clostridium difficile associated diarrhoea a role in inflammatory bowel disease 56 patients with diarrhoea were screened for the presence of clostridium difficile toxin in their stool the test was positive in 9 5 had severe inflammatory bowel disease and were receiving systemic steroids 2 were on steroids for other conditions 1 had been on antibiotics and in 1 there was no apparent predisposing factor in each case clearance of the toxin was associated with clinical improvement evidently cl difficile toxin is not specific for antibioticassociated diarrhoea but is associated with diarrhoea of various aetiologies often unrelated to antibiotic therapy cl difficile may be an important factor in some exacerbations of inflammatory bowel disease