Is there a line between CDI and post-infectious IBS?

There is often overlap of C Difficile and post-infectious IBS. I share recent examples of people feeling recovered from C Diff after 21 weeks to 6 months or more but still being afraid of recurrence. In my case it took 6 months and 8 days from my initial diagnosis, to believe that I was free of C difficile bacteria.

Please email me at khealth11@gmail.com with questions or feedback - I am just beginning my podcast journey and would like to make this resource useful and complete.

Recorded March 28, 2026 (v2 uploaded 10:30pm EST, Sunday, March 29).

In my next episode, I plan to address what I did to rebuild my microbiome.

Transcript

SPEAKER_00 0:01

So I wanted to give a shout out to my neighbors, David and Vivian. Yesterday they brought over some kangee and oranges and some yams. I've been under the weather. And so I don't know how I could have thanked them. And obviously, I sent them a message, thank you so much, and a little picture when I was eating some of the food. But I used that extra time. I thought, you know what, I'm gonna try to pay it forward, and that's why I had the time to record this podcast episode. And uh them uh secondly, um, I did post on Facebook yesterday asking about people's experience. Um, and I got one more response, and so I'm gonna start that off. And the question is what where's the line between C difficile infection and post-infectious irritable bowel syndrome? Um one person said she didn't know for months and that they wouldn't do follow-up testing where she lives. The labs there are pride as their call dips into their set contract too much. So another example of kind of waiting for the testing to get some certainty. And um that was certainly the case for me, but I took multiple tests and finally a naturopathic test before I finally believed it. Um so yeah, it's uh just wanted to share that one as well. This is an addendum here. I asked earlier today when I started planning this podcast episode. I asked on a C diff support group on Facebook um, how did you know when you were better? Um, I wanted to know if there was anybody that felt better immediately after treatment. Um two people said that they went on a vancomycin taper. One person would gradually feel better and then get post-infectious irritable bowel syndrome and started to think it C. diff was back again. That's why she did the taper off of Vanco, and the IBS episodes were less frequent, and then they were gone. And so one woman also responded saying the same. She's on taper for a while on Vanco, then spaced the Vanko out every three days, and only after that felt secure enough to stop. So um, yeah, it's interesting. And that compare that to my situation where I I basically had one round, I did have one round of Vancouver, and that was it. But after that, I had natural pathic treatments. I did berberine and alicin on the weekends, a lot of both, like um don't I mean four I think of each in the morning and four of each in the after in the evening or something like that. Um, then during the week, slippery elm. It was a weed and seed. So during the weekend, take out the bad stuff during the week, try to feed some good stuff, plus probiotics. So, anyway, point being that there is there's this sort of gradual improvement to your gut, rebuilding of your gut, gradual, gradually letting your gut take back over, whether it's with the vanco taper or um you know trying to do something naturopathic. Um every situation is different. I personally could not handle more bancomycin. I did not want any more. I felt so horrible when I was on it. I'm grateful for it. I think it killed the C diff and everything else. Um, and I had a long road of recovery, and I'm grateful I'm back. So I called the last one an addendum. I guess it's really a pre-dendum. I'm recording this third clip. Um, so situations where it takes a while to figure out if you're feeling better. I think I mentioned it at the end of the main segment. But some people do feel better fairly quickly, but it still takes a long time to comfortable with your gut again after all we've been through. After C diff, after antibiotics. Um, maybe you've been through cancer treatment or have some other issues that brought on that helped contribute to the C diff. Take us a while to get better. So um, but I I want to give some hope. Like I think there are situations where people feel better pretty quickly, and you just don't hear about those as much because they've moved on. It was a traumatic experience. They don't hang around the group chats or Facebook groups, um, and they're they're cured, they're free of C diff and they go along their merry way. So looking forward to hearing your story about how you got there. My email is kalth11 at gmail.com, k health11 at gmail.com. Um I have a website, cdifferently canada.org, the letter c differentlycanada.org. And just the idea that we want to look at ourselves a little differently, how we eat, how we live, what we do, uh prudent antibiotic use. Um it's not primarily an advocacy lobby organizations, just hey, let's let's little live a little differently, and you can recover from C diff. And actually, I didn't need FMT, even though I thought I did. Um, although it is the only thing that I know of people call a cure. So um, but thankfully I'm cured as well, I'm