Nutrition to support gut health and C. diff recovery

Sponsored by and developed in part with support from Ferring Pharmaceuticals.

Dealing with a gut infection or consistent GI issues is always rough, but it’s especially horrible during the holiday season when everyone around you is partaking in delicious foods that you know may make your symptoms worse! But what can we do about it to support symptom management and enjoy the holidays as well? Let’s dig into nutrition to support gut health and C. diff infection recovery, focusing on what foods we can add in this holiday season.

First, a little background: C. diff, or Clostridioides difficile, is a colonic infection that can have severe short and long-term effects on the body and the gut microbiota. I’ve seen many clients in my practice who have a history of C. diff infection who are still having GI and gut-related symptoms even years after the initial infection. 

Many people with C. diff commonly have symptoms like diarrhea, loss of appetite and nausea in the short term. In my practice, I’ve seen many people with a history of C. diff develop food sensitivities, gut bacterial imbalances, chronic fatigue, constipation or intermittent diarrhea, and symptoms that immediately follow eating like flushing, headaches, and severe bloating. 

If you have a recent C. diff infection or inexplicable gut symptoms, it’s imperative you work with a doctor and dietitian/nutritionist to make sure you get on the right path toward recovery.One thing I reiterate to all my clients is – unless it’s a food allergy or celiac disease, food alone cannot entirely fix the problem; and

that’s definitely the case with C. diff. Dietary modifications alone cannot cure C. diff – it’s way too complicated of an infection for that! BUT there are some nutritional tools that we can use to help support symptom management in C. diff recovery. Make sure you ask your doctor or dietitian about what you can eat during and after C. diff.

HOW DOES C. DIFF INFECTION HAPPEN?

Let’s talk about the gut microbiome. C. diff infection can commonly happen when we don’t have enough ‘good’ gut bacteria, which are protective against pathogens and other infections. Not having enough beneficial bacteria is called dysbiosis, which can happen as a result of repeated, broad spectrum antibiotic use. Whatever the cause, when we don’t have enough protective bacteria, and we have too low stomach acid, it creates an environment that makes it easy for the C. diff infection to take hold and create all sorts of serious issues. 

C. diff produces toxins that directly target our intestinal cells, specifically the colon. These toxins create intestinal permeability, can contribute to cell death, and allow pathogens to get through to the bloodstream. This process provokes an intense immune response, and creates a hostile, inflammatory environment in the gut where beneficial bacteria and digestive enzymes can no longer thrive. This can lead to food sensitivities, malabsorption of essential vitamins and minerals, and potential nutrient deficiencies as a result of that malabsorption – which can all contribute to the symptoms mentioned above. So while low beneficial bacteria can open the door to C. diff infection, the infection itself also contributes to a further lowering of beneficial bacteria levels and short-chain fatty acids, which are essential in bringing down inflammation in the gut.Important note: these toxins don’t only affect the gut! Symptoms of C. diff can have far-reaching effects via the gut-brain connection, triggering depression and other mental health concerns. If you’ve been dealing with recurrent C. diff and are experiencing these side effects, talk to your doctor or a mental health professional for guidance and support.

CAN FOOD PLAY A ROLE IN C. DIFF TREATMENT? 

Once you’re getting the treatment you need from a medical professional, nutrition can play a supporting role in healing. However, it’s common for many who experience a C. diff infection to lose their appetite, or to worry that any food they eat will trigger their symptoms; which makes it all the more important to work with a doctor or dietitian to come up with a nutritional plan. 

Let’s talk about gut-friendly foods that can be helpful for those who are dealing with C. diff to help the body regain strength, rebuild gut health, balance electrolytes and the essential vitamins and nutrients we need to recover! 

