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JAMA Patient Page |

Clostridium difficile Colitis FREE

Janet M. Torpy, MD, Writer; Cassio Lynm, MA, Illustrator; Richard M. Glass, MD, Editor
JAMA. 2009;301(9):988. doi:10.1001/jama.301.9.988.
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Published online

Colitis (inflammation of the colon) can occur as a result of infection with the bacterium Clostridium difficile (also known as C difficile and C diff). The disease results from disruption or removal of normal healthy bacteria from the colon by antibiotics. The C difficile bacterium produces toxins (poisonous substances) that attack the lining of the colon and can cause severe damage to the colon itself. More commonly, C difficile toxins produce diarrhea and abdominal discomfort. Unfortunately, it is resistant to most antibiotics. Complications of C difficile colitis include bowel perforation (a hole in the colon) and pseudomembranous colitis (patches of severe inflammation and pus in the colon). C difficile is one of the most common infections that are typically acquired in health care institutions, along with MRSA (methicillin-resistant Staphylococcus aureus) and VRE (vancomycin-resistant Enterococcus). Hand washing and disinfection, isolation of infected patients, and appropriate antibiotic use are the best ways to reduce spread of these types of infection. The March 4, 2009, issue of JAMA contains an article about Clostridium difficile colitis.


  • Treatment with antibiotics

  • Hospitalization

  • Nursing home residency

  • Critical illness

  • Immune system depression (such as cancer, steroid treatment, HIV infection)

  • Age older than 65 years

  • Disease of the colon (such as inflammatory bowel disease)

  • Recent gastrointestinal surgery


  • Diarrhea, often watery

  • Fever

  • Abdominal pain and cramping

  • Nausea with or without vomiting

  • Weight loss


Diagnosing C difficile colitis relies on the patient's history of frequent diarrhea for several days, typically in a person who is taking or recently took antibiotics. A stool sample is tested for presence of C difficile toxins. Other tests may be required if complications are suspected, including blood counts, blood chemistry testing, abdominal x-rays, or computed tomography (CT) scanning.



To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA's Web site at http://www.jama.com. Many are available in English and Spanish. A Patient Page on MRSA infections was published in the October 17, 2007, issue.

Sources: Centers for Disease Control and Prevention; National Institute of Diabetes and Digestive and Kidney Diseases; American Gastroenterological Association

The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.




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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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