# FECAL TRANSPLANTS: A Guide



## wildbill_52280

*FECAL TRANSPLANTS and how they could cure IBD.

While this guide discusses home-based fecal transplants, the opinion of Crohnsforum.com is that they should be done under the supervision of a trained clinician as fecal transplants are potentially dangerous. ALWAYS discuss any potential treatment with your doctor.* - Forum Admin



Fecal Microbiota Transplants(FMT) have induced sustained drug free remissions in both forms of Inflammatory Bowel Disease(IBD) and may have cured some cases of IBD in small trials, according to Gastroenterologist Doctor Thomas J. Borody MD, Ph.d. Details of these reports are listed in section 1.

There are 14 clinical trials planned for the use of fecal transplant in both forms of IBD. In this post you will find out everything about them. Fecal transplants restore missing bacteria in IBD patients by obtaining them from healthy donors stool, mixing a stool sample with saline solution in a blender and giving it to the patient as an enema. This procedure has been performed successfully at home, but if your decide to do it, be sure to read the papers in the post below for expert instruction, don't just jump into it, donors need to be absolutely healthy. http://www.cghjournal.org/article/S1542-3565(10)00069-8/fulltext

Latest studies in IBD show reduced diversity of healthy bacteria that regulate the inflammatory response when compared to groups of healthy people without IBD. Therefore, it is believed by some scientists that the restoration of the bacteria in IBD patients will correct the abnormal inflammatory response. So far we have some good scientific evidence this may be the case, but it will take time to prove this theory with absolute certainty. With official reports of UC and Crohn's patients maintaining a drug free remissions for as long as 25 and 13 years, this provides some compelling supportive evidence that they may have been cured by FMT.

Other ways of performing a fecal transplant are orally through a nasogastric/duodenal/jujenal tube or pill form which is currently in development. So far the studies have shown when donors are well screened with blood tests and meet health criteria, this is generally a safe treatment.


*My experiences with Fecal Transplants: *In this thread i have posts which detail my experiances with FMT, I was trying to find a way to make a FMT pill which proved pretty difficult. I tried FMT 4x with 3 different donors, only one FMT led to improvements, such as gaining 10 pounds in 10 weeks, improved bowel movements, lowered anxiety, but the majority of my other symptoms remain so I will have to find a new donor and try it again, but I'm convinced doing this again will likely reduce the severity of my disease even more.

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*Outline 
1. History of Fecal Transplant in IBD: Its success so far
2. Clinical Studies Currently in progress
3. Testimonies.
4. General Information
5. How to select a Donor
6. How to perform a Fecal Transplant*


------------------------------------

*1. History of Fecal Transplants in IBD: Its Success So Far.


Dr. Borody Background*
These studies were done by a doctor in Australia, Thomas J. Borody who is trained in Gastroenterology in addition to other education and experience in scientific research.

Educational/Career background on Doctor Borody.
BSc (MED) (HONS)(Bachelor of Science), MBBS (HONS)(Bachelor of medicine, Bachelor of Surgery), MD(Doctor of Medicine), PhD(Doctor of Philosophy), FRACP(Fellow of the Royal Australasian College of Physicians), FACG (Fellow of the American College of Gastroenterology), FACP (A Fellow in the American College of Physicians), AGAF (American Gastroenterology Association Fellow)

Link to his website where this information was derived-
http://www.cdd.com.au/pages/clinical_staff.html

Here is a link to the U.S. National Library of Medicine /National Institute of Health where a search on his name will show some of his published contributions to various Medical/Scientific journals, search results on this database reveal 74 references to his name which illustrate more documentation of his professional experience. These references date from as recent as 2013 to as far back 1979, spanning about 34 years.
http://www.ncbi.nlm.nih.gov/pubmed/?term=borody+t



*Fecal Transplant Studies on IBD* -

*1989* – Doctor Borody first used fecal transplants in 55 patients with a wide range of Gastrointestinal disorders ranging from constipation, diarrhea of unknown cause, Crohn’s disease and ulcerative colitis. 20 were considered cured. 9 were improved and 26 were unchanged. At least one of the cured patients were cured of Crohn’s disease and one of ulcerative colitis. This is an early study so it was unknown how many times a transplant may have to be done to get any results.

http://www.cdd.com.au/pdf/publications/All Publications/1989-Bowel-flora alteration a potential cure for inflammatory bowel disease and irritable bowel syndrome, Med J Aust, vol 150, issue 10 p604.pdf


*2003*- Doctor T.J Borody tried this therapy on 6 patients with ulcerative colitis, that elimated all signs of disease symptoms without drugs ranging from 1-13 years after therapy. These patients are considered to be potentially cured since there is no sign of disease, no longer need medication beyond 2 years and they remain disease free to this day. This study was published in the journal of clinical gastroenterology.
http://prdupl02.ynet.co.il/ForumFiles_2/28701499.pdf

*2011*- The same researcher Dr borody reported results in a group of patients with Crohn’s disease and all patients obtained remission without drugs. These were severe cases that didn’t respond to any medication before doing the fecal transplant. The results and details of this study were presented at the American College of Gastroenterology’s (ACG) 76th Annual Scientific meeting in Washington, DC in November of 2011. Here is the Official news release from the American college of gastroenterology-
http://d2j7fjepcxuj0a.cloudfront.ne...2011acg_fecal-transplant-cdiff_FINAL_1025.pdf

    references for the 2011 fecal transplant study on crohn’s
Some reports of the ACG meeting in 2011 on various news websites
http://www.medicalnewstoday.com/releases/236885.php
http://www.sciencedaily.com/releases/2011/10/111031114945.htm

*2013*
July- 14 year old boy with crohns achieves remission with FMT -http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3742951/?report=classic

September- Early results from the mcmaster study, news segment-
http://www.ctvnews.ca/health/experi...tionize-treatment-of-bowel-diseases-1.1445800

November - man with severe crohn's disease achieves complete remission without drugs and with only one fecal transplant delivered orally.
http://www.ncbi.nlm.nih.gov/pubmed/24222969?dopt=Abstract

November- patient with crohn's responds to fecal transplant
http://www.ncbi.nlm.nih.gov/pubmed/24239403
FULL TEXT
http://ecco-jcc.oxfordjournals.org/content/8/3/256



*2014*

March- Woman remains in remission for 13 years after recieving an oral fecal transplant for Crohns disease, she may have been cured. http://www.abc.net.au/news/2014-03-18/sydney-doctor-claims-poo-transplants-curing-diseases/5329836

additional source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3868025/
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3868025/figure/F2/

May-Mcmaster Ulcerative Colitis Study.
Mixed results, some bad responses while some very good responses to FMT.
http://www.medscape.com/viewarticle/824930

August - Beth Israel deaconess Medical center Crohn's Disease,
After 4 weeks of follow-up, 55% had clinical response; 36% were in clinical remission.
http://www.healio.com/gastroenterology/inflammatory-bowel-disease/news/online/{13d3a6cd-6dde-4871-b904-21770537217d}/fecal-microbiota-transplant-improved-symptoms-in-patients-with-crohns-disease

*2015*

January-Crohn's- 23 out of 30 patients achieve remission with one oral administration of Fecal Transplant.
http://www.ncbi.nlm.nih.gov/pubmed/25168749

March-Crohn's-
http://journals.lww.com/ibdjournal/...icrobial_Transplant_Effect_on_Clinical.7.aspx



*Fecal Transplant History of use for C. Difficle Infection.*

Here are some reports about the latest study on Fecal Transplants  outperforming standard Antibiotic therapy for C. Diff.-
http://www.cbsnews.com/8301-204_162...cs-for-curing-diarrhea-caused-by-c-difficile/

Here is a link to the actual study published in the New England journal of medicine 2013
http://www.nejm.org/doi/full/10.1056/NEJMoa1205037#t=abstract

EXCERPT from the study-
“The study was stopped after an interim analysis. Of 16 patients in the infusion group, 13 (81%) had resolution of C. difficile–associated diarrhea after the first infusion. The 3 remaining patients received a second infusion with feces from a different donor, with resolution in 2 patients. Resolution of C. difficile infection occurred in 4 of 13 patients (31%) receiving vancomycin alone and in 3 of 13 patients (23%) receiving vancomycin with bowel lavage (P<0.001 for both comparisons with the infusion group). No significant differences in adverse events among the three study groups were observed except for mild diarrhea and abdominal cramping in the infusion group(fecal transplant) on the infusion day.







Here is a quote by University of Minnesota Doctor and Researcher Alex Khoruts
some info on him- http://www.med.umn.edu/gi/faculty/khoruts/

"Those of us who've been doing this procedure(fecal transplant) for some time didn't need any more convincing, but the large medical community needs to go through these steps," Dr. Alexander Khoruts, a gastroenterologist at the University of Minnesota in Minneapolis who was not involved in the new study, told Nature. "It's an unusual situation where we have more than 50 years of worldwide experience and more than 500 published cases, and only this far along does a randomized trial appear.”

link to quote- http://www.cbsnews.com/8301-204_162...cs-for-curing-diarrhea-caused-by-c-difficile/




*2. CLINICAL STUDIES: Currently In Progress*


These studies were found on www.clinicaltrials.gov. To verify their existence, enter the identifier code into the website search engine.

