To treat or Not to Treat

[healthys]

Hello All,

I got cdiff in Oct 2020 after using abx. I took vanco for 10 days and was treated. Never tested for cure. I have had PI-IBS ever since. Since the last week, I have more foul smelling, mucousy stools with lot of undigested food. Water or loose in nature. More frequent than what I am used to getting with IBS. The foul smell and urgency alerted me and I had my GI test me for C diff. I got the PCR done. It is positive but negative for strain B. I took doxycyline on Nov 2nd , one time, one bag for a D&C procedure. I am having formed stools ( small in quanity) in the morning but the subsequent stools become mushy, watery, mucousy and that horrible smell. Including the formed stool in the morning, I have been going 4 times a day to the bathroom. I have upped florastor and probiotics. Honestly, I thought doxy was low offender so I wasn't too worried but seems like it has affected me. I am meeting my GI today but let me know what you all think. Should I take vanco/difficid to treat now? Or wait for my own immune system to outwin this as I am having some formed stools. The urgency with the rest of the 3 mushy/watery stools through the day make me panic every time. Please let me know your thoughts.

I also got worried if something is going on with pancreas/gall bladder because the mucous look neon yellow in color which made me wonder if I am dumping bile. And the stools smelled so bad. So, the GI is running a pancreas elastase test as well.

Thank you for any suggestions, advice, recommendations.

[Lissaucd]

Hi there! I would have a toxin EIA test done for an active infection. From my understanding, c diff can be a normal part of the gut and thus the PCR may be misleading. Keep us posted and I hope things turn around for you!

[beth22]

Yes, the PCR can be misleading. At the hospital where I test each positive PCR is followed up with an EIA to see if there is active infection. I tested positive after having been given IV antibiotics and the PCR showed positive for over two years, but except for the first few days of symptoms, I had no D during that entire time. I never treated it except with Pepto Bismol as that is what the doctor told me to do. Of course, if your symptoms continue and the other test is normal, you will have to decide what to do. If I had a choice between vanco or Dificid, I would take the Dificid. I never had good luck with vanco. It only made things worse in the long run for me.

[roy]

Please check your test result.
PCR tests only detect the toxin B gene so if yours did not detect toxin B gene it's not a positive test.
PCR does not look for any type of toxin.
Possibly they did NOT do a PCR but did antigen followed by EIA.
That one can be positive for antigen but negative for toxin. (that's a negative as far as there's no treatment needed)

[healthys]

Thank you All.
Below is what the test says- I asked my gastro for EIA and she said that is not needed, PCR is gold test and asked me to go on vanco. I have not started that as first stool of the day is formed for me albeit very yellow though.

Component Results
Component Your Value Standard Range Flag
C Diff Result POSITIVE NEGATIVE A
This organism requires infection control precautions to minimize the risk of transmission to other patients. Pay particular attention to hand washing.
027 NAP1 BI STRAIN NEGATIVE <<DO NOT REPORT>> A
PRESUMPTIVE RESULT
This specimen was evaluated using the Cepheid GenXpert DX system and real-time polymerase chain reaction (PCR).

[roy]

It's a confusing result
This part of the result looks like it means you tested positive.
"Component Results
Component Your Value Standard Range Flag
C Diff Result POSITIVE NEGATIVE A
This organism requires infection control precautions to minimize the risk of transmission to other patients. Pay particular attention to hand washing"

The second part refers to the NAP27 strain of C. Diff and is nothing to do with toxins.
It's not supposed to be shared with the patient because its "A
PRESUMPTIVE Result".
In non medical terms that's just a guess!

"027 NAP1 BI STRAIN NEGATIVE <<DO NOT REPORT>> A
PRESUMPTIVE Result"

[healthys]

I think it means it is positive for c diff but negative for NAP27 strain which is the most virulent I believe. I am having general malaise, feverish feelings now and then and body aches. Diarrhea has reduced but overall stomach feels off, some cramping and feelings of wanting to go to the bathroom are there. I just dont know what to do.

[roy]

Sounds like your body is beating it off naturally.
My own thoughts are that is the best way and "probably" results in a higher degree of future immunity.
Might be worth waiting to see if improvement continues.

[beth22]

If you do go on an antibiotic, I would ask your GI for Dificid. It kills less good flora and targets the c difficile more specifically.