Treatment Options for C. diff
C. diff is a debilitating disease that causes chronic diarrhea. It is usually caused by antibiotic use so the first step is, if possible, to stop taking the antibiotic that triggered the C diff infection.
After C diff is positively diagnosed, your doctor may start by prescribing an antibiotic.
Antibiotics may sound counterintuitive for the treatment of C diff. How is something that is caused by antibiotics treated with more antibiotics?
The answer is that the antibiotics used for a C diff infection are different from the ones that cause it. Broad-spectrum antibiotics such as clindamycin, fluoroquinolones, and cephalosporins usually trigger a C diff infection. Antibiotics used for C diff are usually metronidazole or vancomycin and are more specific for C diff.
The Role of Probiotics for C diff
For C diff that is not cured after multiple rounds of antibiotics, Fecal Microbiota Transplant (FMT) is used. This is a process in which stool containing probiotics from a healthy donor is used to restore the gut microbes of someone with C diff.
The basic concept of FMT is to introduce good probiotics into the gut of someone who lacks them. If FMT sounds like an extreme form of probiotic therapy, it is. Here's how it works:
Fecal Microbiota Transplant for C diff
FMT involves taking fecal bacteria from a healthy person and transplanting it into a recipient. This process may be used during or after a C. diff infection, to restore healthy colonic microflora.1 There are several methods for fecal transplantation:
- Enema: patients are given an enema containing stool from a healthy donor. With an enema, probiotics can only reach the distal part of the large intestine.
- Colonoscope: The transplant is performed using a colonoscopy. A colonoscope is inserted through the rectum and the colon is irrigated with liquefied donor fecal material. The advantage of FMT performed via colonoscope is that it allows for inspection of the colon at the same time the procedure is performed. It can also reach the end of the small intestine where C diff can reside.
- Oral: The transplant is performed using an oral capsule containing freeze-dried fecal matter. One study comparing the efficacy of colonoscope FMT with FMT via capsules in 116 patients randomized to either found that rates of prevention of recurrent C diff infection were 96 percent in both groups.2
If you're not ready to undergo a fecal microbiota transplant to get probiotics for C diff, consider taking a probiotic supplement instead. However, keep in mind that over-the-counter probiotics will not contain the same probiotics as the ones in a FMT.
While over-the-counter probiotics will not provide you with the probiotics of a FMT, research indicates that Saccharomyces boulardii and Lactobacillus probiotics could prevent additional C diff infections.3
Probiotics for C diff
Probiotics for C diff
Next article: The Best Diet for a Faster Recovery from C diff
Sources:
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4328137/
- https://www.ncbi.nlm.nih.gov/pubmed?term=29183074
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4769010/
About the Author:
Dr. Bryan Do, D.O. is an osteopathic physician whose research interests include gastroenterology, immunology, and dermatology. He is particularly interested in the role of probiotics in the gut-brain-skin axis and has written many articles on the topic. He graduated from University of California, Los Angeles (UCLA) before graduating from Marian University College of Osteopathic Medicine in Indianapolis, Indiana and becoming a Doctor of Osteopathic Medicine. Osteopathic physicians are taught to take a holistic approach to medicine and to consider mind, body, and spirit when treating a patient. Osteopathic physicians receive training in Osteopathic Manipulative Medicine (OMM) in addition to the standard rigorous medical school curriculum. Both physicians with a Doctor of Osteopathic Medicine (D.O.) degree as well as a Doctor of Medicine (M.D.) can practice medicine.