Dealing with C. diff in Doomsday

The increasing numbers of Clostridioides difficile (formerly Clostridium difficile) infections, most of which were hospital-acquired, made big news a few years back.  While the new kid on the block, COVID, has stolen the medical disaster limelight, it’s important to keep preparing for the other more deadly, if a little less common, killers among us, particularly because we can prevent these deaths through good hygiene and education.  Unfortunately, increasing numbers of the cases of these C. diff infections are occurring outside the hospital and care facilities among those who have no recent connection to either.  It is estimated that there are about half a million cases of C. diff infections in the US each year. 

C. diff colitis, the infection that many worry about because of its potential to kill, occurs most frequently when an antibiotic is prescribed for a different infection, usually a respiratory or skin infection.[1]  This antibiotic, often penicillin, erythromycin, or a sulfa drug, takes care of the bacteria causing the infection, but does not affect the Clostridioides difficile bacteria that are also normally present in the gut.[2]  After the normal bacteria that inhabit the intestines are eliminated along with the infection, the C. diff bacteria no longer have competition from the other bacteria and are no longer held in check.  They are free to multiply.  The toxin that these bacteria release causes diarrhea, abdominal cramping, dehydration, fever, and sometimes the need for hospitalization.  C. diff colitis may be fatal without treatment.[3]

Risk factors

Those at greatest risk for C. diff infections include the following:

• Those taking proton-pump inhibitors.[4]
• Those who have very recently taken antibiotics for some other reason, generally a respiratory or skin infection.[5]
• Those exposed to patients infected with C. diff, especially in a hospital or care facility.[6]

Treatment

C. diff infections are much more difficult to treat in people taking proton-pump inhibitors (PPIs), such as Nexium, Prevacid, Prilosec, etc.  That’s because those PPIs work to diminish the hydrochloric acid levels in the stomach.  However, not only does that hydrochloric acid help digest our food, it also kills many microbes that we consume along with our food and drink.  Lower levels of hydrochloric acid in the stomach mean that C. diff can proliferate more easily.[7]

Options for treatment include the conventional, the herbal, and the crazy (but apparently effective).

• Conventional
• Oral metronidazole, 500 mg, 3-4x per day, 5-10 days[8]
• Herbal (use an antibacterial in addition to the immune and antidiarrheal herbs for best results)
  
• Antibacterials 
• Japanese barberry, Oregon grape, or Nandina domestica, tincture, 1-3 teaspoons, 3-6 times per day[9]
• Usnea is another good herbal antibiotic effective against C diff.  Unfortunately, no dosage is recommended.[10]   
• The same goes for Isatis.[11]
• Juniper berry tincture may also work.[12]
• Immune support herbs
• Echinacea, ginger, and licorice tinctures in equal parts, 1 teaspoon, 6 times per day[13]
• Antidiarrheal
• Blackberry root and marshmallow root in equal parts, infusion, up to 6 cups per day.[14]
• Crazy, but apparently effective
• Resistant infections have recently been treated with fecal transplant.  That’s just what it sounds like.  Someone else’s waste is inserted into the patient.  The process for this last ditch effort is detailed in Armageddon Medicine[15] and Herbal Antibiotics.[16]  A nasogastric tube can be used, if you have it and if you have a doctor or nurse to insert it, and is preferred as it is more rapidly effective.  However, making an enema is a DIY that anybody can do.  Unfortunately, it may require several treatments every other day.  Here’s how it’s done:
• Collect donor specimen from preferably spouse or someone sharing same home. 
• Store it in a bowl in the refrigerator (covered!) while pending use. 
• Mash the feces with fork (here’s hoping you still have some disposables available), adding a little water to achieve creamy consistency. 
• Use an enema bottle or other squirt bottle (mustard bottle, perhaps?) and squeeze a few ounces of the creamy mash into the rectum.  
• The patient needs to retain this fluid as long as possible.  Unfortunately, enemas generally trigger diarrhea, so be prepared.  Do not force the liquid in under pressure—you risk perforating the colon, which definitely will kill the patient most of the time.  Yes, it would be way better to store metronidazole so that you only have to use this treatment on those patients with metronidazole-resistant infections.[17]

Cautions.  Do not use anti-diarrheal medications such as loperamide (Imodium).

Links to related posts:

Metronidazole

Acquiring Antibiotics 

Antibiotic Chart to Guide Acquisition  

Blackberry 

Isatis  

Japanese barberry  

Juniper

Usnea 

Loperamide  

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[1] Cynthia Koelker, Armageddon Medicine, 2012, 169.

[2] Cynthia Koelker, Armageddon Medicine, 2012, 87.

[3] Cynthia Koelker, Armageddon Medicine, 2012, 90-91.

[4] Cynthia Koelker, Armageddon Medicine, 2012, 86.

[5] Cynthia Koelker, Armageddon Medicine, 2012, 169.

[6] Cynthia Koelker, Armageddon Medicine, 2012, 169.

[7] Cynthia Koelker, Armageddon Medicine, 2012, 86.

[8] Cynthia Koelker, Armageddon Medicine, 2012, 169.

[9] Stephen Harrod Buhner, Herbal Antivirals, 2013, 48.

[10] Stephen Harrod Buhner, Herbal Antibiotics, 2012, 197.

[11] Stephen Harrod Buhner, Herbal Antivirals, 2013, 200.

[12] Stephen Harrod Buhner, Herbal Antivirals, 2013, 48.

[13] Stephen Harrod Buhner, Herbal Antivirals, 2013, 48.

[14] Stephen Harrod Buhner, Herbal Antivirals, 2013, 48.

[15] Cynthia Koelker, Armageddon Medicine, 2012, 458.

[16] Stephen Harrod Buhner, Herbal Antibiotics, 2012, 197.

[17] Cynthia Koelker, Armageddon Medicine, 2012, 458.

 

 19 november 2021