C. difficile, Toxin B

Clinical Implications:

- Symptoms include inflammation, abdominal pain, cramping, fever, and diarrhea

- Symptoms often present during antibiotic use and often subside once antibiotics are discontinued

- Gastrointestinal (GI) infection can cause reactive arthritis

Therapeutic Approaches & Considerations:

- See calprotectin and secretory IgA (SIgA) levels to determine GI inflammation and immune response.

- Consider Saccharomyces boulardii, high dose probiotics, broadspectrum antimicrobial herbs, and 5R Protocol (Read: "What is the 5R Protocol?")

- Mild infections can be treated with metronidazole (=an antibiotic that is used to treat bacterial infections)

- Heavy infections can be treated with vancomycin and fidaxomicin

- Asymptomatic people may not need treatment

- In asymptomatic people with positive toxins A and/or B, the genes are likely not “turned on,” and thus not causing disease. It is still prudent to avoid antibiotics to prevent CDAD (=Clostridium difficile associated diarrhea). Consider antimicrobial herbal formulas, which can suppress C. diff without activating toxin production.

- Additional testing for toxins A and B may be warranted

C. difficile is an opportunistic anaerobic bacterium which causes symptoms ranging from mild diarrhea to pseudomembranous colitis when the normal flora has been altered (as in antibiotic use).

C. difficile produces two toxins:

- Toxin A is a tissuedamaging enterotoxin,

- while toxin B is referred to as a cytotoxin.