    -----------------------------------------
Pediatric Inflammatory Bowel Disease(Ulcerative colitis)
Helen DeVos Childrens Hospital (HDVCH)  
Grand Rapids, Michigan, United States, 49503
ClinicalTrials.gov Identifier: NCT01560819
Estimated Primary Completion Date: May 2013

recently released study results April 4, 2013-
http://www.sciencedaily.com/releases/2013/04/130405112859.htm

excerpt-
“Results showed that, 78 percent subjects achieved clinical response within one week while 67 percent subjects maintained clinical response at one month after FMT. Thirty-three percent subjects did not show any symptoms of ulcerative colitis after FMT. Patient's clinical disease activity (PUCAI score) significantly improved after FMT compared to the baseline. No serious adverse events were noted. “Patients often face a tough choice between various medications that have significant side effects. Allowing the disease to progress can lead to surgical removal of their colon," said Dr. Kunde. "Our study showed that fecal enemas were feasible and well-tolerated by children with ulcerative colitis. Adverse events were mild to moderate, acceptable, self-limited, and manageable by patients."


----------------------------------------------------------
Ulcerative Colitis
University of Washington  
Seattle, Washington, United States, 98103
ClinicalTrials.gov Identifier: NCT01742754
Estimated Study completion Date:               April         2013
------------------------------------------------------------------------
Ulcerative colitis
Academic Medical Center
Amsterdam, Netherlands, 1100DD
ClinicalTrials.gov Identifier: NCT01650038
Estimated study Completion Date:                December 2013
------------------------------------------------------------------------
Ulcerative Colitis
Hamilton Health Sciences / McMaster University  
Hamilton, Ontario, Canada, L8N 3Z5
ClinicalTrials.gov Identifier: NCT01545908
Estimated Primary Completion Date:    March    2014

-----------------------------------------------------------------------
Crohn's Disease
Beth Israel Deaconess Medical Center  
Boston, Massachusetts, United States, 02215
ClinicalTrials.gov Identifier: NCT01847170
Estimated Enrollment:    20
Study Start Date:    May 2013
Estimated Study Completion Date:    April 2014
-------------------------------------------------------------------------
Crohn’s disease and Ulcerative colitis
Seattle Children's Hospital  
Seattle, Washington, United States, 98105
ClinicalTrials.gov Identifier: NCT01757964
Estimated Primary Completion Date:            December 2014
--------------------------------------------------------------------------
Crohn’s Disease
Medical Center for Digestive Diseases, The Second Affiliated Hospital of Nanjing Medical University
Nanjing, Jiangsu, China, 210011
ClinicalTrials.gov Identifier: NCT01793831
Estimated Study Completion date:               December 2014
--------------------------------------------------------------------------
Ulcerative Colitis
Medical Center for Digestive Diseases, The Second Affiliated Hospital of Nanjing Medical University
Nanjing, Jiangsu, China, 210011
ClinicalTrials.gov Identifier: NCT01790061
Estimated Study Completion Date:               December 2014
--------------------------------------------------------------------------
Ulcerative Colitis
University of Chicago Medicine    Recruiting
Chicago, Illinois, United States, 60637
ClinicalTrials.gov Identifier: NCT02058524
Estimated Enrollment:    20
Study Start Date:    June 2013
Estimated Primary Completion Date:      June 2015
------------------------------------------------------------------
Ulcerative Colitis
University of South Wales
ClinicalTrials.gov Identifier: NCT01896635
Estimated Enrollment:    80
Study Start Date:    September 2013
Estimated Study Completion Date:    September 2016

-------------------------------------------------------------------------
Ulcerative Colitis
Texas Children's Hospital/Baylor college of medicine  
ClinicalTrials.gov Identifier: NCT01947101
Estimated Enrollment:    10
Study Start Date:    December 2013
Estimated Study Completion Date:    December 2016

---------------------------------------------------------------------------

Crohn's Disease
Gastroenterology department, Saint Antoine Hospital  
Paris, France, 75571
ClinicalTrials.gov Identifier: NCT02097797
Estimated Enrollment:    18
Study Start Date:    March 2014
Estimated Study Completion Date:    February 2016
------------------------------------------------------
IBD both forms
Department of General Surgery, Jinling hosptal,Medical School of Nanjing University    Nanjing, Jiangsu, China, 210002
ClinicalTrials.gov Identifier: NCT02016469
Estimated Enrollment:    30
Study Start Date:    December 2013
Estimated Study Completion Date:    February 2016

--------------------------------------------

--------------------------------
IBD both forms
Wolfson Medical Center, Holon, Israel.
ClinicalTrials.gov Identifier: NCT02033408
Estimated Enrollment:    20
Study Start Date:    January 2014
Estimated Study Completion Date:    January 2016

------------------------------------------------
Seattle Children's Hospital, David Suskind.
ClinicalTrials.gov Identifier:NCT02272868
Estimated Enrollment:    32
Study Start Date:    October 2014
Estimated Study Completion Date:    October 2016
*3. TESTIMONIES.
-*

_*Testimony #1*_

This is the best testimony I have found so far because it is so detailed. This is a guy who used his son and his wife as donors. You don’t have to watch the entire videos, you can skip to the parts I have defined in the summary to verify the story. You will notice in the last video that the energy in his voice changes and his speaking ability improves a bit and his mood seems slightly improved, which are signs his health has is improving due to the fecal transplants.


Video #1 –  



video length- 33 minutes

Summary of video/skip to these parts-
2:52- 30 years old, Married for 8 years, Bachelors degree in Business Adminstration, Self Employed, Works in financial services industry, Healthy most of life. Has had ulcerative colitis for about 5 years.
7:20- Took antibiotics for 2 years for staph infections on legs, he suspects the antibiotics had something to do with his development of IBD as symptoms appeared while on antibiotics.
9:50 - Description of  initial onset of disease.
14:30-19:00 Describes symptoms before doing the fecal transplant which include Fistula, fissures, hemmorhoids. Starting transplants on meds @ 40 mg prednisone recently at 80mg. explains all the medications he has tried during the course of his disease for IBD.
26:00 when and how he heard about fecal transplants


Video day#3-



Summary
1:25  bowel movement frequency reduced from 20X per day to around 2x per day, in about 5 days


Video Day #20 



2:50 almost entirely off of medication at this point. he’s generally still doing very well bowel wise and feeling pretty good.
6:00  encourages people to try it, considers it a miracle for him and his condition.


Latest update April 30th, 2013- 




0:00-3:30 gained 30 pounds since starting fecal transplants, eats a normal diet now and most symptoms are gone without medication.
    3:30-7:32- tips on how to perform the transplant




*Testimony #2*-

His screen name is Dr. Briggs and he is a university physics professor who is trained as a scientist and who has done the treatment successfully at home using his wife as a donor.
link to the forum discussion where this testimony was found- http://www.healingwell.com/community/default.aspx?f=38&m=2541306&p=4

summary- he has had ulcerative colitis for 12 years, then later was diagnosed with crohn’s disease. He suspects that a course of antibiotics had something to with him developing IBD.
symptoms before starting the Fecal transplant were 3 bm’s per day, previously he has had up to 20 per day. after the transplants he averaged 2 bms a day and he was able to eat foods that used to cause his symptoms to worsen, this indicates a major change occurred in his ability to digest food.

    A few quotes from his fecal transplant experience-
posted on 11/27/2012
Dr Briggs-
“So, things are going very well. To recap - I was diagnosed with UC about 12 years ago, and spent time on sulfasalazine and prednisone with no benefit (15-20 bloody very loose stools a day), then eventually Remicade after developing a fistula. I was on the Remicade for a little over 7 years, which partially controlled things (5-7 loose stools a day, no bleeding as long as I got infusions every ~11 weeks).
I am now off all medications, and doing great. Two well-formed stools a day.”