healed, I'm free. So uh hey, let's keep it up. Welcome back to the podcast on C. diffacil and post-infectious irritable bowel syndrome recovery. The subject of episode two, today's episode, is where is the line between CDI and PIIBS? Where is the line between C. diffacil infection and post-infectious irritable bowel syndrome? I'm your host, Carl Mickelsons, and I'm going to share with you um my timeline, when did I feel I was no longer facing C. diff and what I experienced in the middle. The point is, it's really hard to know if you're cured of C. diff if you just go by feel. And I'm talking about my experience after antibiotic treatment. I have heard stories of people being cured after FMT, fecal microbiota transplantation, which is not for everyone. Uh, but in in some of those cases, uh, one lady in specific I'm thinking of, one of the, if not the first woman in the US told by doctors to do that for her C. divacil, she said that once she did it, um after a couple of times, she felt better. And as I tell that story, I'm thinking to myself, well, when exactly did she feel it? After the first, after the second, after the third, the doctor told her she had to do a whole bunch of them because of how sick she was. Um, but the point for me today is it's really hard to know if you're cured or free of C diff if you just go by feel after antibiotic treatment or any other treatment that you might have, um, with that slight exception with the FMT. So let's jump into it, as I mentioned. My timeline, January 6, 2020, that's over six years ago. It's March 2026 right now, as I record this. So January 6th, six years ago, I tested positive for the C. diff bacteria and its toxins, and I was diagnosed with a severe C. divacilla infection by my primary care physician, a medical doctor here in Canada. I did another test two weeks later. This is after treatment, actually, well, January 27th. How many days is that? Um 21 days later, exactly three weeks later. And I tested positive for the C. diff bacteria, but not its toxins. And so this meant I was carrying the bacteria, but it wasn't it wasn't spitting out these toxins that were damaging my colon previously. Um normally they don't test for C diff within a certain number of days of um treatment. Uh, I'm not sure how I managed to get that test, but I was not given further antibiotic treatment at that time because I did not have toxins, but I still had blood in my stool, perhaps a little bit, but I more felt gross. I had diarrhea. Eventually I it turned to constipation and going back and forth. But at that point, I still had mushy stools. I felt pretty gross. I had stomach pain. I was just today, I was just reviewing my symptoms um tracker report. I can see if I can see if I still have it open right here. Um, well, this tracking just starts March 2nd, and I did have stomach pain for sure, June, July, and I I didn't look at March. So let me see here. March 2nd, stomach pain intensity two. So that's not much on March 2nd. Um, so let me move on. Um, but when I do tell my story, I just the way I tell it is that I'm experiencing all the same symptoms that I had during C diff, just without the blood. Um, and the only reason I said blood a moment ago is that I've been looking at the tracker, I have notes in May, June, July that I was noticing blood in my stool. But uh, you know, as I said, as I when I tell my story, I I say that I wasn't I was seeing all the symptoms except the blood. So February 14th, 2020, this is another almost three weeks later, I had another stool test because I went to the ER. The pain had moved along my colon. Uh some doctors say that you you don't have nerve endings in your colon. I don't know who told me that, and that I shouldn't be able to tell where the pain is. I could tell where the pain was. I know where my colon is and I know where the pain was moving. I also had a sigmoidoscopy which showed inflammation in the colon. So I'm not making this up. Um, I went to the ER. The pain had was was about to reach my anus, and I thought I was gonna die, I didn't know what was gonna happen. Um, and they didn't they did a stool test, um, but it was spoiled because it wouldn't, it took five days for it to reach the lab. Um, so it came back negative for the bacteria. So they didn't test for the toxins. This was a GDH by EAE test. Pardon me for sounding a little stuffy, I'm a little sick today. So uh May 27th, March, April, May, three months later, I did a PCR test, which was negative. As you can tell, I'm like, do I still have it? I you know, I felt horrible. I'm like, what's wrong? How come I can't eat salads? I hadn't been able to eat salads for a while, but how come my stomach hurts? How come I can't eat this? How come I can't eat that? I was scared to eat. And I thought I had C diff. I thought, well, what else could it be? And the answer came June, July, August, three months later, August 31st, 2020. So a full seven months, pretty well seven months after my diagnosis. I did what's called the GI map test with a natural path. Um, and this test for various bacteria, parasites, and other things, it's Mac maps out your gastrointestinal tract. Did not detect C deficil toxins A or B, so no surprise there. But what it did detect is klebsiella bacteria and E. coli. And um, I don't remember if it was somewhere I read or the naturopath told me