C. Diff, NOT The Same As Occasional Diarrhea!

Our articles are usually geared towards those living with a spinal cord injury (SCI), however our topic this time can have an impact on ANYONE because we’ve all been prescribed antibiotics for one reason or another. Antibiotics are important for clearing up bacterial infections but sometimes those same antibiotics can trigger a potentially life-threatening infection caused by a type of bacteria called CLOSTRIDIUM DIFFICILE, or or C. DIFF. Symptoms from C. Diff can range from mild diarrhea to a more severe inflammation of the colon. There’s been quite a bit of discussion around C. Diff but do you really know what it’s all about? We are here to break it down for all to understand.

C. Diff bacteria actually exist all around us. Many people naturally carry these bacteria in their intestines and never have any symptoms. When you take an antibiotic to treat an infection, these drugs tend to destroy some of the normal, helpful bacteria in addition to the bacteria causing the infection. Without enough healthy bacteria to keep it in check, C. diff can quickly grow out of control. The majority of C. Diff infections are spread in health care facilities, like hospitals or nursing homes, where health care workers can unknowingly share it with patients or residents. Older adults taking antibiotics are at higher risk of obtaining C. Diff but studies are revealing increasing rates of C. Diff infection among people traditionally not considered to be at high risk, such as young and healthy individuals who haven't used antibiotics and who haven't been in a health care facility. So, listen up, it’s for everyone to learn.

WHAT ARE THE SYMPTOMS OF C. DIFF??

The most common symptoms of C. Diff are smelly, really stinky, watery diarrhea three or more times a day for two or more days and mild abdominal cramping and tenderness.

More severe symptoms of C. Diff include:

• Watery diarrhea, 10 – 15 times a day

• Dehydration leading to hospitalization

• Severe cramping

• Inflamed colon

• Blood or pus in stool

• Fever

• Nausea

• Loss of appetite/weight loss

• Increased heart rate

• Swollen abdomen

• Kidney failure

• Elevated white blood count

HOW TO HELP PREVENT THE TRANSMISSION OF C. DIFF:

• Avoid unnecessary use of antibiotics. Antibiotics are sometimes prescribed for viral illnesses that aren't helped by these drugs. We cannot stress this topic enough.

• Hand-washing. Do we even need to explain the importance of hand washing now? Hand washing is the #1 best practice to prevent the transmission of bugs. Any bugs!!

• Contact precautions. Persons with C. Diff are placed on “contact precautions” when hospitalized in an attempt to prevent transmission to others. Wearing gloves and gowns when caring for patients with C. Diff and remembering hand sanitizer does not kill C. Diff.

• Thorough cleaning. In any health care setting, all surfaces should be carefully disinfected with a product that contains chlorine bleach. C. Diff spores can survive exposure to routine cleaning products that don't contain bleach.

DIAGNOSIS OF C. DIFF:

Diagnosis is simply done by a stool sample to the lab.

TREATMENT OF C. DIFF:

• Antibiotics. Ironically, the standard treatment for C. diff is another antibiotic. These antibiotics keep C. diff from growing, which in turn treats diarrhea and other complications.

SUPPORTIVE TREATMENT FOR DIARRHEA INCLUDES:

• Plenty of fluids. Choose fluids containing water, salt and sugar, such as diluted fruit juice, soft drinks, and broths.

• Good nutrition. If you have watery diarrhea, eat starchy foods, such as potatoes, noodles, rice, wheat and oatmeal. Other good choices are saltine crackers, bananas, soup and boiled vegetables. If you aren't hungry, you may need a liquid diet at first. After your diarrhea clears up, you may have temporary difficulty digesting milk and milk-based products.

• Probiotics. These can help to keep the digestive system healthy. · Check out our article regarding probiotics here.

• Meticulous skin care. As with any diarrhea, care must be given to skin to avoid irritation and breakdown.

Bottom line from The Rollin’ RNs… Remember, not all diarrhea is C. Diff but if persistent diarrhea continues for days with a disgusting, lingering odor, you should contact your health care provider and get a stool sample tested. Hand washing is the simplest way to prevent C. Diff. DO NOT HESITATE to ask your healthcare provider to wash their hands if you don’t witness them doing so. None of us want to contract C. Diff and deal with foul stools.

It’s all good, so keep on rollin’.

Patty, BSN, RNC and Roberta, RN

The ROLLIN’ RNs ™

References:

C. Difficile infection. Retrieved January 19, 2020 from https://www.mayoclinic.org/diseases-conditions/c-difficile/symptoms-causes/syc-20351691

What Is Clostridium Difficile (C. Diff)? Retrieved January 13, 2020 from https://www.webmd.com/digestive-disorders/clostridium-difficile-colitis#1