Posted 2/28/2013 1:14 PM

Dr briggs- “Sorry for not responding sooner (a lot sooner) - with my UC seeming to be completely gone, I'm getting caught up in other things, so I have to remind myself to occasionally check out this thread.
Potatoes are often not well digested if you have a compromised GI system, they have lots of complex starches in them. I can eat them now without problems, but before the transplants they gave me issues - and early on after the transplants when I ate potatoes they would give me a very mushy stool afterwards (I have continued healing since the transplants, and now tolerate everything very well it seems - except wheat). “




*Testimony# 3 *

Here is another testimony from a women with the screenname bustersmom, she avoided a colectomy by doing a fecal transplant at home using her husband as a donor-
link-http://www.crohnsforum.com/showthread.php?t=15548&highlight=bacteriotherapy

post# 139
I have Crohn's disease and was on Flagyl and Cipro for over two weeks and got three abscesses. I figured i had nothing to lose by trying the transplant. I waited three weeks after finishing the antibiotics and was in bad shape. abscesses were terrible. I did the transplant daily for a while and the abscesses, Two which were large, Began to shrink every day. After a month they were gone, and made NO fistula! I haven't had one bit of trouble down there since. I believe the transplants work. I don't know if it works all through the colon, but it worked on me in my lower colon and i was a complete mess. Bree


Testimony#4

"Last Fall I went to Sydney Australia on a vacation and while I was there I looked into their programs and research. I found FMT. Fecal Microbiota Transplantation. I was grossed out and said oh hell no. Still, the more I studied and read the more it seemed worth a try. So, I called my doctor here and asked if I could be in one of the clinical studies. Unfortunately there wasn't one here. Only in Portland Oregon. He happened to know the doctor running the study though and offered me another way to treat myself at home. My husbands stool was tested for HIV, Hep A B and C, C Diff, and he passed all the tests with flying colors. So, we bought a retention nozzle, enema bag, tons of Zip lock freezer bags, went through training with our nurses so he could help me complete the series of enemas and my flora was checked and measured by my doctor every other week 7 days after each treatment. I was really sore down there from all the surgeries so instead of 7 days of back to back enemas we changed it to once every other week for 2 months.
I felt it was my last hope and I wanted to try something because nothing else seemed to work and I just wanted to become a guinea pig if I could. 4 months after my (home treatment) I went in for a scope, except some scarring from the past issues I had no inflammation, no diarrhea, no pain, and had started to work out again. I have felt better this past year than I have since I was 26. I have my life back! I have not been on any meds for 6 mos and after my scope today I was told I was in complete remission. (They still don't know how long it may last or if it will.) Right now I feel normal, no pain, no D and I have energy again!"

source-
http://www.crohnsforum.com/showthread.php?t=48939

*4. GENERAL INFO*
Here are some general videos explaining how this treatment has potential for IBD and many other diseases. Various environmental toxins and even antibiotics are suspected to be involved in damaging intestinal bacteria, which may contribute to developing these conditions.



*Video Interview of Professor Lawrence J. Brandt. *
Here are some credentials/education: Chief Emeritus of Gastroenterology and Professor of Medicine and Surgery at the Albert Einstein College of Medicine. He also has been performing studies on fecal transplants in C difficile in the U.S. since about 1999. C difficile is very similar to Inflammatory Bowel disease which the mains symptoms are chronic diarrhea and often include colonic inflammation just like inflammatory bowel disease.

Link to verify Professor Brandt’s credentials http://www.einstein.yu.edu/departme...gy-liver-diseases/faculty/profile.asp?id=2519



Part 1- 



-talks about his experience studying fecal transplants for C. Difficile Infection.

Part 2- http://www.youtube.com/watch?v=ot7e9bQO2U8
-his opinion on fecal transplant overall safety, and its potential for other diseases.

Part 3- http://www.youtube.com/watch?NR=1&feature=endscreen&v=u8eNvAVfc0M
SUMMARY-
1:10  history of fecal transplant in veterinary medicine
2:18 different routes of administration of Fecal transplant
3:00 self/home administration of fecal transplant
4:00 more on the future and potential of Fecal Transplant
5:38 mentions pill form as the final future method of administration in the future for fecal transplant.


here is an article published on February 13, 2013 by Lawrence J. Brandt and another professional which was published in current opinion in gastroenterolology

Fecal Microbiota Transplantation: Past, Present and Future
Olga C. Aroniadis, Lawrence J. Brandt
Curr Opin Gastroenterol. 2013;29(1):79-84.
link to article-
http://www.medscape.com/viewarticle/776501_1


*Video, By Cara Louise Santa Maria* - Science educator, Masters
Degree in Neuroscience
link-  http://www.youtube.com/watch?feature=endscreen&NR=1&v=kLB5Pasjjis



Here is a very well written article On FMT by  KSS , a member of this website. there are testimonies of people who have tried Fecal transplant in this article.
http://diyehr.com/analysis-of-crohn...e-peer-to-peer-observational-treatment-study/


Article for TIME magazine in June 2012 about microbiome research-
http://healthland.time.com/2012/06/14/the-good-bugs-how-the-germs-in-your-body-keep-you-healthy/


http://commonfund.nih.gov/hmp/overview


Dr. Martin Blaser has studied the role of bacteria in human disease for over 30 years. He is the director of the Human Microbiome Program at NYU. His new book was just published and discusses the new evidence suggesting antibiotics have contributing to rising rates of diseases like Crohn's by killing off good microbes. - http://martinblaser.com/

http://www.npr.org/2014/04/14/302899093/modern-medicine-may-not-be-doing-your-microbiome-any-favors

http://www.amazon.com/gp/product/08...iveASIN=0805098100&linkCode=as2&tag=yoadsu-20

--------------------------------------------

*5. How to Select a Donor*

Overall, as long as the Donor is in good health, there is very little risk with doing a fecal transplant. Even in some of the documents below they reported bypassing blood tests and health screening for some patients who chose a donor that was a family member that they knew and trusted, buts it probably best to take precautions.  All the criteria for selecting a healthy donor and directions for what blood tests they need were obtained from these two papers, one of which was written by doctor Borody and other professionals in the field.



Requirements:
NO ANTIBIOTICS IN LAST 6 MONTHS, OR EVER IS BEST.

NO Gastrointestinal COMPLAINTS LIKE FREQUENT DIARHEA OR CONSTIPATION/excessively firm stool that is hard to pass, blood, No Mucus  in stool  or intestinal pain. You should have a generally regular stool frequency of 1-2 bowel movements per day.


Absence of metabolic syndrome- http://en.wikipedia.org/wiki/Metabolic_syndrome
Symptoms and features are:
-Fasting hyperglycemia — diabetes mellitus type 2 or impaired fasting glucose, impaired glucose tolerance, or insulin resistance
-High blood pressure
-Central obesity (also known as visceral, male-pattern or apple-shaped adiposity), overweight with fat deposits mainly around the waist
-Decreased HDL cholesterol
-Elevated triglycerides
Associated diseases and signs are: hyperuricemia, fatty liver (especially in concurrent obesity) progressing to NAFLD, polycystic ovarian syndrome (in women), and acanthosis nigricans.

No autoimmune conditions- list of conditions-
link- http://womenshealth.gov/publications/our-publications/fact-sheet/autoimmune-diseases.cfm#d

No allergic diseases - asthma, atopic dermatitis (eczema), allergic rhinitis (hay fever), food allergies



Required Blood Tests for donors- full blood count, liver function,
Negative viral screening for HIV 1 and 2,  Hepatitis a, b, c. cytomegalovirus, Epstein Barr Virus, Syphilis.



Some studies have bypassed donor screening only in cases where close family members have been selected as donors.

None of the Testimonys I listed in sections #4 of this paper mentioned taking the suggested  precautions to follow the donor selection criteria, as most were able to get help from family members who they were confident were healthy. I plan on taking full precautions no matter how healthy my donor is, or whether they are a family member or not. I also have additional criteria that go beyond the advice listed here.

The papers below is where i found most of this information. It is not required that you read these papers with the web links listed below, but if you would like to look them up to verify they exist, feel free to do that.

Article 1
Details on page 3-
http://www.2ndchance.info/inflambowel-Hamilton2011.pdf

Article 2
Details on page 479-
http://www.cdd.com.au/pdf/publications/paper12.pdf




    Recommended diet for donors- this will encourage all the good bacteria in your intestine to grow and make it a more potent medicine.
    High fiber foods, like whole grain oats and wheat
Berries.
    eat at least one apple per day.
    veggies.
    if you smoke, reduce your smoking as much as possible.

Things to avoid- anything with aspartame or saccharin in it, excessive meat. excessive amounts of processed food in packaging as it may contain preservatives that inhibit bacterial growth.
over consumption of meat-  beyond 8 ounces in a day would be excessive.

other tips-
if you become sick or get food poisoning while  doing the transplants you will have to stop until you become better.

--------------------------
*6. How To perform a Fecal Transplant*

_chapter a work in progress_


RECTAL METHOD/BY ENEMA
I have not included yet any details on how the transplant is done in any precise way, but typically it is done by making a solution of  saline (.9% sodium chloride solution/aka salt water) mixed with stool in a blender and giving it as an enema to retain in the body for 6-8 hours or as long as your body can hold it. I will add more very soon but i think it's all here if you want to figure out the details for yourself, otherwise i will soon give some better instructions to make it easy for people to try themselves. There are some details on page 5 and 6 of this paper by doctor borody.
http://www.cdd.com.au/pdf/publications/paper12.pdf

how to make saline solution at home-Quick instructions- mix one gallon of distilled water with 4 teaspoons of salt(preferablly pharma grade neti pot salt) in a pot and stir on low heat so salt easily dissolves. this will make a gallon of saline solution.

