The bacterium Clostridium difficile, also known as C. difficile, causes about 3 million episodes of diarrhea or colitis in the U.S. every year and kills about 1 to 2.5 percent of those infected, according to a 2005 report in American Family Physician. This infection often strikes while patients are already hospitalized, hitting people when they are at their most vulnerable. Probiotics have shown promise as a way to help treat C. difficile infections, but talk to your doctor before trying them to determine whether they are appropriate for you, which type to use and how much you should take.
C. Difficile
C. difficile strikes many people when they are most vulnerable: during recovery from another illness. Many infections begin in the hospital, but they can also occur in the home. The most common symptom is diarrhea, but C. difficile can also cause abdominal cramping, fever, nausea, dehydration, weight loss, blood in the stool and loss of appetite. When symptoms last for more than three days, this can indicate a severe infection that requires immediate treatment.
Antibiotics and C. Difficile
C. difficile typically infects people after a round of antibiotics. This occurs because antibiotics destroy the natural gut bacteria that normally protect the intestines from invading bacteria such as C. difficile. The most common antibiotic culprits are fluoroquinolones, cephalosporins, clindamycin and penicillins. C. difficile infections can sometimes be treated using other antibiotics that specifically target this bacteria, but up to 20 percent of C. difficile infections return even after a round of the antibiotics metronidazole or vancomycin, according to a January 2000 study in the "American Journal of Gastroenterology." New strains of antibiotic-resistant C. difficile make probiotics important as an alternative treatment for this type of illness.
Probiotics
Probiotics are healthy bacteria or yeast strains that help recolonize the gut after infection or antibiotic use. They can be found in food products, such as yogurt or miso, as well as in supplement form. Two common probiotics used against antibiotics-associated diarrhea, including diarrhea caused by C. difficile, are Lactobacillus GG and Saccharomyces boulardii. In different clinical trials, one or both of these two probiotic strains have helped reduce the recurrence of C. difficile, but not all trials agree on which one is most effective or if other strains might also work. A review in the journal "American Family Physician" noted that dosages of 10 colony forming units per day were more effective than smaller doses, so some of the inconsistency in study results could be due to lower dosages being used in some studies.
Considerations
People who are immunocompromised should not use probiotics for the treatment of C. difficile or other antibiotic-related diarrheal illnesses because these healthy bacteria can overgrow and become dangerous in these individuals. Most healthy people can tolerate normal doses of probiotics, with mild abdominal cramping and flatulence as the only reported side effects. If you are using probiotics during or after antibiotic use to try to prevent C. difficile or as a treatment for an ongoing infection, your doctor should monitor your condition to determine whether other treatment is necessary as well.
References
- "American Family Physician"; Clostridium difficile--Associated Diarrhea; Michael S. Schroeder, M.D.; March 2005
- MayoClinic.com; C. difficile; November 2010
- National Center for Complementary and Alternative Medicine; An Introduction to Probiotics; January 2007
- "American Family Physician"; Probiotics; B. Kligler and A. Cohrssen; November 2008
- "American Journal of Gastroenterology"; The Effect of Probiotics on Clostridium Difficile Diarrhea; M. Pochapin; January 2000
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