Health Q&A: Clostridium difficile

Dr Mark Porter / 19 July 2019

Dr Mark Porter responds to a reader’s question about treatment for C. Diff.

Q: A friend contracted the superbug C. diff in hospital and was treated – successfully – with a faecal transplant. It sounds disgusting. Could you explain what’s involved, please?

A: Clostridium difficile is a bacterial infection that typically gains a foothold in poorly people who have had their own natural gut bacteria wiped out by antibiotics, leaving the ‘hardier’ C. diff space to grow. As the bacteria thrive, they release a toxin that can inflame the bowel causing severe bloody diarrhoea, abdominal pains and fever. In the most severe cases, C. diff can be fatal.

It can be treated with more antibiotics, but for some unlucky patients this can result in a vicious cycle of annihilation and early re-colonisation. Imagine using a nuclear bomb to clear a city of cockroaches, only to find that the first thing to re-establish itself in the post-nuclear wasteland is a cockroach. So you drop another bomb, and the cycle continues.

Faecal transplants use a completely different approach. Samples of liquidised faeces from healthy volunteers are transferred into the guts of people infected with C. diff via a nasogastric tube in the hope that the healthy bacteria in the faeces establish themselves and elbow out the C. diff. Disgusting though it may sound, the results can be astonishing, with patients often responding within a day or two, and cure rates of more than 90%. 

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