Clostridioides difficile, commonly known as C. diff, is a bacterium that can cause significant infection within the digestive system. It is common, especially in healthcare settings, and often raises questions about its impact on bowel habits. While C. diff is widely recognized for causing diarrhea, its effects can sometimes lead to confusion about constipation. This article will explore typical C. diff infection symptoms and less common, severe complications that alter bowel function.
C. difficile’s Primary Symptom: Diarrhea
Diarrhea is the primary symptom of a C. diff infection, often watery and frequent. The severity of diarrhea can vary, ranging from mild episodes occurring a few times a day to severe cases with up to 10-15 watery stools daily. This fluid loss can lead to dehydration.
Other common symptoms include abdominal pain and cramping. Fever, nausea, and decreased appetite may also occur. Severe infections can also cause a swollen belly, rapid heart rate, and weight loss.
The Mechanism of C. diff Infection
Clostridioides difficile forms spores, allowing survival in harsh environments. Ingested spores become active in the intestines. The bacterium then proliferates, especially when the gut bacteria balance is disrupted.
Antibiotic use commonly triggers C. diff infection by eliminating beneficial gut bacteria, allowing C. diff to overgrow. Once established, C. diff produces Toxin A and Toxin B. These toxins damage the colon lining, causing inflammation, fluid secretion, and the characteristic diarrhea.
When Bowel Movements Slow or Stop with C. diff
While C. diff infection primarily causes severe diarrhea, rare, severe complications can slow or stop bowel movements entirely. This is not typical constipation, but a dangerous medical condition. In severe cases, C. diff toxins can cause paralytic ileus. Here, intestinal muscles become paralyzed, stopping food and waste movement.
Toxic megacolon is another serious complication, an extreme colitis where the colon becomes severely inflamed and distended. Both paralytic ileus and toxic megacolon cause the bowel to stop functioning, leading to an absence of bowel movements. This lack of stool passage, though it may seem like constipation, indicates a life-threatening emergency requiring immediate medical intervention.
Diagnosing C. diff Infection
Diagnosis begins with reviewing a patient’s symptoms and medical history, especially recent antibiotic use or hospitalization. If C. diff is suspected, a healthcare professional requests a stool sample for laboratory testing.
Common diagnostic tests include PCR (polymerase chain reaction) for toxin genes or ELISA (enzyme-linked immunosorbent assay) for Toxin A and Toxin B. These tests confirm the presence of toxins responsible for symptoms. Prompt diagnosis is important for timely treatment and preventing further complications.
Recovering from C. diff and Restoring Gut Function
Treatment for C. diff infection involves specific antibiotics like vancomycin or fidaxomicin, usually for at least 10 days. If other contributing antibiotics were being taken, they might be discontinued if safe.
Bowel habits may not immediately normalize after treatment, as the gut microbiota needs time to recover and re-establish balance. Some individuals might experience ongoing changes in bowel function, including post-infectious irritable bowel syndrome (PI-IBS). Maintaining adequate hydration and nutrition is also important during recovery to support healing.