• Watery / foul-smelling diarrhea – 3 or more stools per day for 2 or more days

• Moderate to severe abdominal cramping and pain

• Nausea

• Fever

• Blood or pus in the stool

• Dehydration

• Loss of appetite

• Weight loss

In severe cases.   C. difficile can lead to life threatening complications such as toxic megacolon, peritonitis (inflammation of the abdominal cavity lining), perforation of the colon, sepsis, and death.

Symptoms of recurrent C difficile infection.   Shown to involve more severe illness, abdominal pain, and fever than with initial infection

Discontinue antibiotics and administer fluids /electrolytes

This therapy alone resolves diarrhea in 15-23% of otherwise healthy adults. Schroeder M. Clostridium difficile-associated diarrhea. March 2005. American Academy of Family Physicians Web site

• Discontinue antibiotics
• Drink plenty of water.   To keep well hydrated
• Replace electrolytes (potassium, sodium, chloride, bicarbonate).  Especially helpful are salty soups for sodium, and bananas (or other fruits/veggies) or tomato juice to replace potassium.

Home remedy: Mix and drink 1/4 tsp. salt, 1/4 tsp. baking soda, 1/2 cup orange juice, 2 tbsp. sugar and 1 liter of water). Also eat a banana or some watermelon for additional potassium.

Treat Clostridium difficile using natural pathogen killers in place of medical antibiotics

• Turmeric  (active ingredient: curcumin).   40 U.S. studies are looking at turmeric as a potential inhibitor of C difficile. A turmeric enema may equal vancomycin for C. difficile colitis. Dr. Rattan Patel and his research team found that growth of all strains of C. Difficile was inhibited (in vitro) by extracts of regular grocery store turmeric, at concentrations that would be easily obtained in the colon by adding the spice to food or consuming it in capsule form. Taken orally for therapeutic use, you would need a high quality extract. Dr. Patel maintains that 4 g/day of curcumin achieves a concentration of curcumin in the stool well above the concentrations that inhibited C. difficile growth.

Mercola.com offers a quality curcumin extract

• Iodine.   Will kill C-difficile spores.

Iodine – “Universal Medicine”

• Grapefruit seed extract (GSE)

Grapefruit Seed Extract -“Medicine Chest in a Bottle”

• Wild Oregano Oil (WOO)

Wild Oregano Oil

Probiotics effective at shortening duration of intestinal C. difficile infection

Inhibition of Clostridium difficile strains by intestinal Lactobacillus species and bifidi bacterium species (both lactic acid bacteria) or Saccharomyces species (yeast) (E.g. S. boulardii (Florastor®)) has been clinically shown to shorten the duration of diarrhea.

How do probiotics work against C. difficile (and other pathogens)?

• Antagonistic / Competitive towards pathogenic bacteria
• Stimulate immune mechanisms of intestinal mucosa

Probiotic Supplements.

Take a dose of the highest quality supplemental probiotic you can find – it is generally agreed that:

1. A significant number of microorganisms must be consumed in order to alter the bacterial population in the gut
2. Several different species of bacteria given simultaneously are preferable to using just one species.

Be aware that many products:

• Contain way too few CFU to amount to a “hill of beans”
• Contain less live microorganisms than claimed on their label
• Contain significantly less live microorganisms than on their production date

Some notable probiotic supplement choices to fight C. difficile:

• VSL # 3® – contains 450 billion live bacteria per dose;
• Dr. Mercola® Complete Probiotics -high production quality, 70 billion CFU / dose, 10 strains of lactobacillus and bifidobacterium.
• Culturelle® (LGG) – 10 billion CFU Lactobacillus rhamnosus strain GG (LGG) + 245g of prebiotic inulin / capsule dose; Vitacost.com.  Good survival rate in stomach/bile acid.
• Florastor® -sometimes recommended by doctors but only contains 5 billion CFU / capsule of Saccharomyces boulardii ;  Some complain of stomach rumblings.

Ensure probiotic supplement is taken at least 2 hours away from taking antibiotics (E.g. Flagyl or Vancocin).   Otherwise the antibiotics will destroy too many of the probiotic bacteria;

For more detail on probiotics, see:

Probiotics

For probiotic dosage suggestions against C. difficile:

Antibiotic / Probiotic Therapy Dosages against C. Difficile Infection

Food sources of probiotics

Kefir.   This probiotic liquid contains almost 20 strains of lactobacilli and is used against C. Diff

Dosage.   1/2 cup of kefir four times the first day, then 1/4 cup four times a day for about a week. Can make kefir at home or buy ready-to-eat in a grocery store (in the yogurt section) in plain or flavored. Diluting it with water or juice helps it down.

Yogurt with active cultures.     E.g. Stoneyfield, Dannon. Avoid sweetened yogurt, since sugar is food for pathogenic bacteria.

“Cultured cabbage” or “Kimchi” (one recipe includes Chinese cabbage, green onions and ginger root)

Prebiotics (food for probiotics).   Research suggests that prebiotics, such as fructooligosaccharides (FOS), may have a role in prevention and treatment of C. difficile infections by helping to restore normal indigenous microflora.  These naturally occurring, non-digestible food components are fermented in the colon, having these benefits:

• Selectively utilized by beneficial/probiotic bacteria already in the colon to promote their growth and colonization – thereby having a role in preventing/treating C. difficile infections.
• Normalize bowel function – may be used to manage diarrhea and constipation

• Fructooligosaccharides (FOS) are the major class of prebiotics.    Found in chicory, garlic, onion, wheat, rye, bananas, leeks, tomatoes and honey. Other prebiotics include inulin and oligolactulose.

Other adjunct treatments for Clostridium difficile

Build immune system – E.g. by regularly eating garlic and onions, plus take daily probiotics;

Anti-diarrhea and opiate pain medicines should be avoided.  Aince these medications reduce intestinal motility, and stopping diarrhea could cause an already inflamed colon to retain C. Difficile toxins. Better natural options to control diarrhea, would be:

• Consume 2 ripe bananas and a glass of organic buttermilk every day
• Coconut (milk, oil or flakes).    Take 1 Tbsp Extra Virgin Coconut Oil or 2 Tbsp. unsweetened, shredded coconut (from health food store), drink coconut milk, or some people have simply eaten supermarket coconut macaroons, but these contain a lot of sugar

A child’s dose of bovine colostrum

Activated charcoal or bentonite clay taken orally will adsorb C. Diff toxins – it is thought that by binding the toxins produced by C. difficile, they will be removed faster from the intestine, causing less damage. However, such adsorbers should not be eaten three hours before or after taking antibiotics or other medications,because it will interfere with their effective natural digestion, and so weaken medication.

Minimize sugar intake.  Unless you want to feed the little C. Difficiles !

Recurrence of Clostridium difficile

Occur in ~20% of cases – usually within 2 months after stopping antibiotics for CDAD;

Usually due to reinfection or germination of spores in colon;

Who is likely to have C. difficile recurrence?

• Females
• Patients who have one recurrence – 65% more likely to have further recurrences;