Mild cases of C. difficile disease are characterized by frequent, foul smelling, watery stools. More severe symptoms, indicative of pseudomembranous colitis, include diarrhea that contains blood and mucous, and abdominal cramps. An abnormal heart rhythm may also occur. C. difficile diarrhea is confirmed by the presence of a toxin in a stool specimen. A positive culture for C. difficile without a toxin assay is not sufficient to make the diagnosis of C. difficile - associated disease.
Endoscopic findings are useful in diagnosis of pseudomembranous colitis.
As soon as C. difficile disease is diagnosed, current antibiotic therapy should be reassessed by the physician. Patients with severe toxicity or unresolved diarrhea may need to have their antibiotic treatment modified to use drugs not known to result in C. difficile diarrhea. Patients should be monitored for dehydration and electrolyte imbalance following prolonged bouts of diarrhea. Antidiarrheal agents such as Lomotil or Imodium have been shown to increase the severity of symptoms and should NOT be taken. Individuals with C. difficile -associated disease shed spores in the stool that can be spread from person to person.