Research Outline

Clostridium difficile-Casused IBS


To determine whether the infection Clostridium difficile or C. diff can cause irritable bowel syndrome (IBS) for educational purposes.

Early Findings

Based on three medical studies conducted between 2008 and 2016, IBS can be caused by a C. diff infection in between 10% and 33% of patients.

New-onset IBS common after C. difficile infection

  • This article by Wadhwa A, et al. was published in the journal Aliment Pharmacology and Therapeutics in August 2016.
  • Its conclusion is that "patients with Clostridium difficile infection have a high risk for developing post-infectious irritable bowel syndrome, particularly those with longer duration of C. difficile infection, anxiety and higher BMI."
  • The conclusion is based on a study in which it was "found that a quarter of... survey responders without IBS prior to CDI have developed PI-IBS following the CDI."
  • Of the individuals who developed PI-IBS, "52% had mixed IBS and 40% had diarrhea-predominant IBS."
  • People who had C. diff symptoms for longer than a week, anxiety, or a higher BMI were more susceptible to PI-IBS.

Post-Infectious Irritable Bowel Syndrome with Functional Diarrhea Following C. difficile Infections: Case Studies of Responses Using Serum-Derived Bovine Immunoglobulin

Long-Term Gastrointestinal Complications of Clostridium Difficile-Associated Diarrhea (CDAD)

  • This article by Saurabh Sethi was published as a dissertation at The University of Texas School of Public Health in 2008.
  • It discusses the theory that the "increased use of broad spectrum antibiotics" used to treat C. diff and "the introduction of a clonal hyper-virulent strain called the BI strain." are responsible for the increase in cases of Clostridium difficile -associated diarrhea (CDAD), including "long-term consequences such as irritable bowel syndrome (IBS), chronic dyspepsia/diarrhea, and other GI effects."
  • The authors hypothesize that patients that develop CDAD as a short-term complication of a C. diff infection are more likely to develop IBS in the long-term.
  • Following a study of adult CDAD patients at St. Luke's Episcopal Hospital, Houston who had developed CDAD after a C. diff infection, it was found that 10% also developed new onset IBS "within six months after initial infection compared to matched controls."