Diet and C.Difficile
I hope you can provide me with some much-needed direction. I was recently diagnosed with a severe case of C.difficile. After treatment and a hospital stay, I am now allowed soft foods. Are there foods I should avoid or focus on?
If you have not done so already, the most important thing to introduce into your diet are *friendly bacteria*, often called probiotics, that will help repopulate your gut and crowd out the potential for regrowth of the C-diff bacteria. A review conducted in August 2018 concluded that using probiotics results in a large reduction in C-diff associated diarrhea without an increase in adverse side effects (1).
Probiotic bacteria are found in fermented foods such as yogurt, kefir, sauerkraut, tempeh (fermented) and miso (fermented soybean paste). Make sure the brand you purchase contains live cultures. This should be stated on the packaging.
In addition, an over-the-counter probiotic supplement may be of benefit to you. Your local pharmacy can order for you if they do not have it on the shelf, or your doctor may be able to prescribe prescription strength probiotics. Remember that over-the-counter supplements are not regulated in the US, so ask your dietitian, pharmacist or doctor for a recommendation on what brand they suggest. Additionally, check your hospital policy to see if probiotic usage is allowed. Thus far, the cumulative data suggest that the most useful probiotic agents for prevention of CDI include combination L. acidophilus and Lactobacillus casei, other mixed species, S. boulardii, or L. rhamnosus [3,4]. In addition, a dosage of >10 billion colony-forming units per day may be more effective than lower doses.
With regards to your question on following a soft diet, a soft diet usually means avoiding foods high in fiber, nuts, seeds, and gassy foods and includes foods that are easy to chew. However, there are very few research studies showing which diet is most effective for recovery of C-diff. Some animal studies showed that using diets including soluble fiber (oat bran) helped eliminate the C-diff infection sooner than a diet with insoluble fiber (wheat bran).
Foods high in soluble fiber include: oats and oat bran, oatmeal, beans, peas, carrots, barley, citrus fruits, strawberries and apple pulp.
Foods high in insoluble fiber include whole-wheat breads, wheat cereals, wheat bran, rye, brown rice, most other whole grains, cabbage, beets, Brussels sprouts, turnips, cauliflower and apple skin.
You can also read more about using foods to manage diarrhea here.
In addition, some experts recommend banana flakes for controlling diarrhea because they add pectin and soluble fiber to the diet. This product can be ordered from your local pharmacy.
Lastly, we recommend seeking the professional expertise of a Registered Dietitian Nutritionist (RD or RDN) in your location, either in the outpatient department of your local cancer center or in private practice, to help you with this transition back to full recovery. You may have other nutritional needs that should be taken into account as you recover from this serious illness. You can find a dietitian by typing in your zip code here.
You can read more about the infection in your large bowel caused by the overgrowth of the bacteria called Clostridium difficile (commonly called Cdiff) at the following web sites:
Centers for Disease Control and Prevention
The original question and answer were generously donated by Diana Dyer, MS, RD a cancer survivor, registered dietitian, organic garlic farmer, and the author of "A Dietitian's Cancer Story: Information & Inspiration for Recovery & Healing from a 3-time Cancer Survivor.
Question and Answer updated and revised by Melissa Strohl, MS, RD, CSO, LDN, CNSC on behalf of ON DPG
- Goldenberg JZ, Mertz D, Johnston BC. Probiotics to Prevent Clostridium difficile Infection in Patients Receiving Antibiotics. JAMA. 2018;320(5):499–500. doi:10.1001/jama.2018.9064
- Friedman G. The role of probiotics in the prevention and treatment of antibiotic-associated diarrhea and Clostridium difficile colitis. Gastroenterol Clin North Am. 2012 Dec;41(4):763-79. doi: 10.1016/j.gtc.2012.08.002. Epub 2012 Sep 28.
- Johnston BC, Ma SS, Goldenburg JZ, et al. Probiotics for the prevention of clostridium difficile-associated diarrhea: A systematic review and meta-analysis. Ann Int Med 2012. https://annals.org/article.aspx?articleid=1390418 (Accessed on December 03, 2012).
- McFarland LV, Evans CT, Goldstein EJC. Strain-Specificity and DiseaseSpecificity of Probiotic Efficacy: A Systematic Review and MetaAnalysis. Front Med (Lausanne) 2018; 5:124.
Page Updated: March 2019