.9% sodium chloride w/v solution is expressed as a mass concentration weight/volume solution. in other words, it is telling us how much mass of a certain substance is dissolved within a volume of a fluid.  in this case, 100 milliliters of a fluid. and in this case sodium chloride aka salt. So there is .9 grams(just shy of one full gram) of salt dissolved in every 100 milliliters of h20 aka water.

_more to come..._


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## ***Lisa***

Thank you for posting this, Wildbill! I have been trying to find this info in one location and here it is! My daughter goes to a GI from a large hospital and when we asked about it, they said they are not doing them now, but will be "soon." How can the donor have their stool tested if GIs refuse to run test it for us? Please keep posting anything you find! The FMT is very promising and needs to be made available to the general public ASAP.  Thanks again!


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## wildbill_52280

I wont claim to be an absolute expert on this but here is some information.

you can order these tests yourself through online companies like labtests online, here is a link- 
http://labtestsonline.org/understanding/analytes/stool-culture/tab/test
http://labtestsonline.org/understanding/analytes/op/tab/test

but i would say testing the stool may not be necessary for a fecal transplant donor, unless they are a complete stranger, who may give a biased/inaccurate report on their health status. Otherwise if they are a friend or family member you can trust to tell you about gi system abnormality, testing the stool is not necessary. But testing for hiv and hepatitis should always be done for a donor.

It will be easy to tell if the person's gi tract has been infected by some pathogen, as they will have symptoms like diarhea etc. that lasts for a few days. There is only one other exception and that is certain parasites that may persist without symptoms. i would say that risk is very minimal and non serious and in almost every case, diarhea would be a symptom of this infection which your donor would inform you of if they are honest and trustworthy.


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## wildbill_52280

*News Update*

FDA Grants Fast Track Designation to Rebiotix for Its Microbiota Product for Recurrent Clostridium difficile Infection. Wall Street Journal, June 24, 2013
http://online.wsj.com/article/PR-CO-20130624-906399.html?mod=googlenews_wsj




*What is REBIOTIX?*

all the descriptions are vague, but its basically a "preparation" of live bacteria to solve current problems of giving someone a fecal transplant. I believe they are talking about a creating pill to take orally, but they don't say this anywhere, nor describe the product in development. 



*What is the fda fast track development program?*

The FDA Fast Track Development Program is a designation of the United States Food and Drug Administration (FDA) that accelerates the approval of investigational new drugs undergoing clinical trials with the goal review time of 60 days. Such status is often given to agents that show promise in treating serious, life-threatening medical conditions for which no other drug either exists or works as well.

http://en.wikipedia.org/wiki/FDA_Fast_Track_Development_Program


having some sort of fecal transplant pill would be cool, although im not positive that is what they are developing. but what other kind of product would they be developing and selling right?


----------



## wildbill_52280

*Best Pract Res Clin Gastroenterol. *
2013 Feb;27(1):127-37. doi: 10.1016/j.bpg.2013.03.003.
Fecal transplant: A safe and sustainable clinical therapy for restoring intestinal microbial balance in human disease?


Source
Department of Internal Medicine, AMC, University of Amsterdam, The Netherlands.

Abstract
Recent studies have suggested an association between intestinal microbiota composition and human disease, however causality remains to be proven. With hindsight, the application of fecal transplantation (FMT) does indeed suggest a causal relation between interfering with gut microbiota composition and a resultant cure of several disease states. In this review, we aim to show the available evidence regarding the involvement of intestinal microbiota and human (autoimmune) disease. Moreover, we refer to (mostly case report) studies showing beneficial or adverse effects of fecal transplantation on clinical outcomes in some of these disease states. If these findings can be substantiated in larger randomized controlled double blind trials also implementing gut microbiota composition before and after intervention, fecal transplantation might provide us with novel insights into causally related intestinal microbiota, that might be serve as future diagnostic and treatment targets in human disease.


----------



## wildbill_52280

a new video that is related

http://www.youtube.com/watch?v=Ke0_ye5Jjqs&feature=c4-overview&list=UUnjXYJADimmVAiSq9YtfGlA


----------



## wildbill_52280

more updates:

*The Problem of DIY Fecal Transplants*
If the FDA continues to heavily regulate the procedure, people will do it themselves.
ANDI L. SHANE    JUL 16 2013, 9:02 AM ET

http://www.theatlantic.com/health/archive/2013/07/the-problem-of-diy-fecal-transplants/277813/


----------



## wildbill_52280

here is a great new testimony of someone trying a Fecal transplant.

http://www.healingwell.com/community/default.aspx?f=38&m=2799459


----------



## 723crossroads

wildbill_52280 said:


> here is a great new testimony of someone trying a Fecal transplant and also provides an example of why i have developed a way to encapsulate fecal material to be taken orally:
> 
> http://www.healingwell.com/community/default.aspx?f=38&m=2799459


Thanks WildBill.
I was interested in knowing about this and it did help me understand what it is all about. I hope the capsules become mainstream and can be prescribed.


----------



## Beach

wildbill_52280 said:


> here is a great new testimony of someone trying a Fecal transplant and also provides an example of why i have developed a way to encapsulate fecal material to be taken orally as enemas are difficult to perform correctly and reach entire affected colon up as far as the ileocecal valve, and especially for crohn's which involves the ileum and small intestine where an enema would never reach.
> 
> http://www.healingwell.com/community/default.aspx?f=38&m=2799459


I used to work in the encapsulation industry.  When I saw this, in a way made me chuckle in that I can see companies hesitation in bringing fecal matter into their facilities.  They would do it I'd imagine once QC was satisfied, just the sanitation issues that would need to be resolved.    

You might not be interested in mentioning due to proprietary reasons, but what route are you looking at, softgel or two piece?


----------



## wildbill_52280

*Rebiotix Receives FDA IND Approval to Begin Phase 2 Trial of Pioneering Microbiota Restoration Therapy*
Reuters.
Mon Jul 29, 2013 5:10pm EDT

Rebiotix Inc. announced today that the U.S. Food and Drug Administration has approved the company’s Investigational New Drug (IND) application to begin the Phase 2 clinical study of RBX2660 for the treatment of recurrent Clostridium difficile infection (CDI). If successful, RBX2660, a preparation containing live microbes designed to rebuild a healthy intestinal microbiome, has the potential to become the first FDA-approved drug based on the human microbiome.

*About RBX2660*
RBX2660 (microbiota suspension) is a preparation containing live microbes designed to rebuild a healthy intestinal microbiome.

Fecal transplant, the predecessor to microbiota restoration therapy, has demonstrated high rates of success in curing recurrent CDI in clinical studies. However, the non-standardized and unappealing processes involved in sample preparation, in addition to expensive and time-consuming donor screening, are limiting factors for patients and physicians. RBX2660 is designed to solve these problems and, if clinically successful, is anticipated to be physician friendly, ready to use, and available on demand.

*About the Planned Clinical Study*
The PUNCH™ CD study is designed to assess the safety of RBX2660 (microbiota suspension) for the treatment of recurrent Clostridium difficile-associated diarrhea (CDAD). Secondary objectives of the multi-center, open-label study include gathering efficacy information, data to assess patient quality of life, and cost-effectiveness of the therapy.

full article- http://www.reuters.com/article/2013/07/29/mn-rebiotix-inc-idUSnBw296437a+100+BSW20130729


they still havent said whether or not this is a fecal transplant pill or what the live bacteria preperation actually is, but i still anticipate it is a fecal transplant pill.


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## rollinstone

so this trial is going to be for Cdiff? Then hopefully for Crohns


----------



## wildbill_52280

Joshuaaa said:


> so this trial is going to be for Cdiff? Then hopefully for Crohns


the time will come, but so far the evidence we have for crohns and fecal transplants is only good, but not great. so some doubt remains whether it can ever be as effective for crohns as it has been shown to be for ulcerative colitis. i believe the protocol for treating crohns with a fecal transplant has to be improved somehow, such as following a special diet, only taking bacteria in an oral capsule daily or even multiple times a day and taken simultaneouly with fiber. not until extreme measures like this are added to the protocol will we begin to generate better results for crohns.

the soonest studies on fecal transplant for crohn's isnt until december 2014. we may have to wait another year from that until they build upon the results of that study, to show that there IS STILL potential for fecal transplant for crohn's.

for me it is a matter of interpretation of current evidence. people may interpret the lack of dramatic success of FMT for crohns as meaning, "see, FMT isnt working as good as is for UC, therefore, no further studies are needed" and i say to that, the protocol just needs to be different, that is why the results have been different, because of differences in nature of crohn's compared to UC. The evidence that exists doesnt prove that FMT will not work for crohns, therefore, potential still exists, and not until the fecal transplant pill is tried in crohns will we start to see any good results for crohns. there are currently no plans on doing it this way that i am aware of from searching clinical trials.gov or reading almost every study that exists, although they do mention oral route may be better for crohns, just no mention of the use of pills or the nature of a protocol that differs from the status quo.


