What's Your Gut Pain Really Mean?

african doctor examining female patient(BlackDoctor.org) — Your stomach is cramping, you’re in pain, and you’re afraid to venture too far from your bathroom. What’s going on?

You may have a clostridium difficile infection, often referred to as C. diff.

What Is C. Diff?

C. diff is a bacterium that causes a wide range of symptoms, the most common being diarrhea. While C. diff most frequently impacts older individuals in hospitals or long term care facilities, it can also affect the general public.

How Common Is C. Diff?

Infections with C. diff have become more common, more frequent, and more difficult to treat over the last few decades. Thousands of Americans are infected with this particular bacterium each year, and those who have recently taken antibiotics are often at great risk of infection.

How Is C. Diff Spread?

C. diff is generally passed through the fecal-oral route, wherein people handle food, food preparation surfaces and utensils without properly washing their hands. Some people naturally carry the bacterium in their large intestine, and C. diff is known to live for weeks (or even months) on contaminated surfaces.

C. diff can be spread via door handles, faucets, telephones, remote controls, stethoscopes, toilets, sinks, bedside tables, and any “high touch” surfaces where contaminated hands can leave a trace of bacteria.

What Are The Symptoms?

Watery diarrhea more than three times per day for at least two days is the main symptom of a C. diff infection. Abdominal cramping and tenderness is also common. In severe cases, a grossly enlarged colon (large intestine) can result in bleeding, severe abdominal pain, bloody stool, dehydration, loss of appetite, weight loss, and severe and protracted diarrhea, as well as bowel perforation.

Am I At Risk?

Again, while most cases of C. diff occur in hospitals and nursing homes, infections also occur outside of health care facilities and institutions. Other risk factors include:

• Taking antibiotics, especially “broad spectrum” antibiotics that are used to kill a wide range of various bacteria
• Being 65 or over
• Having been recently hospitalized
• Living in nursing home
• Having inflammatory bowel disease or intestinal or rectal cancer
• Having a history of previous C. diff infection
• Having a weakened immune system
• Undergoing chemotherapy or other treatment that weakens the immune response

Complications Of C. Diff Infection

Individuals with C. diff infection are at great risk of dehydration, which can lead to kidney failure if not properly treated.

If C. diff infection becomes out of control, enlargement and perforation of the large intestine can result, which causes fecal matter to leak into the abdominal cavity and may lead to a potentially deadly case of peritonitis (an inflammation of the membrane which lines the inside of the abdomen and all of the internal organs).

If left untreated or improperly treated, the ultimate complication of C. diff. is death.

Treatment

There are several different steps you can take to help control a C. diff infection:

• Antibiotics. C. diff is, oddly enough, treated with antibiotics that can kill off the bacterium and allow the system to return to normal.

• Probiotics. It is now widely accepted as prudent to take probiotics (especially if you are also on an antibiotic regimen). Probiotics are naturally occurring “friendly” bacteria that need to propagate inside your large intestine for optimal health. Antibiotics cannot tell the between good and bad bacteria, so replacing your good bacteria with probiotic capsules (or yogurt or kefir) is an important step to take in assuring that your normal intestinal “flora” is healthy.

• Home Care. Handwashing, drinking plenty of fluids, and eating foods that will not exacerbate your diarrhea are all important if you have an active C. diff infection. Diarrhea can cause massive fluid loss, so replacing that lost fluid is essential.

• Brat Diet. For active diarrhea, a “BRAT” diet is often recommended, which consists of bananas, rice, applesauce and dry toast. Crackers, soup and boiled vegetables can also be used, while dairy products should be avoided. Once the diarrhea is over, you can reintroduce other foods, including yogurt or kefir.

Conclusion

All of us have a plethora of bacteria living in our large intestines, and many of those bacteria are essential to good health and help to fight off the growth of detrimental bacteria like C. diff. Unfortunately, taking antibiotics can kill off your supply of healthy bacteria, and with wider antibiotic use, resistant strains of C. diff are developing. This unfortunate reality makes handwashing, avoiding unnecessary antibiotic use, and the thorough cleaning of surfaces in health care facilities ever more important ways to prevent the spread of this troublesome and potentially life-threatening bacterium.

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