Diet

It takes a lot of work to recover from C Diff, and guess who is going to do the work? You are :)

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My philosophy was: 

• starve the C Diff

• overwhelm the C Diff with an army of good bacteria

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Starving the C Diff means not eating things that C Diff likes.

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Your colon has been taken over by an evil bacteria call C Diff. It is very strong. In addition to antibiotics, I overwhelmed it with an army of good bacteria. FMT might be the best probiotic there is. (The below will be moved to a separate page about probiotics, soon - please skip below for 

                                                       more information about diet.)

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(Still probiotics.)

​These ones worked best for
me. The dairy did bother me,
which is common with C Diff,​

but BioBest doesn't have

lactose, and I put up with the

"electric" feeling in my nasal/

chest area from the Liberté kefir.

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I used 1/2 tsp red miso paste with some meals. Not a lot - it has a lot of salt. Don't boil the red miso paste. It will kill the probiotics.​

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I also used HMF Replete, 1/2 sachet with lunch for 14 days. When finished, I dropped to HMF Forté and I think I went through two bottles. I worked with a naturopath, on a "weed" and "seed" protocol. "Weed" means weed the bad bacteria using Berberine and Allicin. "Weeding" happened on the weekends. "Seed" means seed good bacteria using probiotics. This went on for four weeks or more.

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Antibiotics or some other measure might be necessary such as FMT.

 

In terms of food, this was my protocol:​

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• no sugar, fat, salt, or spice

• no caffeine or alcohol*

• ⁠get a dietician

• consider joining a food support group

• ​​manage diarrhea​

• high nutritional value

• stay hydrated as possible (helps digestion)

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*Alcohol use disorder increases C. diff risk, particularly during withdrawal (article: Alcohol use as a risk factor for Clostridioides difficile). If you need support to quit, reach out to AA.org. If you choose to drink, weigh the risks carefully.

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Re: the risk of sugars/sweeteners - https://pmc.ncbi.nlm.nih.gov/articles/PMC12530488/#s0004 

Re: Trehalose (found in some processed foods in Canada since the 2000s, for example certain ice cream products) - https://pmc.ncbi.nlm.nih.gov/articles/PMC5984069/ ​

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Foods I Avoided

• Sugar, fat, salt, and spicy foods—believing C Diff thrives on these.

• Used cooking spray rather than oil and gradually reintroduced healthier fats.

• Processed foods, even healthy options like hummus, are often high in salt.

• Spicy foods may increase inflammation, making them unhelpful during recovery.

 

Consider Eliminating or Reducing Caffeine and Alcohol

Caffeine may be a diuretic and upset the stomach, especially during CDI, possibly causing further dehydration. I did not drink coffee before CDI, but online sources suggest avoiding it, as well as black teas during CDI.

Alcohol use disorder increases C. diff risk, particularly during withdrawal. If you need support to quit, reach out to AA.org. If you choose to drink, weigh the risks carefully.

After recovery, I can enjoy a beer socially, though I usually avoid coffee and alcohol.

 

Manage Diarrhea effectively.

• Avoid insoluble fibre (e.g., salads, legumes, raw vegetables, apples’ peel) as it may worsen diarrhea.

• Eat soluble fibre, which absorbs water and may aid hydration. Miso paste can add probiotics, but boiling destroys their effectiveness.

• Oatmeal is often recommended for diarrhea, but was a trigger for me.

• Probiotics, such as kefir and plain yoghurt, normalized gut behaviour for me. Try different kefirs/yoghurts until you find the one that is least bothersome. My dietician recommended yoghurt options.

• Some use the BRAT diet.

 

Thoughts on the BRAT Diet

• The BRAT diet is high in natural sugars and flour.

• My “rich” BRAT alternative was sweet potatoes, oat bran, and plain kefir—the “SPOK” diet.

• Refer to the appendix for recipes.

 

Stay Hydrated

Replenish water and nutrients lost from diarrhea. I used electrolyte drinks with low sugar/sweetener content during severe symptoms and drank water throughout the day, not all at once.

Tap water usually contains chlorine; I purchased large jugs of water for home use and recommend delivery services for those unwell. Drinking water can assist both weight retention and loss, though it may increase urination, especially after vancomycin.

