What Is C. Diff? Understanding the Infection, Symptoms, and Causes

Last medically reviewed and updated: November 2025. Information based on CDC, Mayo Clinic, and IDSA/SHEA guidelines.

c diff bacteria can live on surfaces for years

Being diagnosed with Clostridioides difficile (C. diff) can be overwhelming — especially when it’s not clear why it happened or how to keep it from returning.

C. diff is a toxin-producing bacterium that can overgrow in your intestines after antibiotics disturb the natural balance of good bacteria in your gut. For some people, this imbalance triggers mild diarrhea, while for others, it can lead to severe inflammation of the colon called colitis.

The information here reflects current research and clinical guidelines, along with insights from my experience helping thousands of people recover from antibiotic-resistant and gut-related infections over the past two decades.

The encouraging news is that recovery is possible — and understanding what’s really happening in your gut is the first step toward healing and preventing recurrence.

What Happens During a C. diff Infection

Inside the colon, C. diff releases two potent toxins — Toxin A and Toxin B — that irritate and inflame the gut lining. This toxin activity drives pain, cramping, diarrhea, and sometimes bleeding. When antibiotics or other stressors wipe out your protective gut flora, C. diff spores can germinate and multiply, releasing more toxins that keep the cycle going.

These toxins don’t just cause symptoms — they can also slow your body’s ability to heal the intestinal barrier. That’s one reason many clinicians and integrative practitioners focus on gut repair and toxin-binding support as part of recovery.

Learn more: Gut Repair & Toxin Support →

Common Symptoms of a C. diff Infection

Symptoms may appear a few days after antibiotic use or even weeks later. They may include:

Watery diarrhea (three or more times per day)
Abdominal pain, tenderness, or bloating
Fever and chills
Loss of appetite, nausea, or dehydration
Severe cases: blood or mucus in stool, swollen abdomen, weakness

If you’ve recently taken antibiotics and notice these symptoms — especially worsening diarrhea — contact your healthcare provider promptly for testing and diagnosis.

Why C. diff Is So Hard to Eliminate

C. diff forms spores, tiny protective shells that let it survive on surfaces for months. These spores aren’t killed by alcohol-based hand sanitizers or many household cleaners. Only soap-and-water handwashing and bleach-based disinfectants reliably remove them. That’s why reinfections are common, especially if the gut’s friendly bacteria haven’t recovered.

Who’s Most at Risk

Recent or multiple antibiotic prescriptions
Previous C. diff infection or long-term antibiotic use
Age 65 or older
Hospital or long-term care stays
Weakened immune system or chronic illness
Use of acid-suppressing medications (PPIs)
Recent surgery or chemotherapy

Also see: Top Antibiotics That Can Trigger C. diff →

Is C. diff Only a Hospital Infection?

Not anymore. Once considered mainly a hospital-acquired infection, C. difficile is now showing up more often in people who haven’t been hospitalized or recently taken antibiotics. The CDC estimates that about 1 in 5 cases are now community-associated — meaning they start outside of healthcare settings.

Researchers have found C. diff spores in environments as ordinary as public restrooms, gyms, and even household surfaces. These hardy spores can persist for months and spread easily from person to person when handwashing and hygiene are overlooked.

Even healthy individuals can become vulnerable if their gut microbiome becomes imbalanced from antibiotic use, stress, or diet. That’s why protecting and rebuilding gut health is an important part of prevention and recovery.

Recent C. diff Facts & Public Health Trends

According to the CDC (2024), C. diff causes more than 500,000 infections and about 13,000 deaths each year in the U.S. While hospital-related cases have decreased, community-associated infections continue to rise — now accounting for roughly one in five cases.

C. diff remains listed by the CDC as an Urgent Threat pathogen due to its antibiotic resistance and recurrence potential. Older adults (65+) account for most hospitalizations and deaths linked to this infection.

Source: CDC Antibiotic Resistance Threats Report, 2024

How Doctors Treat C. diff (From 2025 Guidelines)

Medical treatment usually focuses on stopping the infection and controlling symptoms. Current clinical guidance (IDSA/SHEA; ACG) recommends:

Fidaxomicin (Dificid) as the preferred first-line antibiotic for many adults
Vancomycin as an accepted alternative
Microbiome restoration therapies such as VOWST (oral capsules) or REBYOTA (rectal preparation) to help repopulate beneficial bacteria after antibiotics
FMT (fecal microbiota transplant) is used less often as standardized microbiome products become available

Even with these treatments, relapse can occur. That’s why recovery doesn’t end with antibiotics — the gut microbiome needs to be restored afterward.

Learn more: C. diff Medical Treatments (Antibiotics & FMT) →

Why C. diff Keeps Coming Back

Many people improve with treatment only to have symptoms return weeks or months later. Antibiotics, while important for killing C. diff, also reduce the “good” bacteria that help keep it in check. Without that balance, spores that remain in the intestines can reactivate and cause another infection.

The key to long-term success is rebuilding your gut ecosystem once the infection is controlled.

Learn more: 3 Steps to Lasting Recovery →

Can C. diff Be Prevented?

Use antibiotics only when truly necessary and as prescribed
Wash hands thoroughly with soap and warm water (sanitizer isn’t enough)
Disinfect high-touch surfaces with bleach-based products as directed
Eat a balanced, fiber-rich diet of whole, unprocessed foods
Rebuild gut balance after antibiotics once your provider confirms it’s appropriate

Learn more: Probiotic & Natural Therapy Basics →

What to Do Next

Healing takes time, but recovery is possible. Understanding what’s happening inside your gut — and the medical and natural options available — can help you make informed, confident choices about your next steps.

Download the Free C. diff Recovery Report →

See Gut Restoration Options →

Reviewed and updated November 2025 to reflect CDC, Mayo Clinic, and IDSA/SHEA guidance.

Continue Learning about C. diff

What Your Doctor Isn’t Telling You

5 Myths about C. diff.

3 Steps to Get Rid of C. difficile

Michelle Moore, BSc— Microbiologist & Holistic Health Educator

Author of C. difficile Treatments & Remedies and MRSA Secrets Revealed.

After a career in pharmaceutical microbiology and overcoming her own antibiotic-resistant infection, Michelle founded Embrace Health in 2007 to help people recover naturally through science-based, holistic education.

Read Michelle’s full bio →