Clostridium difficile is a strain of bacteria that causes severe diarrhea and intestinal infection. It may also lead to inflammation of the colon.

Although it can occur in people of any age, C. difficile is most common in older adults. People who have recently taken antibiotics and who are in a hospital or long-term care facility are also more likely to develop the infection.

Antibiotics can destroy the healthy bacteria in a person’s intestines, making it easier for disease-causing bacteria, such as C. difficile, to grow in its place.

When a person has C. difficile, the bacteria will be in their stool. These bacteria can contaminate any surface or material that they come into contact with. C. difficile spores can survive on a surface for up to 5 months without proper decontamination and disinfection.

Surfaces on which these spores may live include:

  • bathtubs
  • toilets
  • showers
  • handrails
  • bed rails
  • light switches
  • clothing
  • blood pressure cuffs

Healthcare workers can inadvertently spread the infection when they come into contact with the bacteria or spores on one of these contaminated surfaces and then touch another person.

Approximately 500,000 people in the United States get a C. difficile infection every year. According to some research, people who have the infection for the first time may have a higher 30-day mortality rate than those who have a subsequent infection. Many of the people included in that research were over 65 years old.

When a person has a C. difficile infection, the most important thing in terms of diet is to consume foods that contain probiotics. Probiotics are microorganisms that can help regulate a person’s digestion.

They are usually present in fermented dairy foods, such as aged cheese, yogurt, or kefir. Other foods that include them are sauerkraut, fermented tempeh, and miso, which is a fermented soybean paste. It is vital to consume products that contain live cultures. A person can find this information on the product package.

Also, after talking with their doctor, a person may want to take probiotic supplements. Some of these are available over the counter, while others may require a prescription.

Other than this, making dietary changes is also an important part of treating a C. difficile infection. However, the exact diet a person needs to follow will vary depending on the severity of the infection.

Anyone with this type of infection should be sure to speak with a doctor about what they should and should not eat.

Someone with diarrhea may benefit from eating foods that contain soluble fiber. These include:

  • grains such as bran and barley
  • fruits and vegetables
  • oatmeal
  • natural applesauce without added sugar
  • lentils
  • finely ground flaxseeds
  • white rice

Avoid dehydration

Someone with severe diarrhea may also become very dehydrated, meaning that they have lost a lot of fluid. For this reason, a person should be sure to drink plenty of clear fluids, such as water, broth, or herbal tea.

Young children, older adults, and people with compromised immune systems are at higher risk of dehydration and complications associated with it.

In addition, a person with a C. difficile infection may want to avoid or limit the following foods:

  • whole milk or foods made from whole milk, as the person may become sensitive to lactose during the infection
  • acidic or spicy foods
  • greasy or fatty foods
  • raw foods
  • caffeine, which, as a diuretic, can exacerbate fluid loss
  • foods that contain solid fats, total saturated fats, and added sugar, which may reduce colonization odds, according to some research

Generally speaking, in order to increase the probiotics in a person’s gut, it is better to consume probiotic-rich foods uncooked. This is because high heat above 80°C can destroy these helpful microorganisms.

However, there are some recipes a person can make that are fermented and produce probiotics in the cooking process. They include the following.

Sauerkraut

Serves 8

Ingredients

  • 1 pound of cabbage, finely shredded (about 6 cups)
  • 2/3 tablespoon (tbsp) of salt

Directions

  1. Mix the cabbage and salt in a bowl for about 5 minutes. Massage the mix and be sure to release most of the liquid.
  2. Let the mixture sit for about 1 hour.
  3. Place the mixture in a jar, making sure that the liquid (or brine) is fully covering the cabbage, and seal.
  4. Leave the jar to ferment for at least 5 days. A person can leave it for longer if they prefer it to taste tangier.
  5. Open the jar once daily to release the pressure and make sure that the brine is still covering the cabbage. Push down if needed.
  6. When done, move to the refrigerator and enjoy.

Macrobiotic miso soup

Preparation time: 10 minutes

Ingredients

  • 1–2 inches of wakame sea vegetable per cup of water to be used
  • 2–4 thin slices of a root vegetable per cup of water to be used
  • 1/8–1/4 of a cup of leafy greens, finely chopped
  • 1/2 to 1 level teaspoon (tsp) of miso per cup water to be used.
    • People should purchase their miso from a health food store to make sure that it is naturally fermented. Some good examples include barley miso, brown rice miso, and sweet-tasting brown rice miso.
  • finely chopped scallion, for garnishing
  • 1 and 1/8 of a cup of water per serving or 2 and 1/8 cups of water per 2 servings

Directions

  1. Soak the wakame in water for 1–2 minutes. If it is not soft enough, soak it for longer. Take it out of the water and cut it into even pieces.
  2. Pour the measured water into a pot and put the wakame in the water. Turn the oven on and wait for the water to boil.
  3. Add the root vegetables and cook for about 5 minutes.
  4. Measure the miso and place it in a small bowl. Dilute the miso in the bowl using a small ladle of the cooking stock until the consistency is thin enough to dissolve once added back to the pot.
  5. Add the leafy greens to the boiling pot, followed by the diluted miso paste.
  6. Reduce the heat to the lowest setting and simmer for 3–4 minutes.
  7. Pour into a small bowl to serve and garnish with the scallions.

