C. diff infection and UC
In a recent blog regarding UC and fecal biotherapy, mention was made about a gastrointestinal infection known as Clostridium difficile or C. diff for short. I wanted to expand on this topic as patients with IBD, and particularly UC, have a predilection for becoming ill with C. diff infections.
C. diff is a bacterium that commonly resides in the gut. The population of C. diff in the gut is usually small because other bacteria in the intestine keep it in check. At times, however, the balance of bacterial populations in the gut can be thrown off allowing the C. diff type of bacteria to overgrow. Overgrowth of C. diff results in severe diarrhea that may or may not be bloody and abdominal pain. Precipitants that can disrupt this balance of bacteria include antibiotics, proton pump inhibitor medication (ie; omeprazole, rabeprazole), immunocompromise, and exposure to hospitalized settings or nursing homes. It is easily diagnosed through collection of 2-3 stool specimens. The infection is treated with antibiotics such as metronidazole and vancomycin that restore the appropriate bacterial balance.
A study published in 2007 showed that IBD patients who are hospitalized are 3 times as likely to have a C. diff infection as other hospitalized individuals without IBD. Furthermore, when patients were sub-divided into those with Crohn's vs. UC, hospitalized individuals with UC were found to be 4 times as likely to have C. diff compared to hospitalized individuals without IBD. As we learn more about C. diff, we are finding that it is not only a problem in hospitalized patients, but also for those living everyday life in the community. As such, it is important that IBD patients are educated about this infection because it can be a cause if flare symptoms. Any patient experiencing worsening diarrhea and abdominal pain should review their risk factors for the infection with their doctor and consider stool analysis for the bacteria.