 

Eat Foods That Soothe Your Gut and Are Easily Digested

Trust your gut. The principles I followed—avoiding sugar, fat, salt, and spicy foods—worked for me, but your needs may differ. If you find something beneficial, continue it.

 

Work with a Dietician Experienced in C Diff or Gut Issues

Not all dieticians are familiar with CDI recovery. I worked with Leigh Merotto, Registered Dietician and Owner of GutFit Nutrition, and later a local clinic dietician.

 

Avoid Personal “Trigger” Foods

Identify foods that bother your stomach over time. For me, salads, oatmeal, bread, raw vegetables, peanut butter, and excessive almond milk were problematic, though some may work for you. Many people develop dairy intolerance during CDI. The BRAT diet (Bananas, Rice, Applesauce, Toast) helps some people, but I tended to be cautious and avoided many items. Insoluble fibre also bothered my stomach, but I was gradually able to reintroduce insoluble fibre and salads.

 

Develop “Recovery” and “Flare-up” Protocols

Eventually you will reach a point in your recovery where you can begin to reintroduce/challenge foods. My dietician recommended the following recovery protocol:

• Introduce a half serving of the “challenge” food on day 1.

• If symptoms are not bad, have a full serving of the challenge food on day 2.

• Have none of the challenge food on day 3.

• Do not reintroduce other foods during days 1-3.

If your symptoms flare-up, return to eating only the foods that are least likely to cause you symptoms. This is your “flare-up” protocol.

During my recovery I first reintroduced proteins, such as black beans by gradually increasing the amounts I could eat. I also tried eating 3 or 4 meals per day depending on how big of meals I could eat and if my sleep schedule permitted a 4th meal. It took a long time to be able to eat salad again, and only after five years did I eat my first burger. This was in Tobago, and it was delicious! Travelling when you are recovering by eating healthy is difficult, but by this time I was recovered.

 

Eat Nutritious Foods

I relied on non-sugary kefir, sweet potatoes, oat bran, and homemade soup with non-salt broth as my “flare-up” protocol. Basmati rice, cooked in non-chlorinated water, is nutritious and easy to digest. Refer to the appendix for soup recipes, including “Jewish penicillin,” which was recommended for gut healing. I tolerated eggs, cooked spinach, and cooked vegetables, but avoided salad for a period post-CDI. Additional sources about nutrition through a CDI are in an Appendix.

 

I used probiotics including HFM Replete, then HMF Forté as prescribed by my naturopath. Prebiotic food increase the effectiveness of probiotics. Foods that include probiotics include kefir, yoghurt, kim chi (though this includes salt), tempeh, sauerkraut (though this includes salt), and other foods.

 

Join a Support Group (if Appropriate)

During infection, I ate less to starve the bacteria but eventually had to overcome my fear of eating. Support groups for food addiction provided valuable structure, tips, and community. For example:

• Avoid processed foods with sugar/sweeteners among the first four ingredients.

• Shop the perimeter of grocery stores for healthier options.

• Use support calls or techniques to avoid tempting foods.

While support groups offer help, always prioritize your doctor’s advice. I treated my sugar addiction and mental illness as severe diseases, finding support from sponsors and fellow members. The program provided a framework for addressing fears and emotional challenges.

During COVID-19, I joined an online support group and learned from others with food addiction, anorexia, or bulimia. The support network helped me maintain healthy habits and provided encouragement.

 

Tips on Food Support Groups

• Some sponsors understand the need for individualized approaches, but don’t use health reasons as an excuse to eat indiscriminately.

• Work with your doctor and sponsor to find a balance.

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Nutrition resources

• “Clostridioides difficile Infection: Is There a Role for Diet and Probiotics?” (Nutrition Issues in Gastroenterology, Series #202) (https://med.virginia.edu/ginutrition/wp-content/uploads/sites/199/2020/09/September-2020-CDiff-Diet-Probiotics.pdf)

• Nancy Caralla’s “Nutrition; Managing Meals through a C.difficile Infection” (Published by “The Book Patch”) (https://app.thebookpatch.com/BookStore/nutrition;-managing-meals-through-a-c-difficile-infection/f8fa5082-f073-42d1-a065-e33a8b9a62fd?isbn=9781947519565 or available on Amazon or Audible)

• https://microbiome.ferring.com/patient-c-diff-infection/#info-center

• https://cdiff.org/nutrition-guide-form/ (by the Peggy Lillis Foundation)

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