this that those two combined mimic C. diff, but without the blood. So I took that information, or that supposed information. That's when I told my story going forward. I said, Well, I guess I had all the symptoms, but without the blood. And I thought I had C def, but it turns out I had these other things. Guess what? I was treated with vancomycin, and guess what is a common long-term effect of vancomycin? E. coli and klebsiella. There is a research article on this, and um, so this is in my head, this is all adding up. I hope it makes sense to you too. And the article was published in 2016. Uh, it says it's by S. Isaac, and you can find it uh on the journal of antimicrobial chemotherapy. Um it's on PubMed online. This is a reputable source by Sandrine Isaac. Um, so she's at the Department of Genomes Genomica y Salud, Centro Superior de Investigación and Salud Pública in Valencia, Spain. I don't know what that is. Apologies. Um Department of Jose Scher, Department of Medicine, New York University School of Medicine and Hospital for Joint Diseases in New York. Anna Jukovich from the same Valencia, Spain as Sandrine Isaac, Nuria Jimenez from the same location in Spain, Dan Littman from the Molecular Pathogenesis Program in the Kendall Center for Biology and Medicine of the Sperball Institute, New York University School of Medicine, and the Howard Hughes Medical Institute from that same school, Steve Abrahamson from the New York University School of Medicine, Eric Hamer, Immunology Program, Infectious Disease Service, Memorial Sloan Kettering Cancer Center in New York. And Carlos Ubeda from the same location I mentioned about Spain, and the centers of biomedical research network and epidemiology and public health in Spain. Sorry for the long list of names there. One, two, three, four, five, six, seven, eight names from two locations in Spain and New York. Sound like reputable schools to me. I don't know these places. Anyway, point is it was clear in my mind that okay, I didn't have C diff. I had other things to deal with. But it took me seven months to get that clarity. So that was my timeline for between three and seven months. I thought I had C diff and I felt gross. I was scared to eat because I thought I had C diff. And I was pretty lightweight. So I uh I weighed 137 pounds on February 14th, 2020, the day I went to the ER. Um August 31st, I weighed 145 pounds, so that's good. I had gained at least eight pounds. Well, now the 137 was an anomaly. Typically, I was hovering 138, 140, uh, 141, then slowly creeping up. So then from August 31st, yeah, hovered around 146, 147 until December. Then in January, all of a sudden gained a few pounds. Holidays were good to me. And then by that summer, I gained another 10, another eight, nine pounds. So um, this is because uh once a month or once a week, sometimes I weigh myself as part of the food program I was in. Now here's my timeline. When did I feel I was no longer facing C diff? I answered that question. This is part two. Is it possible that that between the testing that maybe I did have C diff, maybe I did have some of those toxins coming back? Um, so January 27th, I told you I was positive for the bacteria but negative for the toxins. Um, I I think it's possible if I had the bacteria, you know, why not? Um now the thing is I'm I was very strict, and I try to be still very strict with my diet, but I focused on what I could control, and I was quite afraid of feeding the C. diff with sugar or ruining my gut further with more antibiotics. Thankfully, I didn't need them. Um that's another story. So during those six months, I was feeling horrible, and I don't know when exactly I felt I was no longer facing C diff. I think definitely August 31st, I felt sure. Or, you know, within a few days of of thinking about that information, um, hopefully a little bit, but I was still afraid of getting it back. That that fear of recurrence doesn't go away very quickly. So returning to the topic of this podcast episode, where is the line between C diff cell infection and post-infectious irritable bowel syndrome? You can look at it in two ways here. If I'm no longer actively infected, okay, that's that's a clear line. You could say once you're testing negative, there's no tox, there are no toxins being injected. Uh on the other hand, could it be that you they inject uh, you know, like let's say for the day, it just reappears all of a sudden. But overall, your gut is rebuilding, it's able to fight it off, and and the symptoms subside. Is this something that could happen? I'm gonna say no. I'm not a doctor. I don't want to plant worries in your head. That's why I'm gonna say no. Um, but so so so that's the one way to look at are there toxins? Okay, so it's no longer C defacil infection. Now I'm just dealing with the after effects. I'm dealing with whatever else may have gone wrong in my gut. In my case, it was E. coli and club Ciella, and could have been other things, who knows? After, you know, we've been through a lot. You may have been through a lot. Um best case, let's say, well, best cases, you know, or contract C diff that you could say. Uh, another good case could be okay, it's a one-off, somehow, you know, after one course of some antibiotic you didn't need, you got sick, all of a sudden out of the blue, you're otherwise very healthy. You take one