June 26, 2017

Fecal Transplants treating c. diff: conversation with a reader

The following is a conversation over email with a person who bought my book about how to use fecal transplants to cure Ulcerative Colitis. For more information check out a copy of my book about how Fecal Transplant Cures Ulcerative Colitis However the information in my book will also help you if you are using fecal transplants to treat other conditions like Crohn’s Disease and c. diff related Colitis.

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Thank you Michael!
My issue was a re-occurring C-diff infection, so I was cured in one application.  I feel better today than I have in five months.  You are like an angel to me…a miracle.  I am so happy today.  I know  many people who will benefit from your message; like my nephew, who is your age and  has suffered from Crohn’s disease for over ten years now.  I’m sending him a link to your video.
I’ve sent your link to three other people so far.  My sister-in-law, whose son is suffering from Crohn’s was so happy, she said “I finally have hope again.”
I had to do one more application this morning for a bit of a relapse, but now my gut is quiet, calm and happy….still eating soup and taking things slow. I can’t thank you enough for your thorough information.

Thanks again for your tenacity in spreading this information and your user- friendly delivery of it.

Sincerely,

Lisa

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I’m glad it worked for you, oftentimes if  c. diff is the only problem then it only takes one shot. So hopefully that will be enough.

– Michael

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Well Michael…I may have spoken too soon.

I had a relapse this week and had to go into the doctor. (I think the immunosuppressant piece may be crucial).  My doctor was very interested in the fecal transplant..and asked for the detail of how I did it.  He says that our Kaiser facility does them through colonoscope, but I would have to qualify as a candidate, so I went to see the GI doctor, but she said I don’t.  (I think you have to be practically dieing first).
I will start up again after my colonoscopy Monday.

Thanks again.
Lisa
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Yes, I do think the immunosuppressant piece is crucial and probably necessary until after the intestinal walls have gotten the chance to significantly heal from the inflammation and the new bacterial colony is well established.
The main advantage of using a colonoscope being that you can get that stuff all the way up there (literally) :) However it will most likely not be practical to have a doctor do it using that method on a regular basis day after day. This is because of availability of colonoscopy equipment and cost. So even with a doctor, you will most likely have to do your own follow-up enemas at home. Unfortunately at this time FDA restrictions do not allow doctors to use this treatment approach for Ulcerative Colitis at this time. So doing this through the vast majority of doctors at this time in the U.S. is unfortunately not really a viable option at this time.
Once again, I would combine fecal transplants with the other drugs including Prednisone to get a flare under control and then mesalamine, some sort of anti-spasmodic drug and also drugs like Wellbutrin which still seems to be helping me a great deal.
– Michael
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Thank you Michael,
When you were doing your transplants those five weeks, did you have any flair ups during that time?  If so, did you continue anyway?  How did you know when to stop?
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Hi Lisa,

Yes, I did have a returning flare, which I believed to be in part due to stopping taking Apriso too soon and not continuing to take the whey protein shakes as often. I ended up continuing the fecal transplants daily for five weeks and then going back on Prednisone after about 3 weeks and kept increasing it until I had gotten back up to 40 mg. I actually did not know when to stop the fecal transplants, I was prepared to keep going until they worked to get the symptoms under control. The reason I actually stopped them was at the request of my old GI doctor when I had to go to him to get some more Prednisone. When I started re-taking Prednisone my sense of smell came back and so I concluded that the new bacteria had successfully taken root, now I just needed to try something else which I believed meant trying some more drugs.

Then I stopped the fecal transplants for a week and then piled on the drugs, Bupropion 300 mg, Doxepin 6 mg, Apriso, mesalamine suppositories and upped the whey protein shakes to 3 times a day all on the same day while continuing on 40 mg of Prednisone. Then I had my big break through of mostly solid stool in late July 2011, and I starting tapering off the Prednisone over the next two weeks.  Then I tried to stop the Apriso, but noticed things were back sliding a little, so then I went back on the Apriso. By December 2011 I finished tapering off the Apriso and have never taken it again. Since then I have taken Bupropion on and off and sometimes Valerian root extract for sleep, which also helps stool quality. I believe that even though I have not had blood in stool since July 2011 nor periods of time with chronic, urgent diarrhea there is still some variation from time to time. I believe that diet and / or Irritable Bowel Syndrome influenced by stress and possibly some residual bacterial imbalances might still have a slight impact, but I am still better off than I have been for most of my life.

