C. Difficile Diarrhea: Prevention & Treatment.

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C. Difficile diarrhea in Lyme disease image by Marty Ross MD

Clostridium Difficile (C. Diff) in Lyme Disease Diarrhea

Clostridium difficile (C. diff) overgrowth in the intestines causes diarrhea. This is a bacteria, which lives in our intestines, that can grow too much when a person is on prescription antibiotics. Here are the steps to treat and prevent this condition.

C. diff normally lives in the intestines in balance with the other intestinal organisms. However some antibiotics result in the germ becoming excessive. In excess it releases a toxin that leads to severe diarrhea and abdominal cramping. There is a stool test that physicians and healthcare practitioners use to determine if a person has this infection. When it is present, antibiotics must be stopped and an effective one for C. difficile started. Saccharomyces Boulardii is a beneficial yeast that lives in the intestines that can help treat and prevent C. difficile. A newer treatment for C. diff uses transplants of stool from healthy donors.

C. Difficile Prevention in Lyme Disease

Prevent C diff by taking probiotics. This is very important in someone who has a history of C diff diarrhea. In this type of situation, Sacro B s very effective at preventing another episode of C diff.

  • Probiotic 5 billion cultures.  Start at 2 pills 1 time a day. For diarrhea double the dose to 2 pills 2 times a day. Be sure to take it as far away from antibiotics as possible.
  • Saccharomyces Boulardii. Start at 4 pills 1 time a day for active diarrhea. Once you have had a C. difficile infection you should remain on this at 4 pills 1 time a day while you are on herbal or prescription antibiotics for Lyme to prevent C. difficile from causing diarrhea again.

C. Difficile Treatment in Lyme Disease

Antigerm Action Plans
For Lyme Disease

When diarrhea occurs due to C. difficile, herbal and prescription antibiotics for Lyme and the co-infections must be stopped. There are three antibiotics that treat this condition. Use Vancomycin or Fidaxomicin first. If they do not work, then consider Metronidazole. In addition, you should use an effective probiotic and Saccharomyces Boulardii (Sacro B).

Antibiotics

  • Vancomycin 125 mg 1 pill 4 times a day for 10 days
  • Fidaxomicin 200 mg 1 pill a day for 10 days
  • Metronidazole 500 mg 1 pill 3 times a day for 10 days

Probiotics

  • Probiotic 5 billion cultures.  Start at 2 pills 1 time a day. For diarrhea double the dose to 2 pills 2 times a day. Be sure to take it as far away from antibiotics as possible.
  • Saccharomyces Boulardii. Start at 4 pills 1 time a day for active diarrhea. Once you have had a C. difficile infection you should remain on this at 4 pills 1 time a day while you are on herbal or prescription antibiotics for Lyme to prevent C. difficile from causing diarrhea again.

Fecal Microbiota Transplant

This is a very effective way to treat C diff if one or two rounds of antibiotics do not work. Studies show it works about 90% of the time. It can be administered in a physician's office or the home by enema. Another option is to take 30 to 40 freeze dried pills a day for about 10 days.

References

  1. Fitzpatrick LR. Probiotics for the treatment of Clostridium difficile associated disease. World Journal of Gastrointestinal Pathophysiology. 2013;4(3):47-52. doi:10.4291/wjgp.v4.i3.47.
  2. McDonald LC, Gerding DN, Johnson S, Bakken JS, Carroll KC, Coffin SE, Dubberke ER, Garey KW, Gould CV, Kelly C, Loo V, Sammons JS, Sandora TJ, Wilcox MH. Clinical practice guidelines for clostridium difficile infection in adults and children: 2017 update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA). Clinical Infectious Diseases, 2018;66(7):e1–e48. doi:10.1093/cid/cix1085
  3. Quraishi MN, Widlak M, Bhala N, et al. Systematic review with meta-analysis: the efficacy of faecal microbiota transplantation for the treatment of recurrent and refractory Clostridium difficile infection. Aliment Pharmacol Ther. 2017;46:479-93. 10.1111/apt.14201
  4. Saha S, Khanna S. Microbiota replacement for Clostridium difficile by capsule is as effective as via colonoscopy. Journal of Thoracic Disease. 2018;10(Suppl 9):S1081-S1083. doi:10.21037/jtd.2018.04.18.

Antigerm Action Plans
For Lyme Disease

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