By: Sasha Klemawesch, MD

 

Many people have heard of C-diff.  If infected, you could be stuck at home in your bathroom with annoying (but benign) diarrhea, or you may wind up in surgery or the ICU with life threatening complications.  And while many people have heard of the disease, few are aware of how difficult it can be to eradicate.

Now get ready for a scary fact.  You might have C-diff.  Yes, you.  In fact, up to 3% of healthy individuals are walking around with it right now, a rate that jumps to 1 in 5 people who’ve been hospitalized ending up colonized with it.  Our GI tracts are home to millions of bacteria, up to 1000 different species at any given time.  But when a good & balanced mix of microbes exists, they all stay in check and actually promote health by doing jobs like making vitamin K, detoxifying chemicals, and augmenting the immune system.  They also make sure that “bad” bacteria don’t get out of control and run amok through your bowels.

This is the problem in C-diff; when you are given an antibiotic for something else, say a skin infection, or pneumonia, it doesn’t just target the one culprit bacteria causing that one infection in that one place; it also kills off a multitude of others, including most of the good guys in your gut.  When this happens, C-diff becomes the dominant force and starts causing distressing pathology.

You may say, “if an antibiotic caused it, why give me another to fix it?”  A good point.  Especially because the antibiotics we have to treat C-diff are often ineffective, and up to a third of people will end up relapsing even if the initial treatment helped.  C-diff is a “spore former” meaning it leaves little hard-shelled spores all over which antibiotics cannot penetrate, so even if the medicine got rid of the active bacteria, the spores are left behind which germinate new bacteria to then resume infecting your gut and releasing their toxins.  It is often a vicious cycle, with subsequent relapse increasing your likelihood of another future episode.