Natural Health Advisory

Clostridium difficile (C-diff) is a nasty bug that infects the colon and causes severe diarrhea, resulting in an estimated 250,000 hospitalizations and 14,000 deaths in the U.S. each year. While C-diff isn’t (yet) drug-resistant, stronger strains of this bacteria are emerging, and the CDC recently identified it as one of the country’s top 3 “urgent threat” microbes, meaning it is at risk of becoming a drug-resistant superbug which poses “an immediate public health threat that requires urgent and aggressive action.”[1]

Scientists attribute C-diff’s spread to unnecessary and incorrect use of antibiotics, which can wipe out beneficial bacteria in the gut, opening an opportunity for C. difficile to infect the colon. Once C-diff colonizes the colon, it releases toxins that cause inflammation and damage to the colon’s mucosal lining. All this overuse of antibiotics is threatening doctors’ ability to combat infections, according to the CDC’s recent 114-page report, which was written for the general public and offered the first comprehensive picture of drug resistance in the U.S.[1]

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C-diff symptoms

Symptoms of C-diff range from mild, self-limited diarrhea to severe abdominal pain with bloody, life-threatening diarrhea. Some people with C-diff have no symptoms at all and are simply “carriers” of the bacteria, while others can develop severe infection that results in loss of the colon or death. Between 4 and 7% of those infected with C-diff die from the infection.

Symptoms of C-diff often include the following:

• Mild to moderate watery diarrhea that is rarely bloody
• Cramping abdominal pain
• Anorexia
• Malaise
• Fever, especially in more severe cases

People with C-diff develop diarrhea during or shortly after starting antibiotics. However, 25-40% of people may not become symptomatic for as many as 10 weeks after completing antibiotic therapy.

Standard treatments for C-diff

Ironically, even though C-diff infection is almost always caused by antibiotics, the standard treatment is another antibiotic. Depending on a number of factors, including how severe the infection is and how otherwise healthy the infected person is, another antibiotic may truly be necessary, even life-saving. Currently, there are only two standard antibiotics that can be used for C-diff (vancomycin and metronidazole) and the success of metronidazole has been declining. It is also unfortunate that those infected are often left vulnerable to re-infection with C-diff because their repeated antibiotic use leaves their gut bacteria unable to fully recover. Up to 60% of patients have recurrent C-diff infections.

Natural remedies for C-diff

A number of natural options for treating C-diff are available. In some cases, the use of natural therapies along with an antibiotic is the best option. Several human studies have shown that taking probiotic supplements is helpful for both treatment and prevention of C-diff infection and diarrhea. Probiotic supplements contain healthy colon bacteria, such as Lactobacillus acidophilus, Bifidobacterium bifidum, other strains of Lactobacilli, and a yeast named Saccharomyces boulardii.

Dr. Lynne McFarland, PhD, a researcher and professor at the VA Puget Sound Healthcare System and the University of Washington, in Seattle, Washington, has published a number of review papers on treatment of C-diff with probiotics. She describes a meta-analysis of six randomized controlled trials using probiotics combined with one of the two standard antibiotics to treat C-diff.[2] The results showed that probiotics, in general, significantly reduced the risk of C-diff infection.

• In one of the trials that was analyzed, patients with C-diff  randomly received either a combination treatment of the antibiotic vancomycin and the probiotic Saccharomyces boulardii (1 g/day for 4 weeks) or vancomycin and placebo.[2] Patients treated with the probiotic were significantly less likely to experience a recurrence of C-diff compared with those treated with vancomycin and placebo (16.7% vs. 50% recurrence rate, respectively).
• In another study that was analyzed, patients taking antibiotics for various infections (not C-diff) received either a probiotic drink mix (Actimel drink by Danone, Paris, France) or a placebo drink along with their antibiotic.[2] None of those in the probiotic group contracted a C-diff infection, while 17% of those in the placebo group did.
• In another study, hospitalized people being treated with antibiotics were randomly assigned to receive either one capsule of a probiotic supplement (containing L. acidophilus and B. bifidum) or placebo per day for 20 days.[3] The number of people developing C-diff diarrhea was 60% lower in the probiotic group than in the placebo group.

Cure recurring C-diff using probiotics along with other natural treatments

Mona Morstein, ND, a professor at Southwest College of Naturopathic Medicine & Health Sciences and a naturopathic physician who specializes in gastrointestinal diseases has developed a 2-month natural treatment protocol for patients with recurrent C-diff.

1. Natural Antimicrobials. Certain herbs and nutrients have the ability to kill bacteria and treat bacterial infections. Dr. Morstein uses an encapsulated blend of caprylic acid, quebracho tannins, berberine sulfate, garlic, and uva ursi. She may also use allicin capsules (allicin is a component of garlic extract) and/or freeze-dried uva ursi capsules.
2. Probiotics. As discussed above, probiotics have been proven to be effective for prevention of antibiotic-associated diarrhea and to be useful with other antimicrobials for treatment of C. difficile disease. Dr. Morstein recommends a mixture of Lactobacillus, Bifidobacillus, and Saccharomyces boulardii (200 billion live bacteria a day).
3. Small bowel healing. C-diff doesn’t affect the colon only. It has been associated with significant damage to the small intestine, leading to leaky gut. Dr. Morstein therefore also helps her patients strengthen the lining of the small intestine for some months, continuing even after the stools are back to normal. She believes this is a vital component to fully heal patients with post–C. difficile diarrhea. You can find a treatment protocol for healing the small intestine and leaky gut here.
4. Removal of gluten and dairy. Although removal of gluten is not necessarily supported by medical studies, Dr. Morstein has observed that some of her patients develop an intolerance to gluten after repeated antibiotics and C-diff infection. If her patients’ bowel movements are markedly improved but not completely back to normal, she may recommend full avoidance of gluten. Because the damaged small intestine may not be able to produce enough of the enzyme lactase in order to digest dairy, she also considers eliminating it if other natural treatments and a basic healthy diet are not fully reversing patients’ symptoms. (Find a list of dairy substitutes here.)
5. Hygiene. To avoid spreading the bacteria or re-infecting yourself, excellent hygiene is recommended. This includes frequent hand washing, especially before eating and after using the toilet; frequent cleaning/disinfection, especially in bathrooms; and fingernail cutting.

Additional C-diff natural remedies

In addition to the 2-month protocol above, Dr. Morstein addresses the patient’s basic diet to remove irritating, pro-inflammatory, unhealthy foods. She also recommends lifestyle treatments, such as getting good sleep and maintaining more peace of mind in stressful situations. In addition, she recommends a good multivitamin and a fish oil supplement. With these natural remedies for C-diff, you can beat this nasty bug once and for all.

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[1] CDC. Antibiotic resistance threats in the U.S., 2013.

[2] CurrOpinGastroenterol. 2009 Jan;25(1):24-35.

[3] Can J Infect Dis Med Microbiol. 2006 Sep-Oct; 17(5): 291–295.

[4] Nat Doc News Rev. Jan 9, 2012.

 

This article was originally published in 2013, and is regularly reviewed and updated.

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