round of treatment and you're you're no longer testing positive, you're getting better. And so I'm thinking of a man I was speaking with via email that was supporting um John, a US vet, and he was treated with diffacid or fidaxamycin, which is more targeted to C. diffacil, whereas vancomycin is more broad spectrum. So in his case, he says 21 weeks out, he is pretty much able to eat um what he wants. And I'm not saying that he's just going out and eating chips all day. Um the the diet that he was letting me know kind of what he's eating, and I was asking questions, and he was asking questions. It was healthy and it was rebuilding proteins, reintroducing fats, reintroducing coffee, reintroducing um maybe even a little cake. With the coffee or something like that. And so 21 weeks later, he's he's feeling a lot better. He's still paranoid, which I think is a normal response. And um so don't read too much into the word paranoid there. Um just kind of I guess it's it's more of a wondering of oh, what if I eat this? What's gonna happen? Something gonna happen. Um, can I eat this? Can I eat that? Um so what I'm getting back to here is the fear of recurrence. Like how quickly can that go away? And how quickly can you feel better? Maybe the toxins are not reproducing or not producing, and and for me, a few months after C diff, I didn't I wasn't a carrier anymore either, according to the stool test on February 14th. Now, that one I mentioned was spoiled, so I don't know. But um in terms of feeling better, it took me quite a while. Some people maybe quicker, and in terms of dealing with the fear of recurrence, there I think there is another line between C divisible infection and post-infectious irritable bowel syndrome. Because, yes, maybe you're cured, but you're still wanting to eat and live the way that you did while fighting C def so that you don't get reinfected. So that is a subtopic of this episode, and maybe a topic for another episode. Um because you can start reintroducing things, and it is up to each individual person. Diet is so individual. That was the thing that I could control most. Like I couldn't control whether I had the C. diff back or not, whether the doctors wanted to give me more antibiotics or not. Although to a certain extent, I could ask questions about the antibiotics, and I decided I was given metronidazole and ciproflaxicin, I'm not pronouncing that right, cipro and flagell to treat um the inflammation in my colon. I took one or two doses of each. I was supposed to take both together, and my stomach hurt so much, like it was a sharp pain, and I just could not. I just decided I was not going to take any more. I'm like, you know, if I die, I die. And plus, flagell is not good for C diff. And I hadn't spoken with my infectious disease doctor about that. And so I wasn't, I just I stopped taking that. I'm glad this is a podcast, so I can ramble a bit more. All the podcasts I listened to a little bit rambly, which fits my personality very well. I am trying to keep it focused here. I have my timeline in front of me. Um trying to remember where I was going with that point, though. Focus here are what I could control. Pardon me, diet is very individual, and so um something may work for you and not. You can start challenging things when you feel ready. Uh, you might need a prod and a push from a doctor or a friend or a family member. In my case, it was I was uh I was so lightweight, I was done fighting C. difficile bacteria. So let me see here. July 19th. July 18th, 2020. I dropped 134.6 pounds. That could be when I went on a soup diet for a few days. I was complaining to somebody in a food program that I was in about the stomach pain, the discomfort, just the symptoms. He said, Well, let me give you a soup recipe. He didn't say in those words, but I have I have a soup blend, and he this is a person who lost his colon, not to C deaf, but um to type of colitis. And he had used this soup recipe. He said, There's nothing in here that will harm your colon. And it's a blended soup, it had chicken, it had spinach, um, all of this cooked. Um, the chicken bone and back, you kind of like um you could ask for the butcher to crush it or like kind of mallet it, cleave it into pieces, or you could do it yourself into one or two inch pieces. You boil, you kind of um make the broth out of that, then you take the meat off the bones and put it pot with spinach and um other greens like um zucchini, uh celery, I don't remember what else, but uh a certain type of salt, like um I don't know, sea salt or or something. Not not your regular table salt, and there are other things too. Um, you can contact me for the recipe. Uh he called it Jewish penicillin. Um, and at the risk of uh sounding insensitive, or well, I don't know what there's no reason they should sound insensitive, but just kind of a soup that Jewish mothers might give their children or give someone when they're sick, Jewish penicillin, something to make you feel better. But his point just in this was that there's nothing in this soup recipe that's gonna hurt your stomach. So I want you to have this for three days, or just just make a huge batch of it. And I was probably I was exhausted. I'm like, I can't even get to the grocery store, I can't do this. I was just like at the end of my rope, I just can't anymore. And I was on