C. diff and can lead to gut dysbiosis in general. Fortunately, naturopathic and integrative medicine can work wonders in preventing re-infection or chronic diarrhea. Natural antimicrobials can eradicate diarrhea-causing microorganisms, probiotics can help re-establish healthy gut bacteria, and specific nutrients can be used to heal and strengthen the lining of the intestine.

    Dr. Kathleen Jade

  • Has doctor Morsteen successfully treated anyone with just the natural route? Does she take clients over skype? My situation is more complicated. I have damaged nerves in my gut and it could go a month without moving before the c.difficile infection. Would these still work even with that? Or would being constipated (sometimes too long) prevent it from killing the infection. Right now everything is moving because of the infection, but once it’s mostly healed, when my gut can’t get id of it, wondering how it will get rid of the last of it.:/

  • Hello. I have had C DIFF now for 16 weeks. Pretty miserable to say the least. Started with flagyl, but I couldn’t tolerate it. I was on vancomycin for about 10 weeks. I am currently on chlolestyramine. I have been off vanc for 4 weeks. I have microscopic colitis. My gi is trying to figure out if I have small intestine issues from gallbladder being out, or postinfectious IBS, or this is the “new me”. I just took another stool test yesterday. Anyone else had a hard time getting rid of this mess??

  • I have been fighting this for months now can get rid of it, it is making me sick and hurt up my back and down my legs, I been on all kinds of of things to help get rid of it , but nothing is working , it my my upper back hurt so back that is got me down,, my legs hurt so bad I just cry with them and Noone understand what I’m going though. Please if any one can help please. I have never hurt so bad in my life, I also got MRSA with it and that itself is hard enough. My prayers go out to you all.with love to you all Darlena

  • I have had c-diff for 15 months now, and after multiple rounds of antibiotics and six FMTs, it is back. This has been heart breaking for not just me, but my family as well. I believe the doctors have given up on me as well. I don’t know what I am doing wrong. I use gloves, and germicidal bleach on everything. Even after my transplants, I wore gloves to prepare my food and change them to eat. I eat and drink probiotics daily but it keeps recurring. This has been a long and frustrating battle that I can’t seem to win.

  • I’ve had CDIF for 5 months now. Been on Flagyl 14 days, then Vancomycin 14 days & had every side effect possible with the Vancomycin. I can’t do another round. Thought I was going to die. Bloody stools for a week, vomiting, diarrhea, rashes, everything possible thing. No way am I taking a second round of it. I’m a 54 yr old divorced, disabled woman and couldn’t even afford the $660 the Vancomyin cost. Had to make payments. Now taking Probiotics. If it doesn’t go away I don’t know what’s next?

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  • There is no way a symptom of c diff is anorexia. If you mean weight loss that is extremely different. Anorexia is a serious mental health issue.

  • Can this treatment be used without antibiotics? I don’t know if I have contracted a mild case of c diff from a patient, or just have a stomach bug. Either way the probiotics, along with natural antibiotic agents, seems like worth trying. I have only had diarrhea 4 times total in 3 days, and my symptoms didn’t start until 3 weeks after treating the patient that had c diff. Thanks for your advice!

  • I have acute myeloid leukemia. After chemo (which is every 6 weeks) I am neutropenic and during this time I presented with c diff. I reacted violently to vancomycin and Was switched to metronidazole. I haven’t had diarrhea since but do have excessive bloating. Could this be c diff still in my system? Should I take metronidazole each time I am neutropenic?

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