Clostridioides difficile Infection-Associated Functional Bowel Disorder: A Three-Year Cohort Study

Area of Science:

• Gastroenterology
• Infectious Diseases
• Psychiatry

Background:

• Recurrent diarrhea is common after Clostridioides difficile infection (CDI), but not always due to disease recurrence.
• Postinfectious functional bowel disorders (FBDs) can arise after bacterial or viral gastroenteritis.
• Distinguishing CDI-associated FBD from recurrent CDI is crucial for effective management.

Purpose of the Study:

• To compare the characteristics of patients diagnosed with CDI-associated FBD.
• To contrast these patients with those diagnosed with initial or recurrent CDI alone.

Main Methods:

• Retrospective review of electronic medical records from a Complicated Clostridioides difficile Clinic.
• Analysis of patient demographics, risk factors, and outcomes.
• Comparison between patients with CDI-associated FBD and CDI alone.

Main Results:

• Of 159 patients, 44 (27.7%) had CDI-associated FBD, and 90 (56.6%) had CDI alone.
• Patients with CDI-associated FBD were younger, more likely female, and had fewer comorbidities.
• A history of anxiety and depression was more frequent in patients with CDI-associated FBD.
• At 3 months, patients with FBD had less frequent symptom resolution and more persistent gastrointestinal issues.

Conclusions:

• CDI-associated FBD is prevalent and may be misdiagnosed as CDI recurrence.
• This misdiagnosis can lead to incomplete symptom resolution despite treatment.
• Further research is needed to improve diagnosis and management of CDI-associated FBD.