the phone in my old apartment there. I remember the the little Lean Flooring and the little galley kitchen, and he somehow you know encouraged me, convinced me to just go to the store, buy what you need, make this giant pot of soup, and it was giant, let me tell you. Like run for their money. Um I remember sitting by the stove because I was so exhausted. I would stand and cut and sit while I don't know, cooking and guess. Made the soup, ate it for three days, dropped three more pounds to 134.6. And that is when I decided, you know what? No more being afraid of eating. If I don't start eating, I'm gonna disappear into nothing. I'm gonna like either face my fear of recurrence or keep starving. So it looks like my exact date was July 18th, 2020. So from January 6th diagnosis to July 18th is um February, March, April, May, June, July, six months plus eight days, a week after uh one of my sisters' birthday. That's how long it took me to feel ready to face my fear of C def to start eating again, to start, and then priority number one was protein, getting my weight back. Um, and so that was my focus probably for a couple of months at least, reintroducing uh black beans because I couldn't tolerate fiber very well. Fiber really bothered me. Um like the uh the insoluble fiber and the roughage. So, where is the line between CDI and PIIBS? Well, for me, it was six months and eight days. Um when I both no longer had the toxins and was able to face my fear of recurrence. Um that time frame may be earlier for you. You may not have the luxury of time off work like I did. I was off work for uh for one year. Actually, from March to March. I was working from January to March, and then March, somewhere in February, I think the day I went to the ER, actually, February 14th, that was my last actual day of work because I was depleted, decimated, I was sitting there, I couldn't think. Now, what was I experiencing this part three? I was gargling my stomach, stomach pain, diarrhea and constipation, well, constipation later on, difficulty tolerating fats, occasional blood in my stool, according to my records. Um, and I mentioned that article on the short and long-term effects of vancomycin, the E. coli, the klebsiella dot I was dealing with probably for a longer time, but I didn't just to close the loop on that, I didn't take anything specifically for the E. coli or the klebsiella. The naturopath said, Carl, I need your weight up first. Um, it you'll get some protein, and then we'll fight this back to whatever this is. The only thing she said is add a little bit of cinnamon for the E. coli, and I and you can look this up. They put it on meat and things, and it's actually preventative. Like in the food industry, they use E. coli to prevent if pardon me, they use cinnamon to prevent E. coli infection. Um, so we end with some hope here. You can get better. Um, doesn't matter how you got here, doesn't matter what got you C. diff. Doesn't matter what you were treated with. You know, I say that more with a little bit of a caveat because if you were treated with antibiotic after antibiotic after antibiotic, that was gonna be the number on your system. Um and it'll might be a harder recovery. And actually, I think that's always for me because the year before CDI, C. diffacil infection for me, I had two to three rounds of antibiotics. I had two of amoxicillin, I had one of clindamycin, which triggered my C def. Um, I had other sprays and creams and like different steroids, like different things for nasal infections, uh, toe fungus, like I was, you know, other medications, I'm saying, right? So my immune system was down. So that's partly why I think it took me so long to recover. And I wasn't gonna recover just by having more of the same, more of the same antibiotics, more of the same um sweets and everything. Not that I was eating only cake, but I like my sweets. Every day I'd like a sweet drink or something, you know, besides all the vegetables and and healthy stuff that I tried to eat. I wasn't gonna get better by doing more of the same. I had to eat better. Um, I had to face the things that got me sick in the first place. And thankfully, Bancomycin seems to have done the trick. Thankfully, my stool test on February 14th was spoiled. So even if I had C diff, it said I didn't. Because it was five days late to the lab. Thankfully, I got better. I was in a strict food program. You can get better, you can do it, no matter how you got here. Um and well, there are things you can do, is what I'm saying. And and hey, if you're not to make if you're not gonna make it, let's face it, one day one day will be our last here on this earth, uh in the topic of another episode, or maybe between you and and your pastor or rabbi or or sheikh, or um ultimately between you and God. And you may have to face that fear, and I I definitely did. Um, but there are things you can do, and I got better. I was pretty rough. I've heard some pretty rough stories. Um, Linda L, I don't think she'll mind me sharing, but uh maybe she will. Um, regardless, um there are people that have been on multiple, multiple rounds of antibiotics and got better. Uh sometimes with FMT. For me, I didn't need the FMT, and I'm glad that I I did it because I had to face the things that got me sick in the first place. So um do that. Thanks for listening. Take care.