C. diff infection (CDI) occurs when the balance of gut flora is disrupted, often following a course of antibiotics, allowing the C. diff bacteria to multiply and release toxins in the large intestine. These toxins damage the lining of the colon, resulting in inflammation and a range of gastrointestinal symptoms. The most prominent symptom is severe diarrhea. Understanding the specific characteristics of this diarrhea can be an early indicator of the infection’s presence and severity.
Defining the Stool Symptoms
The most defining characteristic of a C. diff infection is the onset of watery, unformed diarrhea. Mild to moderate cases typically involve three or more unformed stools in a 24-hour period, often described as mushy or porridge-like. The sheer frequency can be a major issue, escalating from just a few episodes to as many as 10 to 15 bowel movements per day in more severe infections.
The color of the stool may sometimes present with a greenish tint, though this is not exclusive to the infection. The stools may contain mucus or traces of occult (hidden) blood, which signals inflammation and irritation within the intestinal lining. Visible blood is rare.
Many individuals with a C. diff infection report a highly distinctive and foul odor associated with the diarrhea. This pungent smell is often described as unusually strong and sickly sweet. The unique scent is caused by volatile organic compounds, which are metabolic byproducts of the toxin-producing bacteria within the gut.
The consistency of the stool is a major criterion for diagnosis, as tests for the C. diff toxin are usually only performed on unformed stool specimens, meaning they must be liquid or semi-liquid. This is because formed stool suggests the bacteria is likely present but not producing the toxins necessary to cause active disease.
Recognizing Severe C. diff Symptoms
In advanced cases, the inflammation of the colon (colitis) can become profound, leading to complications that require immediate medical intervention. Signs of advanced colitis include the passage of stools containing pus or visible blood, indicating deeper tissue damage to the intestinal wall.
Severe infection is marked by hypovolemia, a decreased volume of blood plasma due to massive fluid loss from the digestive tract. This rapid fluid depletion can quickly lead to severe dehydration and electrolyte imbalances, which stress the body’s organ systems.
A rare but serious complication is the development of toxic megacolon, where the colon becomes severely inflamed and distended. Paradoxically, a patient may experience a reduction in diarrhea despite the infection worsening, as the colon loses its ability to move gas and stool. This condition is often accompanied by a severely swollen and tender abdomen, representing a life-threatening emergency.
Accompanying Systemic Symptoms
The body’s response to the bacterial toxins creates noticeable systemic symptoms. Patients frequently experience severe abdominal cramping and tenderness, localized in the belly area, which can range from moderate to intense. This pain is a direct result of the inflammation and damage occurring in the large intestine.
A persistent fever is a common systemic sign that the body is fighting infection. This is often coupled with other general signs of illness, such as nausea and episodes of vomiting. These symptoms contribute to the patient’s discomfort and can accelerate fluid loss.
The feeling of illness often results in a significant loss of appetite, contributing to weight loss. The combination of severe diarrhea, vomiting, and lack of fluid intake can also lead to a rapid heart rate, which is the body’s attempt to compensate for decreased blood volume caused by dehydration.
When to Seek Immediate Medical Help
Certain symptoms signal a medical emergency and require immediate consultation with a healthcare provider or a visit to the emergency room. Signs of severe dehydration are a major concern, including dizziness or lightheadedness, a decrease in urination, or feeling excessively thirsty with a dry mouth. If dehydration is not quickly corrected, it can lead to serious complications, such as acute kidney injury.
Extreme or worsening abdominal pain and distension, especially if the belly becomes noticeably swollen and tender, should be treated as an urgent situation. Additionally, a high fever or shaking chills are indicators of a severe systemic response to the infection.
Any instance of stools that are almost always bloody, or severe vomiting that makes it impossible to keep down liquids, also warrants immediate medical attention. Patients who have recently taken antibiotics and develop watery diarrhea should speak with a doctor promptly to arrange for stool testing to confirm the presence of the C. diff toxins.