Manatee snowbird’s advice: ‘Do gut check’ for C. Diff

Manatee County snowbird Ed Shoulders came down with one of the world’s most common and increasingly seen bacteria infections last month while home in Indiana.

He describes the symptoms as being like nothing he has ever experienced in his life.

Shoulders, in his 50s, had caught a case of Clostridium difficile, commonly known as C. Diff.

“What I think happened,” Shoulders said by phone, “is that I had come down with walking pneumonia and doctors up here gave me antibiotics for that and those antibiotics killed out the good bacteria I had. I think I got the C. Diff from that.”

Ironically, doctors gave Shoulders still another antibiotic, the powerful Vancomycin, which finally relieved his symptoms, he said.

But before Shoulders was cured he went through more than a month that he describes as “a living hell.”

“My weight dropped from 176 to 152,” Shoulders said. “Everything I ate ran right through me. I had constant, horrible diarrhea, six to seven times a day. Horrible. It sapped all of my strength and energy. You don’t feel like eating anything. I would go two or three days with only leaving the couch to go to the bathroom.”

“I got to where I could only eat one egg a day,” Shoulders said. “Anything that touched my intestines was powerfully injected out.”

Shoulders would like other Manatee County residents to learn from his story.

His advice? Be aware that antibiotics kill everything in the gut, even good bacteria, which can lead to some unwanted results.

Wash hands vigorously with soap and water, don’t rely on hand sanitizer, after visiting public rest rooms or hospital settings, he added.

“All I can say is that it is horrible,” Shoulders said of C. Diff. “To now be rid of it feels wonderful, like a miracle.”

When a good bug goes bad

C. Diff isn’t always a bad bug, said Dr. Seetha Lakshmi, assistant professor of infectious disease at the University of South Florida in Tampa and a practicing physician at Tampa General Hospital.

Human beings are inhabited by a galaxy of bacteria, including C. Diff, which scientists call microbiota or microflora, which all work together to keep the person healthy, Lakshmi said.

“In one study, 50 to 60 percent of newborns were found to have C. Diff in their guts,” Lakshmi said. “The bacteria in our bodies usually work like a symphony. They all play along.”

But there are “disruptors” that can come along and alter the microbiota landscape, leaving the normally well-behaved C. Diff in the driver’s seat alone, where its personality can change.

Faced with no competition, it can go haywire, Lakshmi said.

“Believe it or not, the antibiotics and anti-acids that we take so liberally are now known to increase the imbalance in the gut,” Lakshmi said. “Bowel surgery is also a risk factor.”

“It’s when the good guys are all gone that C. Diff creates havoc,” Lakshmi added.

Prevention

Keeping hands as germ free as possible is one way to prevent C. Diff from invading the body in its spore form, which produce toxins that cause the severe diarrhea, said Eric Deppert, MD, the chief medical officer for the Manatee Healthcare System, including Manatee Memorial Hospital and Lakewood Ranch Medical Center.

“The older alcohol versions of the hand sanitizers, referring to about 10 years ago, weren’t really working as well,” Deppert said last week. “It could have been the ingredients or the fact that people didn’t do a good enough job washing their hands. The recommendation was to use soap and water and we still use soap and water.”

Although newer gels have proven more effective, Deppert still recommends frequent hand washing during the day, after twisting door knobs or rubbing surfaces, both of which C. Diff can live for long periods of time.

“I think a good hand wash, 30 seconds, do the alphabet while you are washing both hands and don’t forget your non-dominant thumb,” Deppert said. “If you are right handed I guarantee you will forget your left thumb.”

Like Lakshmi, Deppert believes strongly in “antibiotic stewardship” to control C. Diff.

Another important consideration to maintain healthy bacteria in the gut is food, Lakshmi said.

“Make sure your diet is diverse,” Lakshmi said. “Eat yogurt. Do not take antibiotics unless absolutely necessary.”

Lakshimi advises to also be cautious about bowel cleansers.

This story was originally published June 19, 2017 at 4:51 PM with the headline "Manatee snowbird’s advice: ‘Do gut check’ for C. Diff."