Fiber is one of the most important nutrients we consume to help feed good gut bacteria. It’s important to note that many people with C. diff have difficulty digesting insoluble fibers, like raw vegetables, unpeeled fruits, wheat, barley, nuts and seeds, which could contribute to more diarrhea and bloating. Instead, we can focus on consuming more soluble (easy to digest) fibers, like oats, white rice, quinoa, bananas, peeled fruits like apples or pears, and cooked vegetables. 

Fiber is also a key nutrient that helps the body produce butyrate, which has been shown in research to protect the intestinal lining from damage caused by C. diff. Butyrate increases tight junctions (reducing intestinal permeability) and fights against intestinal inflammation caused by C. diff. (important note: Butyrate doesn’t work against C. diff infection, but it does help counteract the damage caused by C. diff.)

If tolerated, we can also start to slowly add in fermented foods that contain probiotics to help with the growth of good gut bacteria, like sauerkraut, pickles, kimchi, and greek yogurt. I would recommend starting with very small amounts depending on the severity of symptoms.

If symptoms are very severe, it can be helpful to focus on adding in semi-solid foods like toast, eggs, crackers, and starchy foods that are easily digestible – think mashed or baked sweet potatoes, oatmeal, rice, or things like banana bread. If you are experiencing diarrhea frequently, the body is also losing large amounts of electrolytes, so adding in some extra sea salt (or mineral-rich salt), and potassium sources like bananas to your daily routine will also be helpful.

Fad diets aren’t the answer…

Research has also shown that high-fat, high-protein diets can exacerbate the symptoms and spread of C. diff infection, where high-carbohydrate, or high-soluble fiber diets, are protective. This also means that following a low-FODMAP diet, as is commonly prescribed for IBS and other persistent gut conditions, would not be helpful for someone who has C. diff.

In short:

If you or someone you know is dealing with C. diff, they can still enjoy some holiday foods with this nutrition to support gut health! Many fruits and vegetables that come in season in the fall and winter are great sources of soluble fiber, like pumpkin, winter squash, and (peeled) apples. Soups are also a wonderful holiday option for cold days! As pictured above, I highly recommend trying out recipes like stuffed squash, baked apple oatmeal, and pumpkin or banana bread to get in some delicious holiday flavors. 

Interested in learning more about clostridium difficile or C. diff infections? Check out Ferring Microbiome’s website at  https://clvr.li/FerringCdiffBSW2 ! 

References:

• Hryckowian AJ, Van Treuren W, Smits SA, Davis NM, Gardner JO, Bouley DM, Sonnenburg JL. Microbiota-accessible carbohydrates suppress Clostridium difficile infection in a murine model. Nat Microbiol. 2018 Jun;3(6):662-669. doi: 10.1038/s41564-018-0150-6. Epub 2018 Apr 23. PMID: 29686297; PMCID: PMC6126909.
• Mefferd C, Bhute S, Phan J, Villarama J, Do D, Alarcia S, Abel-Santos E, Hedlund B. A High-Fat/High-Protein, Atkins-Type Diet Exacerbates Clostridioides (Clostridium) difficile Infection in Mice, whereas a High-Carbohydrate Diet Protects. mSystems. 2020 Jan-Feb; 5(1): e00765-19. doi.org/10.1128/mSystems.00765-19 
• Roychowdhury S, Cadnum J, Glueck B, Obrenovich M, Donskey C, Cresci GAM. Faecalibacterium prausnitzii and a Prebiotic Protect Intestinal Health in a Mouse Model of Antibiotic and Clostridium difficile Exposure. JPEN J Parenter Enteral Nutr. 2018 Sep;42(7):1156-1167. doi: 10.1002/jpen.1053. Epub 2018 Jan 31. PMID: 29385239; PMCID: PMC6068000.
• Smits WK, Lyras D, Lacy DB, Wilcox MH, Kuijper EJ. Clostridium difficile infection. Nat Rev Dis Primers. 2016 Apr 7;2:16020. doi: 10.1038/nrdp.2016.20. PMID: 27158839; PMCID: PMC5453186.