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## wildbill_52280

relevant news article:

http://www.examiner.com/article/fecal-microbiota-transplantation-for-life?cid=rss


----------



## sir.clausin

One thing that I´ve noticed several times...is that everytime someone else have used a toilet before me, their "aftermath" smells so much more than my shit...the smell is very strong and profound, but mine never smells too much. I wonder if that is a evidence of a diverse flora vs simplified flora?!? I don´t know if you guys have ever noticed.


----------



## ***Lisa***

sir.clausin said:


> One thing that I´ve noticed several times...is that everytime someone else have used a toilet before me, their "aftermath" smells so much more than my shit...the smell is very strong and profound, but mine never smells too much. I wonder if that is a evidence of a diverse flora vs simplified flora?!? I don´t know if you guys have ever noticed.


I've noticed the same thing with my daughter who has CD. The stinkier her BMs, the better she feels.


----------



## sir.clausin

Lisa: Very interesting indeed, as it does not matter if it´s an adult or a kid, like today at the indian restaurant, very distinct odor...almost "personal". Funny thing though, Before I was diagnosed I never had this odorless poop.

Hopefully my FMT next month will fix this.


----------



## wildbill_52280

relevant video:

http://www.youtube.com/watch?v=JVSvbR_sU14


----------



## Rabbita

Vets are def way ahead of doctors.  They don't need 8 years to get through the clinical trials.


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## sir.clausin

FMT: What works and what doesn´t 

http://thepowerofpoop.com/interview-with-fecal-transplant-doctor/

Wildbill: I know you are a strong believer of FMT for Crohns too and Kiny is not for example, only time will tell, but it says that FMT for crohns is unsatisfying. 

I wonder and might be so:

UC: Gut dysbiosis
Crohns: "Gut dysbiosis+leaky gut+?


----------



## wildbill_52280

sir.clausin said:


> FMT: What works and what doesn´t
> 
> http://thepowerofpoop.com/interview-with-fecal-transplant-doctor/
> 
> Wildbill: I know you are a strong believer of FMT for Crohns too and Kiny is not for example, only time will tell, but it says that FMT for crohns is unsatisfying.
> 
> I wonder and might be so:
> 
> UC: Gut dysbiosis
> Crohns: "Gut dysbiosis+leaky gut+?


great article and thanks for showing it to me. 

here is his direct quote:



> *What kind of successes and non-successes have you seen with FMT?*
> 
> We’ve had excellent results with C. diff. and UC. Our success rate for the treatment of C. diff. is nearly 100% and for ulcerative colitis it is in the range of 70 to 80%. We’ve also seen IBS-D predominant patients reduce their diarrhea significantly. The use of FMT to treat Chrohn’s patients has been disappointing.
> 
> - See more at: http://thepowerofpoop.com/interview-with-fecal-transplant-doctor/#sthash.Oib7agGW.dpuf


ok, so he is not giving very much information about his experiances or methods, and certainly not enough quality information for me to completely change my position. and my position is, he is right, crohn's will at first be more difficult to treat then UC, this is what i always anticipated. this is likely because of the protocol being used. Recurrent daily applications by oral infusion(gastric, doudenal, pill form) is when you will see better results for crohns disease, and also in addition to dietary changes. 

We also still have other good sources of information for us to believe there still is potential for FMT with crohn's such as borody's experiments on crohn's patients which seemed successful. so even though its not absolutly clear yet whether crohns will be cured or can be treated with a fmt, there has not ben enough good studies yet. There are more reasons for us to believe that potential exists, then to falsely, or  conclude too early, that it absolutly doesnt work at all.


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## wildbill_52280

here is a testimony of a person who used a Fecal transplant to treat her IBS, and she says it seems like she is cured. 

http://www.reddit.com/r/IAmA/comments/1jzjmp/iama_longtime_sufferer_of_ibs_who_is_now_cured/

FYI tho, the use of FMT for IBS has been documented in the scientific literature already, but im not sure if any more studies are in the works or not. if not now, then very soon there will be more studies for IBS.


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## wildbill_52280

Here is another testimony/news article of a person who used Fecal transplant to treat crohns disease.



> Some, like Toronto resident Charlie Curtis, are even using the treatment for inflammatory bowel diseases. Now 24, Curtis began suffering from Crohn’s disease about five years ago. It got so bad, at one point he lost 65 pounds in two months. He was in severe pain, visiting the bathroom up to 30 times a day to pass blood. It was so debilitating, he dropped out of university several times. He tried standard antibiotic treatment, “massive amounts of steroids,” alternative treatments and special diets, all to no avail.
> His mother, Sky Curtis, researched bacteriotherapy, hooked up with some supportive doctors, including Dr. Thomas Borody from Australia, an international leader in the field, and a year ago began helping Charlie with fecal transplants, using her own stool.
> “In five years I have never felt this healthy,” exclaims Charlie, who last month had a colonoscopy that showed no trace of the disease. “My chest filled up with sunshine. It was amazing.”



published in the toronto Star, Apr 03 2011
http://www.thestar.com/life/health_...ry_fecal_transplant_as_cure_for_superbug.html


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## sir.clausin

Ah, ok that´s Skys son, heard about here a friend of mine have spoken to her as guidance while doing FMT. I wonder how that chinese study is going


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## rollinstone

is the chinese study for crohns or c.diff?


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## sir.clausin

Crohns
http://clinicaltrials.gov/show/NCT01793831


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## rollinstone

wow I hope its successful


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## wildbill_52280

Joshuaaa said:


> wow I hope its successful


http://clinicaltrials.gov/show/NCT01793831
scroll down to where it says "assigned interventions".


it states: 


> Procedure: FMT
> Standard FMT, once



then to the scroll down to the detailed description:


> Detailed Description:
> The present clinical trial aims to re-establish a gut functionality state of intestinal flora through FMT as a therapy for CD. We established a standard bacteria isolation from donated fresh stool in lab. Then the bacteria is transplanted to mid-gut (at least below the duodenal papilla) through regular gastroscope. Patients from multi-clinical centers in this study will be assigned to receive FMT only once or traditional treatments according to associated guidelines and follow-up for at least one year. Blood tests, abdominal X-ray, endoscopy and questionnaire will be used to assess participants at study start and at study completion.



so this study is transplanting it through the oral route/ through a duodenal tube, but only once. Its highly unlikely this will lead to any long term changes, similar to the recent study with one single FMT application through colonoscopy for ulcerative colitis.

at this point i am happy they are trying this for crohn's disease, but afraid that without changing the protocol we will not be able to see the true potential of FMT for Crohns. that's why i say, do not wait for them to be done messing around with this already proven safe therapy. its already been like 30 years since some of the first experiments on UC, even though things are moving quite faster these days in general, they could be moving much faster.


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## VetGirl

WildBill, do you know if duodenal tube has a better efficacy rate with Crohn's than enema/colonoscope (either anecdotally or study-wise)? FMT make alot of sense to me - as a Vet student, I'm not really grossed out by it, I'm really intrigued. If I decide to go down the FMT route (trying to get symptoms, etc under control first, as I'm newly diagnosed) I'd like to give it the best chance of working as possible.


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## wildbill_52280

VetGirl said:


> WildBill, do you know if duodenal tube has a better efficacy rate with Crohn's than enema/colonoscope (either anecdotally or study-wise)? FMT make alot of sense to me - as a Vet student, I'm not really grossed out by it, I'm really intrigued. If I decide to go down the FMT route (trying to get symptoms, etc under control first, as I'm newly diagnosed) I'd like to give it the best chance of working as possible.


off the top of my head, i dont think its ever been done for crohn's this way yet, at least officially. i believe until we have a fecal transplant pill that's the day you will see great results with crohns, but they have had some good success with daily enemas too. really not much evidence overall though just a few soso studies. buts its the theory and accumulating bulk of science that supports it that is so very strong, urging more studies to be done now. do them right now lots of them lets see what this can do, its safe, and already shows some efficacy. for the most part its started tho, still waiting on that fecal transplant pill tho.


----------



## Malgrave

http://www.sciencedirect.com/science/article/pii/S1369527413000830


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## wildbill_52280

podcast of a women who used fecal transplants to correct polycystic ovary syndrome, and other issues she believes were brought on by antibiotics.

http://scdlifestyle.com/2013/08/how-a-fecal-transplant-saved-karens-life/


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## wildbill_52280

just reading a new article in new york times, and this person was tracking their gut microbiota during a  course of amoxicillin and observed many negative changes. i have always suspected my crohns to have been caused by a course of amoxiciliin i took in feb 2008, now here is another piece of info that supports my theory, in addition to what i have found in scientific literature. 

http://www.nytimes.com/2013/05/19/m...crobiome.html?pagewanted=1&_r=2&ref=magazine&



> One of the more striking results from the sequencing of my microbiome was the impact of a single course of antibiotics on my gut community. My dentist had put me on a course of Amoxicillin as a precaution before oral surgery. (Without prophylactic antibiotics, of course, surgery would be considerably more dangerous.) Within a week, my impressively non-Western “alpha diversity” — a measure of the microbial diversity in my gut — had plummeted and come to look very much like the American average. My (possibly) healthy levels of prevotella had also disappeared, to be replaced by a spike in bacteroides (much more common in the West) and an alarming bloom of proteobacteria, a phylum that includes a great many weedy and pathogenic characters, including E. coli and salmonella. What had appeared to be a pretty healthy, diversified gut was now raising expressions of concern among the microbiologists who looked at my data.
> 
> “Your E. coli bloom is creepy,” Ruth Ley, a Cornell University microbiologist who studies the microbiome’s role in obesity, told me. “If we put that sample in germ-free mice, I bet they’d get inflamed.” Great. Just when I was beginning to think of myself as a promising donor for a fecal transplant, now I had a gut that would make mice sick. I was relieved to learn that my gut community would eventually bounce back to something resembling its former state. Yet one recent study found that when subjects were given a second course of antibiotics, the recovery of their interior ecosystem was less complete than after the first.