If I had it to do over again I would have started when my symptoms were as much under control as possible, especially by using drugs like Prednisone and Mesalamine. If I could I would use all of the drugs I ended up using from the beginning with the fecal transplants or starting after having done them for one week. I think limiting diarrhea and inflammation works together to make the fecal transplants effective for Ulcerative Colitis.
Michael
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Thank you for the timely response Michael.  This is helpful.
 My work just granted me a two week leave of absence to get this condition under control. I don’t have a prescription for Prednisone, but then my symptoms aren’t as severe as yours.  I’m on vancomycin and dicylomine…they are keeping things fairly calm.  I just wanted to know from you if you didn’t stop when things got rough…and it sounds like you just continued working and trying different adjustments to the meds you had….it paid off!
I will do two weeks worth of transplants and see what happens.Thanks again,

Lisa
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Well…I’m finishing 14 days of vancomycin now and plan on starting up the transplants tomorrow while in the “taper phase” of every other day.  I’m on this antibiotic for 6 weeks, and don’t want to wait another month to start putting back good bacteria.  I will continue for several weeks with the idea that the good will keep the bad from multiplying too much.
I’m lactose intolerant, so homemade soy shakes are a daily menu item….and Dicyclomine is keeping everything calm for now.  The only piece I don’t have is the immunosuppressant, but I’m going ahead without that…we’ll see.
If Kaiser agrees to do a transplant. I’ll do that as well.
Thanks Michael.  Always glad to have your insight.
Wishing you happiness always,

Lisa
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Hi Lisa,
Thanks as always for the kind words. It sounds like you’ve got a good plan, the Vancomycin should have wiped out everything, leaving a blank slate to build upon and the Dicyclomine anti-spasmodic drug should help limit bowel movements and help retain the enemas.
Even though you are lactose intolerant, many whey protein shakes are actually lactose-free, like Muscle Milk and others which you can find at most drug stores and grocery stores. However if the soy protein shakes can deliver high amounts of easy to absorb protein and is well-tolerated than that would appear to be a viable option. One thing to check it to make sure that the protein shakes lists the amino acids in it and that this includes L-Glutamine, which is specifically helpful for repairing inflammation in the body.
I believe that it is key to keep “seeding” the new bacteria through these fecal transplants past a certain tipping point where the new bacteria has firmly established itself as the new order or business. The reason I say that is at the Human Microbiome Conference in Bethesda in July, they used a chart to demonstrate that after treatment with the anti-biotic Cipro, that the pre-existing balance of bacteria would largely re-establish itself within a few weeks. If the problem is the default mix of bacteria that the immune system has become accustomed to, rather than just the presence of certain infectious bacteria, then suppressing the immune system while the immune system’s
“bacteria memory” resets itself could be one explanation for why immune suppressant drugs could help this process. Another explanation is just that the inflammation needs to be brought under control for a new, stable, helpful bacterial colony to take root.
If Kaiser will do at least one with a colonoscope that could help, and the fact that you had been diagnosed with c. diff would qualify you to receive the treatment now that the FDA has suspended enforcement of rule prohibiting the use of fecal transplants for c. diff. However the main reason doing it with a colonoscope would helpful is if the problems stems bacteria is not getting far enough up there from the enemas alone. If the problem is resetting how the immune system determines which bacteria should be there and which should not over an extended period, then just doing it once with the colonoscope will probably not be enough by itself. Fortunately the enemas stand a good chance of matching the colonoscope if you can get the mixture far enough up there by positioning your body properly.
Doing a full bowel cleanse similar to that which is done before a colonoscopy would also help make sure that the mixture gets all the way up the colon as well as significantly elevating your body and moving it so the mixture can navigate its up through the colon as far as possible should largely replicate the benefits from using the colonoscope.
Michael
Once again for more information about fecal transplants and to have your own questions answered, check out a copy of my book about how Fecal Transplant Cures Ulcerative Colitis