December 9, 2022

Why antibiotics can lead to C. Diff infection — Pain News Network

By Madora Pennington, PNN Columnist

Do you have antibiotics? Then you could be on the verge of contracting a dangerous and life-threatening infection. When antibiotics alter the balance of gut flora, a bacteria that causes diarrhea and inflammation of the colon — clostridioides difficile — can take over and lead to a C. difficile infection.

That’s what happened to Kristy Collins. It took two rounds of antibiotics to clear up his severe ear and sinus infection. A few days later, a midday salad left Kristy with a strangely upset stomach. She thought it was nothing more than a little food poisoning, but soon she had smelly burps and the most foul smelling diarrhea. She also became severely dehydrated.

At first, her doctor suspected a stomach virus. But when her stomach issues didn’t subside, a stool test revealed that Kristy had C. diff. Fortunately, she was diagnosed and treated within days.

Because she has Ehlers-Danlos Syndrome (EDS), a chronic inherited condition, Kristy is a seasoned patient with a medical team in place. But having EDS also makes her more likely to catch C. diff. So far, she has undergone 19 surgeries for EDS-related issues. Most surgeries require a series of antibiotics to prevent infection and more if infection occurs after surgery.

After her fight against C. diff, Kristy needed another surgery. She and her doctors were very concerned about a possible recurrence of C. diff, as about 1 in 5 patients will get another infection. Kristy’s doctors tested her after the operation to make sure she hadn’t come back.

Kristy worries every time she needs antibiotics and asks her doctors if they are really necessary. She already eats a very healthy diet, which is helping her manage her chronic condition and suspects this may be part of why she hasn’t had a recurrence of C. diff. She also follows the advice of her doctors.

“It was the first time doctors told me to take probiotics,” Kristy says, which she did while taking antibiotics. Probiotics are live microorganisms that improve gut health. They are found in fermented foods like yogurt and sauerkraut or made into supplements.

Antibiotics tend to alter this flora in the colon, creating an environment where C diff can thrive. Many people have an immune system that can handle a C. difficile infection without symptoms, but others become seriously ill with watery diarrhea that may contain blood or mucus, or cause nausea, vomiting, loss of appetite, abdominal pain and bloating. At worst, C. diff can cause loss of blood flow, sepsis, perforation of the bowel, or swelling so severe that it closes the colon.

It’s not just antibiotics that can cause a C. diff infection. Other possibilities are chemotherapy treatment, proton pump inhibitor drugs (usually used to treat acid reflux), kidney or liver disease, malnutrition, or simply being an elderly person. C. diff infects about half a million Americans each year, according to the CDC.

C. diff can also be fatal. In the United States, nearly 30,000 people die each year from C. diff infection. Diagnosis is usually made by testing a stool sample. It is treated with antibiotics, monoclonal antibodies or, in severe cases, surgery.

How to Prevent C. Diff

Good hygiene practices can help prevent its spread. For C. diff, washing hands with soap and water is more effective than using alcohol-based hand sanitizers. It is also essential to limit the use of antibiotics to situations where they are really needed, to avoid upsetting the balance of bacteria in the colon. Many doctors recommend repopulating beneficial bacteria with probiotic supplementation during or after antibiotic treatment.

Recovering from a C. diff infection can be as mysterious as it is complicated. Many patients are not informed about how or what to eat or drink. Food can seem like the enemy, and meals can feel traumatic.

To address this unmet need, the Peggy Lillis Foundationa nonprofit advocacy organization created in honor of a beloved kindergarten teacher whose life was suddenly taken over by C. diff, recently released a nutrition and lifestyle guide.

“This guide begins to address the information gap by combining medical expertise, dietary advice and first-hand knowledge from C. diff survivors,” says executive director Christian John Lillis.

The guide is sponsored by probiotic manufacturer Bio-K Plus and developed by the Scientific Council of the PLF. It covers advice on managing the acute phase of a C. diff infection, preventing a recurrence, improving gut health, managing the emotional implications of C. diff, and recipes. It can be downloaded for free by clicking here.

Madora Pennington is the author of the blog about his life with Ehlers-Danlos Syndrome. She graduated from UC Berkeley with minors in Journalism and Disability Studies.