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## rollinstone

I was on doxycycline for ages for my skin, I think that played a part but its impossible for me to prove it.


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## wildbill_52280

Joshuaaa said:


> I was on doxycycline for ages for my skin, I think that played a part but its impossible for me to prove it.



They have identified that particular antibiotic as a risk factor for ibd already, and for crohn's in particular.

http://www.internalmedicinenews.com...ibd-link-considered-worrisome/ef9dbae8ac.html


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## rollinstone

I wish I could sue haha


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## william4

my son had a amoxicilan in sept 2012 dx crohns  march 2013


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## william4

Science News
... From universities, journals, and other research organizations
 Save  Email  Print  Share Fecal Microbiota Transplantation as Effective Treatment for C. Difficile and Other Diseases
Aug. 22, 2013 — Fecal microbiota transplantation (FMT) has emerged as a highly effective treatment for recurrent Clostridium difficile (C. Difficile) infection, with very early experience suggesting that it may also play a role in treating other gastrointestinal (GI) and non-GI diseases. The topic is examined in the Review Article, "An overview of fecal microbiota transplantation: techniques, indications, and outcomes" in the August issue of GIE: Gastrointestinal Endoscopy.


--------------------------------------------------------------------------------

Share This:

3 
Fecal microbiota transplantation refers to the infusion of a suspension of fecal matter from a healthy individual into the GI tract of another person to cure a specific disease. FMT has received public attention recently with the publication of several studies showing that stool is a biologically active, complex mixture of living organisms with great therapeutic potential for Clostridium difficile infection and perhaps other GI and non-GI disorders. C. Difficile is a bacterium recognized as the major causative agent of colitis (inflammation of the colon) and diarrhea that may occur following antibiotic intake. The disruption of the normal balance of colonic microbiota as a consequence of antibiotic use or other stresses can result in C. Difficile infection. It is now estimated that 500,000 to 3 million cases of C. Difficile occur annually in U.S. Hospitals and long-term care facilities.

According to authors Lawrence J. Brandt, MD and Olga C. Aroniadis, MD, Montefiore Medical Center, Bronx, New York, current first-line treatment for C. Difficile includes cessation of the culprit antibiotic, if possible, and treatment with metronidazole, vancomycin, or fidaxomicin, depending on disease severity. Most patients with C. Difficile initially respond to this treatment, but recurrence rates are 15 percent to 35 percent. Patients who have one recurrence have up to a 45 percent chance of a second recurrence, and after a second recurrence, up to 65 percent of patients will have a third. Recurrences are usually treated with additional courses of metronidazole, oral vancomycin, or prolonged oral vancomycin in various pulsed-tapered regimens, occasionally "chased" by other antibiotics such as rifaximin. The high recurrence rates of C. Difficile prompted the need for alternative therapies, to which the authors believe FMT offers a rational and relatively simple approach.

The Review Article addresses FMT methodology, including donor and recipient screening, donor selection, how FMT is performed and safety. FMT is most commonly performed via colonoscopy; however, donor feces also have been administered via a nasogastric or nasoenteric tube, gastroduodenoscopy, and enema. All the studies have reported remarkable cure rates without serious adverse effects directly attributable to FMT. The article notes that current literature on FMT for C. Difficile predominantly comprises single-center case series and case reports, but also a meta-analysis, two systematic reviews, and one recently published randomized, controlled trial. In all, 92 percent of patients were cured of their recurrent C. Difficile, with a range of 81 percent to 100 percent. 

In the only long-term follow-up study of FMT to date that included 5-medical centers and 77 patients who had FMT, the patients experienced a 91 percent primary cure rate and an astounding 98 percent secondary cure rate, the latter defined as cure enabled by use of antibiotics to which the patient had not responded before the FMT or by a second FMT. Patients in this study had symptoms for an average of 11 months before FMT, and most (74 percent) reported resolution of diarrhea within three days. FMT also has been successfully used to treat a variety of other GI disorders including inflammatory bowel disease, irritable bowel syndrome, and constipation. There is a growing literature on an altered intestinal microbiome in these and other disorders.


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## wildbill_52280

*update on my fecal transplant:* 

i found a donor, but they are 2 hours away so we are just waiting for our schedules to line up. im hoping they wont drop out on me, but it seems they are dedicated to helping me do this. well here i go, as soon as me and my donor can hook up!! hopefully anywhere from today to one week from now. i will keep you updated!!




*RANT:*why am i going through these lengths to cure(maybe) my disease?? i dont know, you could call it years and years of frustration leading to anger of the current medical system in looking for advice from doctors on health, and getting careless stares while I suffered from acne and other issues. I recall reading all the acne message boards of people that have taken accutane 2,3,4,5, and up to 6x and still had acne. i realized, they(doctors scientists) dont understand the human body nor how it works....yet. NEVER did i get advice on dietary science in any of my doctors visits(philosophical differences). in the end i learned i could improve my diet and my skin also improved quite a bit, i guess i dont see accutane as my final option anymore this = hope, when previously i only thought the drugs were THE ONLY WAY i almost commited suicide when i seemed to have a bad reaction to accutane in 2007. so when i was devastated with the diagnosis of crohns in 2009, i had a very different attitude from the beginning and also noticed that with dietary changes, i could improve my disease progression and state, but it didnt cure it. but why has both diseases dramatically effected by diet? and why so many testimonys similar to mine on these acne message boards?? why was the SCD diet and its theory so helpful to managing my IBD symptoms? this would begin my obsession with science,philosophy and intestinal bacteria as a possible explanation for all of these(and more) health problems. its somewhat become my life's mission, one of the many.

I read a book by an (old)scientist elie metchnikoff, which theorized gut bacteria to somehow play a large role on longevity and involved many disease states, now i believe we are on the brink of explaining many diseases(beyond genetic), and fecal transplants might be the wave of the future of medicine, and guess what, poop is free!! and most tragically, 50 years of outdated popular theories of disease states or germ theory of disease and the resulting proliferation of antibiotics have only made us become sicker!!!

 interestingly, my mother has been active in alternative health circles for years, she had told me about the horrors of antibiotics years before, me being a little bit on the side  scientism(only scientists and scientific methods can produce knowledge) so i thought i could easily ignore these warnings from laymen right?, and also not truly understanding to scientific process as far as putting some value on testimonys, didnt think much of it. but in these alternative health circles it was "common knowledge" that antibiotics can damage your health. and guess what, now with what science is understanding and verifying, it is looking like those testimonys are factual. i have enough scientific data now to prove almost conclusively that augmentin(amoxicillin-clavulanic acid) could have caused my crohns disease. if not conclusively then at least a 99% probability. 


maybe im crazy, but im the crazy guy who has read the literary works of some of the greatest philosophers and scientists in history, if thats what crazy people do then, call me nuts!! i have risked death multiple times just to avoid any further medications and to learn how the human body really works, which now i believe meds are mostly safe, but unfortunatly thats the route ive taken. right now im taking lialda, but i only take  one pill a day, as any more brings on symptoms of joint pain. who knew a cause of IBD joint pain was the very medication we are taking!!! insane. but the lialda barely improves my symptoms, only helps a little. turmeric is more effective really.


i do realize that this may not cure my crohn's, but the potential is there. i realize that these things need to be proven scientifically, but that's exactly what im going to do. i suppose that's what they would call a bias, but its also called independant thinking and also what scientists are supposed to be good at, giving your own reasoning and observations, merit, sometimes, over and above others, even supposedly more educated others. mainly to reach a true understanding of the universe, and not for insane some ego trip. i definitely took the time to read all existing theories and ideas, and im in no way arrogant or on some ego trip, im here to learn the truth and live a better life.


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## rollinstone

Goodluck brother, keep us posted, I got my fingers crossed for you, just remember one pill might not be enough, especially when you have different types of phylum there that may inhibit the donors bacteria from sticking, I hope it goes well, keep us posted and stay safe


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## wildbill_52280

I basically use SCD diet principles and that alone has me at one solid bm a day without any meds, except one lialda a day which i confirmed is not responsible at all for my bowel control, it is the scd principles, as whenever i stray from them, diarhea immediately returns. 

