Many people infected with C. diff are sick with diarrhea, abdominal pain, nausea, and weight loss. Others are “carriers” of C. diff with no signs or symptoms of disease. Some of these carriers have been recently infected with C. diff but have recovered and now feel well. But carriers still have the C. diff organism in their stools and can serve as a silent reservoir of infection in hospitals and nursing homes.

Hospitals in almost every country have reported outbreaks of C. diff, and the number and severity of cases continues to soar. In 2010 there were 350,000 cases of C. diff diagnosed in U.S. hospitals. That means that of 1,000 patients admitted to U.S hospitals, 10 will become infected with C. diff, most of them elderly. In some hospitals and nursing homes, as many as one in five patients is infected.

In the past five years, C. diff has spread across the globe, helped in large part by air travel, the availability and frequent use of antibiotics, and the graying of the world’s population.

Among frail, elderly patients, C. diff can be fatal in approximately 5-10%. Some patients with severe C. diff end up losing their colon and have a permanent bag on their side to catch bodily waste, via a procedure known as an ileostomy.

Some studies have reported C. diff in food purchased in a supermarket. Dogs, horses, pigs, and rabbits can also be carriers of C. diff, although spread of disease from pets or domestic animals to humans has yet to be documented. Like most infections, it is usually impossible to pinpoint the source of C. diff.

Testing stools for C. diff in patients after they have finished their Flagyl or Vanco for 10 days and after their bowel movements have returned to normal (that is, formed and not watery) is a waste of time and money, and is not helpful to the doctor or patient.

C. diff can sometimes be life-threatening, even in healthy young adults.

Once C. diff leaves the colon of the infected patient in a liquid stool, it usually converts to a spore that is like a seed that lies dormant in the hospital until it gets picked up by a suitable human host. Once swallowed, C. diff germinates (hatches) in the bowel and starts a new cycle of infection.

Some older or very ill patients may not be suitable candidates for fecal transfer. Colonoscopy is an invasive procedure, especially for those patients who are too ill with other conditions like cancer, heart failure, dialysis, or Alzheimer’s.