June 26, 2017

Pro-biotics and FMT question

Here is a letter I got from one of my readers recently that is currently using at home fecal transplants to treat their case of Ulcerative Colitis.

Hello Michael,

I’m writing to you all the way from Denmark. I stumbled across your fmt video on YouTube and got your ebook. I must say I’m very thankful. I’m thankful that one person had the guts to put all this information out there so that people can help themselves and their loved ones with this horrible illness. Here is my story: I’m 31, never smoked, never drank alcohol (religious reasons.) I have had several antibiotic treatments over the years because of severe infections in my throat. Suddenly in march of 2016 I had massive diarrhea and bloody stools, 8-10 bathroom visits when it was at its worst. I had the first colonoscopy four months after the first signs and was finally diagnosed with Ulcerative Colitis. I am not aware of the how far the inflammation goes in my colon that is because the doctors couldn’t get in with the camera all the way. I still had too much stool even after the prep for colonoscopy and it hurt so much getting the camera in that they needed to stop the procedure and try again while I’m sedated.

Hospitals here don’t approve of fmt for colitis, however, there is a clinical trial for the pill form and in about a year it would be available to try for colitis patients. This is not for free and it is very expensive. I’m not the most patient person in the world so after having UC for “only” 9 months now I decided to take matters in my own hand and use my son and daughters fecal matter to do the fmt at home. I did 8 days straight and it helped a lot, however, I didn’t take prednisone and only took mesalamine (asacol) 800 mg 3 times a day. The fmt helped a lot. I had one solid bowel movement a day, they were firm stools but still a little bloody and with inflammation. my diet was no gluten, no sugar, no red meats and no processed foods. The diet helped a lot. I then had a break from the fmt for about a week. A lot happened and I wasn’t able to do them. I then took my doctor’s advice and started on prednisone 4 days ago. While doing 3 fmts since, it has helped a lot. I still see a little bit of blood and a little bit of gas.  However, I feel better and I firmly believe that the fmt has helped.

I get so excited every time one of my kids get a bowel movement. they are 4 and 6 years old, and they tell me every time they go poop, they don’t understand why I’m so excited but they get happy as well;)

Questions:

Should I take a probiotic while I do the FMT’s? I feel as if the fmt doesn’t get all the way through the colon and I fear that it won’t work if I only reach the first part of my colon.

I take iron, vitamin C, vitamin D and calcium. I’m waiting for my isolate whey protein powder.

Sometimes I do curcumin supplements, and I read somewhere that you took an antidepressant and that you consider it as a key factor in your healing. I’m not able to get my hands on drugs like that, will I still have the chance to heal my gut?

Thank you so much for your time and the work you put in to this website and overall keeping the awareness about fmt.

– – –

My Response

Hello Sabrina,

Thank you for your kind words and congratulations on going ahead and doing the FMTs to treat Ulcerative Colitis! I think it takes courage to be willing to take full responsibility for your treatment. I understand your impatience, because while case studies continue to accumulate and studies are underway, FMT is still many years away from being offered as a treatment option outside of controlled studies by medical doctors in most western countries. As long as you have a healthy donor the FMTs are unlikely to do any harm.

I do believe that using drugs to control inflammation is necessary for making the FMTs effective for most people with a severe case of Ulcerative Colitis. It also sounds like you have a good diet and are taking useful supplements too. There is research showing that the amino acid L-Glutamine found in protein powder among other sources helps the body repair inflammation in the colon. It just makes sense that you would need more protein to repair body tissue, just like you do to recover from a workout or from surgery.

To answer your questions

I don’t think taking probiotics from food or oral supplements at the same time you are doing the FMTs will make a significant difference in promoting healing.  This is because the volume of good bacteria and the number of different species of bacteria found in supplements is nowhere near the amount found in human stool. Most of the good bacteria that you could get from the supplements are either already found in the donor stool or are less dominant than the bacteria from stool such that they are neutralized by stool.

I don’t think taking probiotics from food or oral supplements at the same time you are doing the FMTs: I don’t think it will make a significant difference to take probiotics at the same time as the FMTs.  This is because the volume of good bacteria and the number of different species of bacteria found in

taking probiotics from food or oral supplements at the same time you are doing the FMTs: I don’t think it will make a significant difference to take probiotics at the same time as the FMTs.  This is because the volume of good bacteria and the number of different species of bacteria found in human stool is several magnitudes greater than what can be found in any available probiotic supplements. I think eating a diet that helps limit inflammation and diarrhea necessary isvery helpful. Getting adequate amounts of dietary fiber or prebiotics can be helpful to help support the establishment of the new good bacteria.

– As far as getting the solution all the way up the colon goes.  I think the best way to ensure this at home when using an enema is to use a higher amount of liquid solution for the enemas. Since the video I now recommend using two rectal syringes worth of liquid fecal transplant, which is about 16 oz / a little less than 500 ml. This is because the more solution you introduce, and come closer to filling the colon, the more likely it will get higher into the colon. I also think that after an initial period of time doing these a couple times a week and then gradually tapering down often you do the FMTs could also be helpful. That is because some bacteria can take up to two weeks to completely establish themselves after being introduced.

– As for the antidepressant drugs helping control inflammation. As I wrote on this website and in my ebook, I used Wellbutrin (Bupropion) in the immediate release form taken 3 times a day and later the Sustained Release version which is taken twice a day. I tried this because of some case studies I read, a study showing that it was a TNF inhibitor in mice, and the fact that Wellbutrin was the subject of a study for Crohn’s Disease. I do feel the drug made a significant difference for me, however, this was without a controlled study and I was doing several other things at the same time.  Plenty of other people have had success without using Bupropion, so I don’t think it is necessary for everyone to take to be successful.

It sounds like you are on the right track, keep up the good work. I guarantee you the work done to knock out Ulcerative Colitis once and for all is totally worth it!