IBS vs. C. Diff

By the time people end up with an IBS diagnosis, they’ve usually gone through an array of different tests by one or more doctor or gastroenterologist. It can sometimes be a long and frustrating process, but it’s for good reason, and here’s why:

It can be tricky to differentiate between IBS and other medical conditions, as many diseases and infections affecting the gastrointestinal tract (e.g. inflammatory bowel disease, diverticulosis, celiac disease, parasites, bacterial infection, etc.) can have overlapping symptoms of pain, cramping, diarrhea and constipation. The main reason it is so important to cross these off the list before receiving an IBS diagnosis is because these medical conditions, when left untreated, can be harmful to your health and cause damage to your gastrointestinal tract; IBS, however, does not cause damage to your intestines and treatment mainly targets symptom management strategies.

Clostridium difficile aka C. difficile

One type of bacterial infection which affects the colon (also known as the large intestine) is Clostridium difficile, otherwise known as C. difficile. This bacteria produces toxins that damage the lining of the colon while producing symptoms of fever, abdominal pain and cramping, and frequent watery diarrhea. In extreme cases, C. difficile can cause the colon to rupture or can spread to the abdomen, causing life-threatening inflammation.

Illness from C. difficile often occurs after the use of an antibiotic targeting a different infection in the body, while C. difficile remains unaffected by this type of antibiotic. This allows the bacteria to multiply uninhibited by other bacteria in the colon. The infectious bacteria can then spread between individuals in hospitals or long-term care facilities, but can also be contracted outside of a medical setting. It was thought that C. difficile affects mostly older adults, but individuals of all ages can be affected if they have a history of antibiotic use or exposure to health care facilities. Those most at risk tend to be immunocompromised, who have had prolonged hospitalizations, or who have had extensive antibiotic therapy.

Is it IBS or C. diff?

Similarly, IBS can be triggered in an individual with a history of antibiotic use as antibiotics target all gut bacteria in the colon, including the good ones. This can allow gut bacteria which produces IBS symptoms to thrive, also causing diarrhea as a symptom. This is why it can be so confusing to differentiate between IBS symptoms and a C. difficile infection. It is important to rule out C. difficile, if you have the risk factors, before treating IBS symptoms because an infectious disease can cause physical damage and can potentially be life threatening.

The primary means of diagnosing C. difficile is by testing for the bacterial toxins in stool samples, and the treatment of the infection is with appropriate antibiotics. If you are at a higher risk for exposure to the infectious disease (if you have recently been admitted to or visited a hospital, or have previously been diagnosed with C. difficile), talk to your doctor or gastroenterologist about being tested for the bacteria before treating symptoms of IBS.