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Clostridioides (Clostridium) difficile Infection

  • Cynthia M. Johnson, MA
Publication Type:


Clostridioides (Clostridium) difficile Infection

C diff Infection


Clostridioides difficile (C diff) is an infection of the intestine caused by bacteria.


The infection is caused by the C diff bacterium. It makes toxins as it grows. This bothers the lining of the intestine.

The intestines have a healthy balance of bacteria that help with digestion. Antibiotics can disturb this balance by killing some bacteria and letting others grow in their place. C diff may be able to grow after taking certain antibiotics.

The infection can also spread:

  • From direct contact with an infected person
  • By touching surfaces with the spores of the bacteria and then touching your mouth

Risk Factors

C diff is more common in older adults. Other things that may raise the risk are:

  • Recent antibiotic use
  • Having a weakened immune system
  • A recent hospital stay
  • Having intestinal diseases
  • A history of C diff infection
  • The use of proton pump inhibitors


Problems range from mild to severe and may include:

  • Watery diarrhea
  • Belly pain or cramps
  • Bloating
  • Fever
  • Lack of hunger


The doctor will ask about symptoms and past health. A physical exam will be done.

Tests will be done to look for signs of the bacteria and the infection. These may include:

  • Blood tests
  • Stool (poop) tests

Rarely, the intestine may need to be viewed to look for changes. This can be done with an endoscopy.


People who have C diff but do not have symptoms do not need to be treated.

In others, the goal is to treat the infection. Choices are:

  • Stopping or changing antibiotics that may have caused the infection
  • Using specific antibiotics to treat the infection
  • A fecal microbiota transplant (FMT) to place stool from a healthy donor into a person's intestines to restore a healthy balance of bacteria

People who are not helped by these methods may need surgery. Options are:

  • Partial colectomy—The affected part of the colon is removed and the two healthy ends are joined together.
  • Illeostomy with irrigation—The small intestine is brought through the abdominal wall to allow stool to leave the body. A liquid is used to flush the colon.

People who have had C diff in the past are more likely to get it again in the future. Antibody therapy may be given to lower this risk by helping the body to fight the infection.

Partial Colectomy.

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Proper hand washing is the best way to lower the risk of C diff. Other ways are:

  • Using antibiotics as advised
  • Cleaning surfaces




  • C difficile—a rose by any other name... Lancet Infect Dis. 2019 May;19(5)449.
  • C.diff (clostridiodes difficile). Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/cdiff/index.html.
  • Clostridium difficile infection. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/clostridioides-clostridium-difficile-infection-in-adults-19.
  • McDonald LC, Gerding DN, et al. Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children: 2017 Update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA). Clin Infect Dis 2018 Mar 19;66(7):e1.
  • What is Cdiff? C Diff Foundation website. Available at: https://cdiff.foundation/what-is-c-diff.


  • David L. Horn, MD, FACP
Last Updated:

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.