So for the most part, i am controlling the bad bacteria with SCD, or keeping the levels very low.


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## wildbill_52280

thin mice given fecal transplant from obese human becomes obese. 
obese mice given fecal transplant from thin human become thin. 



Published: September 5, 2013
new york times By GINA KOLATA
http://www.nytimes.com/2013/09/06/h...s-can-slim-mice-down.html?pagewanted=all&_r=0


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## rollinstone

have u started ur transplants yet dude?


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## wildbill_52280

found a new study on fecal transplant for U.C. i will add this to the guide in my first post.

http://clinicaltrials.gov/ct2/show/NCT01896635?term=colitis+transplant&rank=4


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## wildbill_52280

Joshuaaa said:


> have u started ur transplants yet dude?


I hooked up with my donor.
 I may start today or tomorrow havent decided yet.


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## rollinstone

maaan those clinical trials are near where I live! except theyre for UC, ohwell promising either way


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## wildbill_52280

its official!!

i took my first fecal transplant pill 40 minutes ago.


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## rollinstone

keep us posted man


----------



## Tracy Mac

Anecdotal evidence suggests that Crohn's is harder to cure with fecal transplant and is only one part of the recovery toolbox, however it can definitely help. Check out Genevieve's FMT Success Story at the Power of Poop website. We also have two members on the FMT facebook group who have gone into remission with FMT.


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## rollinstone

I think its ileitis that is supposably a little bit harder, colonic crohns is a different sub-type in my opinion, I think if the microbial balance can be restored that will be half the problem fixed for some but maybe 100% for others, fingers crossed either way.


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## wildbill_52280

well after my first pill yesterday, im still alive!!!! no bad effects to speak of. 

way too soon to conclude very much but 2 hours after taking the pill i seemed to get a slight energy boost, and each time it would have reached an effected area i seemed to hear and feel some slight gurgling sensations, which were not clearly related to the fecal transplant pill, but may have indicated something positive going on, definitely nothing getting worse tho. also when everything would have hit my ileum and colon, ~4-6 hours after taking it with the a meal, i experienced increased physical strength it seemed.Low energy and low physical strength is something i have dealt with and is a symptom of active crohn's/IBD.

so my interpretation from this first experience is that something may have changed positively in bodily functions and symptoms related to disease, but the effects may have  been too weak to clearly come to any conclusions, but i passed the first test and that is, i experienced no bad effects associated with the pills i made, so today i will take 3 pills with my first meal instead of one, although this still may be too weak of a dose.

as tracy mac stated, existing evidence suggests it is much harder to treat crohn's with a fecal transplant then U.C. it seems with crohns you need a strong enough application of FMT, that is sustained for it to have a good effect, im not sure i will be able to achieve this with the pills i have made, if i have to take 15-20 pills a day then that is actually not too hard but making them is more difficult then taking them, but i have almost got my method perfected by now. 

just a reminder tho, i have my diarhea under control with my diet of no lactose or sucrose/Specific Carbohydrate Diet diet, and this i assume/hope will make it easier to make the new bacteria re-establish themselves, eliminating the need for multiple full strength enemas, but much of this is unknown territory and i will have to change my strategy according to the evidence i find in my experiences.

 also, another option is to take it with a fiber supplement such as inulin, which is classified as a prebiotic. currently im taking it with a bowl of oatmeal, which has fiber that the bacteria can feed from, but may not be as powerful of a prebiotic when compared to inulin.


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## Igor_Passau

you have to use pills that will be resistant to gastric juice otherwise all bacteria will be not survive!


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## wildbill_52280

Igor_Passau said:


> you have to use pills that will be resistant to gastric juice otherwise all bacteria will be not survive!


no they will survive, this is the route they took at birth to get in the gut. Acid resistance/tolerance is a way to define a probiotic bacteria anyway.


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## wildbill_52280

> The bacterial cocktail pill that Rebiotix is working on is not derived from fecal material but from bacteria that the company believes to serve as foundations for a healthy human digestive system. This may be the first in a 21st-century wave of probiotics that are FDA-approved for microbiota restoration therapy in ill patients.


http://www.medicaldaily.com/rebioti...cteria-based-medicine-combat-c-diff-infection

for those of you who have been keeping up with this issue in this thread, i finally found an article that claims that rebiotix is definitely making a fecal transplant pill. but one issue is, its NOT based on the full fecal flora, so it is unlikely this will ever be used to treat IBD and if they do try it, it will likely not be as effective as the full flora, but i do not know this for sure yet. this may be bad news for us. but we may still look forward to treating IBD with a donors stool, and perhaps later the real fecal transplant pill will arrive, but as of now, there is nothing i know of beside the company rebiotix that is making one.

i also bet this is the real reason the fda started to tightly regulate fecal transplants,  as before(like not even a few months ago), they didn't seem to care which doctors did them, until the massive potential was understood. Then perhaps a company needed control over their market. ok sorry for the conspiracy theories!! but it does make me wonder though why when we knew little about them and very uncertain, they were not controlled,but now we know they are pretty safe so they have increase the regulations and they are harder to get?? sounds ass backwards because if the fda is truly protecting us, the regulations would have been tighter because we knew so little. could they be protecting big businesses sometimes too, rather then us? in this case, i dont see why they would want to tighten regulations when the safety profile is become greater. only other reason is that the good evidence that exists now may encourage many more to try it, and i suppose, they should know how to do it right, by someone with experiance in the health field and a proper education. 

either way, real poo is almost certainly better! maybe the work im doing is valuable after all!!


----------



## sir.clausin

Wildbill: I strongly believe FDA etc. will do all in their Power to regulate and don´t come out with a Product that could cure people. Why would they? Everything is about Money, so yes I believe in the Conspiracy theory. 

It´s when you become ill, when you really start to see things in another perspective. It´s all about keeping people in enough good shape so that they can go to work.


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## wildbill_52280

UPDATE: i said earlier my fecal transplant pills may not have had any bacteria in them, but now it seems some changes are taking place. so my 1st attempt at the fecal transplant pill project may not be a complete failure just yet. 

the changes are both simultaneously good and bad, so im not sure if things are being corrected or not.  but i think its safe to say, some changes have taken place as a result of the fecal transplant pills i made. it could be another week before i have any better answers then this.

Trying real hard to make accurate judgments here and not think wishfully or falsely interpret any of my observations, nor lead anyone on. i will readily admit a "temporary" failure, but, i cant say i failed just yet because of the peculiar changes taking place. 

stay tuned!!


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## sir.clausin

That´s awesome news!


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## rlslmshdy

This is great Wildbill.  Any chance of you giving details of how you made your fecal transplant pills.  Also I would think you would need to up your doseage a lot.  When you compare the amount of fecal matter your ingesting compared to a Fecal transplant enema.


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## wildbill_52280

i'll post my conclusions and experiances in a few days. 

I will NOT be taking any more of the pills i made. But i will be making a second attempt with improvements. making a fecal transplant pill is alot harder then i had imagined.


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## sir.clausin

I thought I´d bring some good news. A close friend of mine sent me this SMS: 

"After 85 daily FMTs to treat Crohns Colitis, I had a scope today which showed no signs of inflammation. This is a milestone considering I've pretty much always had inflammation the past 15-years."


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## sir.clausin

We have the same GI and now that GI is a believer in FMT


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## kss

I've just published a blog post about FMT. I used Crohnology members who have tried it. The survey sent to users was modeled after the only review paper on FMT for IBD (2012). It basically adds 6 people to the total. The reference section is robust and raw data provided.

Please see: Analysis of Crohnology’s Fecal Microbiota Transplantation Users: An Open Source Peer-to-Peer Observational Treatment Study


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## wildbill_52280

yet another new study for fecal transplants, this time, and FINALLY, another one for crohn's disease. 

previously there were only 2 studies for crohns and  6 for Ulcerative Colitis. now this new study will total 3 for crohn's. this is a total of 9 studies most ending in december 2014, one ending in 2016 and one recently completed for ulcerative colitis.

i will add this to the list of clinical studies  in the first post.

http://www.clinicaltrials.gov/ct2/show/NCT01847170


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## wildbill_52280

UPDATE:
summary of experiment-
the changes i experianced were 30% positive 70% negative for reasons i may now understand. I made some mistakes, so i am making another attempt in a few weeks. I cant really recommend this to anyone just yet, but if i am successful i will take the time to give more details about my experience. Otherwise there is not much to say if it doesn't seem to work, its kind of risky too. if you want to try a fecal transplant, try an enema. 


more details-
all these results were based on no dietary changes, meaning i ate the same thing every day that i have eaten for the previous 2 months so nearly every bodily change is a pure reflection of the fecal transplant pills i took so as to make a fair judgement of the fecal transplant pills. these are the results of taking only one dose on one single day. before this experiment i have a bm 1x a day every day, no blood no mucus and firmness ranging from generally soft to firm and moist but not super hard or dry. so i started out pretty healthy and normal from following SCD principles.

