The human body is wonderfully complex and filled with interdependent systems. Each of these systems affects the other and must stay in delicate balance to keep us healthy. These systems contain trillions of bacteria such as those in the intestinal tract called intestinal, or gut, flora. Most of these bacteria are harmless. Others perform useful metabolic and digestive activities such as training the immune system, producing vitamins and regulating the growth of other, more harmful bacterial organisms. They are “good germs” – absolutely necessary to our daily health.
However, within this system of intestinal flora are bacteria that can have a negative effect on our health. Clostridium Difficile, also known as “C. diff,” is one type of intestinal flora that must be kept in careful balance.
A spore-forming bacteria, C. diff is part of the normal intestinal flora. It’s there in all of us and, for the most part, is kept in check by the other intestinal flora surrounding it. When something upsets the balance of this flora, normally harmless bacteria can over-grow and make you sick. When C. diff is allowed to grow in this way it can lead to serious problems. C. diff is one of the leading causes of infectious diarrhea in the United States. Toxins released by the bacteria can attack the lining of the intestines and cause colitis.
Yavapai Regional Medical Center Infection Preventionist Sue Boggler explains, “When you become sick, your doctor may give you antibiotics. One problem with antibiotics is that they don’t just kill off the bad bugs, they kill off the good ones too. One of the responsibilities of the ‘good bugs’ is to regulate the C. diff in your system.”
C. diff bacteria can overwhelm the system when antibiotics are used. This can lead to diarrhea, abdominal pain and sometimes nausea. The resulting illness can be very serious, resulting in extreme weight loss, dehydration and an electrolyte imbalance that affects the heart. Ultimately, it can lead to colitis and even be life-threatening.
One strategy used to avoid C. diff infection is to ask physicians to administer probiotics along with antibiotics to help maintain balance in the gastrointestinal tract. The probiotic serves to restore some of the natural flora that has been destroyed by the antibiotics. With natural flora restored and growing, the gastrointestinal tract is better able to fend off the growth of adverse bacterium such as C. diff.
“It’s really a balancing act,” Boggler says, “You want to be able to kill off the bad bacteria and preserve the good bacteria your body needs. Probiotics can help to stabilize the flora present in the digestive tract.”
With many illnesses, the use of antibiotics can mean the difference between cure and greater complications. However their widespread availability, generally low cost, and relative safety make antibiotics an easy target for overuse. Antimicrobials have been routinely overused, which has contributed to an increase in C diff cases. It is important to remember that bacteria are living, breathing, replicating life forms and can learn to protect themselves against destruction. This type of process is called adaptation. The bacteria adapt to resist the antibiotics. The trend in medicine today is to be far more careful about the decision to prescribe antibiotics, which is also helping to lessen the likelihood that a patient will pick up a C. diff infection or the development of a strain of C diff that is antibiotic resistant.
So what is the best way to protect against C diff infection? Here are some basic tips:
– Always wash your hands with soap and water (alcohol-based foams and gels are not effective against C diff).
– Avoid taking antibiotics for viral infections such as head colds.
– Avoid touching your face if you have had contact with someone on antibiotics until you have thoroughly washed your hands with soap and water.
– Never request antibiotics from your doctor; the doctor will prescribe them only if he or she thinks you need them.
– When you do have to take an antibiotic, ask your doctor what he/she would recommend for concurrent probiotic therapy.
– If you are on an antibiotic, report any diarrhea promptly to your healthcare provider.
Preventing C diff is a team effort between you and your physician! QCBN
Kenneth Boush is the community outreach manager at Yavapai Regional Medical Center. He can be reached at 928-771-5396 or KBoush@YRMC.org.