Banana spice smoothie

Serves 2

Ingredients

  • 2 ripe bananas
  • 2 cups of vanilla flavored kefir
  • 1/2 tsp of ground cinnamon
  • 1/8 tsp of ground nutmeg
  • 1/8 tsp of allspice
  • 12 ice cubes

Directions

  1. Blend the ingredients together in a blender until smooth.

Probiotic breakfast bowls

Serves 4

Ingredients

  • 1 cup of quinoa
  • 1 and 3/4 cups of water
  • kosher salt
  • 1 medium avocado
  • 2 medium scallions
  • 2 tbsp of olive oil, divided
  • 4 packed cups or 4 ounces of baby spinach
  • 4 large eggs
  • 1 cup of fermented red cabbage or beet kraut
  • 1 cup of plain Greek yogurt
  • 4 tsp of hemp seeds

Directions

  1. Rinse 1 cup of quinoa and put it in a medium saucepan. Add 1 and 3/4 cups water and a generous pinch of kosher salt. Once it boils, reduce to a simmer and cook uncovered for 10–12 minutes until the quinoa is tender. Remove from the heat, cover, and let steam for 5 minutes.
  2. Slice 1 avocado and 2 medium scallions into thin slices.
  3. Heat 1 and 1/2 tsp of olive oil in a large nonstick pan over medium heat. Add the 4 packed cups of baby spinach and cook, stirring often for 1–2 minutes until wilted. Divide the spinach between 4 bowls and clean the pan.
  4. Heat another 1 and 1/2 tbsp of olive oil in the pan over medium heat. Add 4 large eggs and season each with a pinch of salt. Cook for about 2 minutes until the edges are crisp and the whites are set.
  5. Divide the quinoa between the bowls and top each with a fried egg. Divide 1 cup of purple kraut, the avocado slices and scallions, 1 cup of Greek yogurt, and 4 tsp of hemp seeds among the bowls.

The symptoms of a C. difficile infection include:

It is possible to identify C. difficile by taking a stool sample and analyzing it in a laboratory. This test can determine which species of bacteria is causing the infection as well as the best antibiotic to treat it.

However, just because the test identifies the bacteria, it does not mean that the bacteria are causing disease. It is possible for a person to have the bacteria without having any symptoms.

For this reason, a doctor needs to do a thorough medical history and physical examination in which they specifically ask about any symptoms and try to understand their severity.

In addition, if a stool test identifies C. difficile, the doctor may recommend additional testing to determine whether or not the infection is damaging the colon. These tests can include a CT scan and colonoscopy or sigmoidoscopy.

CT scans involve taking multiple X-rays and computer images to look at the internal organs. Colonoscopy or sigmoidoscopy involves passing a tiny camera through the rectum and into the colon. This allows the doctor to directly look at the colon for irregularities and signs of damage.

When a person develops a C. difficile infection as a result of taking antibiotics for another illness, they may need to stop taking them. However, this may not be possible in all situations — especially for people who have severe infections.

The sections below look at some treatment options in more detail.

Medications

A person who experiences mild symptoms will also require additional antibiotics to get rid of the infection.

Doctors can prescribe a variety of antibiotics, including:

  • Vancomycin (Vancocin): A doctor may prescribe 125 milligrams (mg) to be taken by mouth four times per day for 10 days.
  • Fidaxomicin (Dificid): This is a new antibiotic that works similarly to vancomycin. The dose is 200 mg twice per day for 10 days, and people can take it by mouth.
  • Metronidazole (Flagyl): With this medication, a person takes 500 mg three times per day for 10 days, and they do so by mouth.

In the past, metronidazole was the first-line treatment for C. difficile. Now, doctors prefer to prescribe vancomycin or fidaxomicin, if available, as they are more effective.

A person with C. difficile infection should not take antidiarrheal medications, as these can increase the risk of serious complications.

Surgery

Someone with a severe infection and damage to the colon may also require surgery. If a person’s colon is severely damaged, they may need surgery to remove it.

If antibiotics do not work, a doctor may recommend a fecal microbiota transplant. During this procedure, a doctor collects stool from a healthy donor, rinses it, and dilutes it with saline or another solution. They then transplant it directly into the person with the infection. Doctors can do this using colonoscopy, sigmoidoscopy, or an enema.

This procedure allows healthy gut bacteria from the donor stool to move into the injured or diseased colon, which makes it easier for the colon to heal after a C. difficile infection.

C. difficile infection is a bowel infection that, without treatment, can lead to serious complications. It is essential for anyone who develops diarrhea or abdominal pain after taking antibiotics to contact a doctor.

If a doctor identifies C. difficile infection, they will start treatment immediately.

Making dietary changes is an essential part of treatment and can allow the colon to rest and heal.