2 days after taking the pills which would have represented the results of the pills, i had an obvious increase in bm volume and softness, without any mucus which i interpreted as a slight improvement in bowel health, as a result of taking the pills.

the next day i had another bm that was 3-4x the volume i would typically have compared to the previous 9 months or so, and very soft, there was a slight amount of mucus in this bm with no blood. i interpreted this to mean an improvement in bm health, with some uncertainty about making a qualitative judgement of the presence of mucus, tentatively, i will say that is a decline.

i then started to have increased tenderness in affected areas, and some acute moments of severe pain, then i had a day where i was constipated and had no bm. around this time i had some psychological effects of increased depression/emotional sensitivity. i tentatively interpreted this to mean a decline in health.

the next day was a relief of previous days constipation and came out at a normal time, along with what would have been my normal bm for that day. there was some discolorations and a noticable amount of mucus. the constipated bm was firm and dry and the remaining half of that bm was relatively soft, and more healthy.

the next 2 days my bms were very large soft with hardly any mucus or blood, i interpreted this to mean an increase in health. and possibly the worsening of pain and tenderness to possibly be a severe die off reaction of pathogens OR the pills i made were severely damaged from what had come from the donors body due to how i processed them. the pain and tenderness was now decreasing. my skin health improved, and now it seemed like my abdomen felt very squishy, where typically the places that are inflammed are firm or hard most of the time. i believe inflammation was lower now from where i started. but after the meals when i eat my refried beans, i still felt slight bloating and firmness in only one area. so improvements weren't uniform in entire intestine, but there were some. 

today- now i'm constipated again for seemingly no other reason other then whatever the pills did to me/still doing, as nothing in my diet changed. and my psychological function has been fluctuating, i'm still having periods of depression i didnt have before, but they are definitely getting less then they were at its worst, so most of negative effects from the pills are fading away, it is taking a while though. i still have what seems to be less inflammation in some parts of my intestine, so i hope i retain some of these benefits and the negative effects continue to reside. my energy levels seemed to increase for 3-4 days after taking the pills, then they seemed to decline or go back more towards where i was before taking them, so not sure what that means.



im not sure if i accounted for all days of experiment here but that's my best for now. so you see, its hard to judge whether my experiences would be considered normal or good, i believe the noticeable negative effects i experienced would be abnormal, as i have never heard anyone describe doing enemas to have effects like this, but its also could have been from it being so effective that it killed of so much bad bacteria, and supposedly they release the lipopolysaccharide stored in the cell wall when it bursts, and when alot of them die at once, it can increase disease activity, so that may be considered a good thing.   either way i still believe the pills were not made right but im still not changing anything in my diet and taking notes to see where my disease will eventually end up as i recover. so i will say i experianced 30% good and 70% bad effects due to the fecal transplant pills and will improve the process and try it all again since i'm obviously still alive and still recovering and retained some minor benefits.

*UPDATE:*
sept 21 -constipation relieved

sept 22- had a nice bm with slight mucus no blood. reduction in inflammation still noticable. today i believe i have completely recovered from the psychological side effects of ft pills. energy is back to about where i was before ft pills, as it first increased then declined after the ft pills, now it seem i am where i was before ft pills. so i suppose i have retained the improvements from doing this and all side effects seem to be about 95% gone.




more thoughts- im wondering if the reason im fluctuating in bm quality and symptoms is a sign that i did get some good bacteria to repopulate my gut, and the irregular patterns in side effects and beneficial effects are from them gaining ground, and everytime they come across some bad bacteria, hell breaks lose. of course this is completely theoretical.


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## kss

Excellent reporting Wildbill_52280! 

If you try stuff and it doesn't work that's valuable info too.


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## wildbill_52280

related video:

https://www.youtube.com/watch?feature=player_embedded&v=VbPdrqdXx0g#t=53


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## kss

Wow, YouTube has everything! Unbelievable. If you want feel free to post that in the comments section of http://bit.ly/1bm7R2y


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## mf15

Here is some new info as to what is going on with the gut bugs after
FT for uc.
Old Mike
http://www.ncbi.nlm.nih.gov/pubmed/24060759


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## wildbill_52280

this isnt directly related to fecal transplants, but more about potential causes of inflammatory bowel disease, and a step closer in the direction of "proving" antibiotics can cause IBD, something that i personally theorize and suspect.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3705454/
Streptomycin-Induced Inflammation Enhances Escherichia coli Gut Colonization Through Nitrate Respiration


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## wildbill_52280

this is just a cool article on fecal transplants that  i found.

http://onlinelibrary.wiley.com/doi/10.1111/1751-7915.12047/full


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## wildbill_52280

sir.clausin said:


> One thing that I´ve noticed several times...is that everytime someone else have used a toilet before me, their "aftermath" smells so much more than my shit...the smell is very strong and profound, but mine never smells too much. I wonder if that is a evidence of a diverse flora vs simplified flora?!? I don´t know if you guys have ever noticed.



i thought of your observation when i read this. it is a article i found on the american society of microbiology website blog written by a surgeon or something who says when antibiotics first came out he saw many people gi system destroyed from unregulated doses of antibiotics and they starting giving them feces in pills to restore the flora and it was able to restore their issues.  the report of healthy bowel having a strong odor and damaged flora having little odor was something i thought peculiar.



> The physician in question, who I will simply call Dr. S, thought after examining and talking to patients who had not “felt right” after their surgery had suffered from the aftereffects of the antibiotics that had been given them to sterilize their bowel flora before surgery. The feces of many of these patients would yield no growth on blood agar plates and MacConkey agar for days after their surgery. (We didn’t do anaerobic cultures in those days though). The stools were even odorless. Few stools can make that claim. S thought that their normal flora had been disrupted by the antibiotics. ‘Healthy bowels, and regularity made a happy patient”, he said.


http://schaechter.asmblog.org/schaechter/2013/05/fecal-transplants-in-the-good-old-days.html


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## wildbill_52280

just wanted to let everyone know im still planning on making a second attempt at a fecal transplant pill with many changes/improvements. The time frame is about 4 weeks from now. working hard everyday though on my next plan! 

also, i emailed alexander khoruts from the university of minnesota who is a leading researcher in fecal transplants and owns patents on these processes to perform fecal transplants and to make fecal transplant pills. the email was just to obtain information of any upcoming study's for the use of a fecal transplant pill to treat crohn's disease, he said at the moment he wasn't aware of any, but he is doing a study on treating c diff infection with a fecal transplant pill.


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## Amaze

This sounds gross lol. Best of luck. I read your reports and I don't see improvements. Correct me if I'm wrong. Hopefully that stem cell thing I hear about works.


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## wildbill_52280

Amaze said:


> This sounds gross lol. Best of luck. I read your reports and I don't see improvements. Correct me if I'm wrong. Hopefully that stem cell thing I hear about works.


I agree with you, its confusing for a novice. if you only decide to read some of the information here then you are not going to understand what is going on, and what sense to make of everything. also, there is information i'm not giving here either, that i will make more clear later on.

i did have about 5 days of zero inflammation during the second week after taking my fecal transplant pills, but now i'm almost entirely where i was at the begining and i have only retained some of the benefits.

im trying to demonstrate/prove that fecal transplant pill can be superior way administer a fecal transplant to treat and possibly cure crohn's disease. what you are witnessing here are the ups and downs of that process. fecal transplants have already cured ulcerative colitis and may have cured crohn's as well. there is no standardized protocol for administering fecal transplant either by enema nor by pill, and if you were to read my initial post you would see that the 9 or so studies that are planned for the next 2 years, are going to gather information to determine the necessary protocol for giving a fecal transplant by way of an enema, but not a pill as of yet. what im trying to figure out here is not quick or easy,  but the end results and what i learn will actually be very simple for anyone to do themselves independant of any doctor or medical institution.

i wish the answers were shorter and simpler then that, but thanks for visiting!!


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## wildbill_52280

coincidentally, here is a related article to what i was just trying to explain.

http://www.healio.com/gastroenterol...al-transplant-needs-careful-measured-approach


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## Clash

Hi wildbill_52280, I've been following your journey. I hope this next experiment goes better for you. 

I have a question in relation to this:



> i did have about 5 days of zero inflammation during the second week after taking my fecal transplant pills


How did you determine you had zero inflammation? CRP? ESR? Fecal calprotectin level?

Good luck in your journey.


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## Amaze

I'm looking forward to more updates. You definitely have my attention,


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## wildbill_52280

Clash said:


> Hi wildbill_52280, I've been following your journey. I hope this next experiment goes better for you.
> 
> I have a question in relation to this:
> 
> 
> 
> How did you determine you had zero inflammation? CRP? ESR? Fecal calprotectin level?
> 
> Good luck in your journey.



zero isnt an accurate description there was nothing precisely numerical about my measurements, what i meant precisely was, there was no detectable abdominal mass/masses, upon my own physical examination.

 i check this on a daily basis and feel my abdominal area to see how things are going at least 2 times a day or more, i did this before and after the fecal transplant pills so i have a good comparison, to judge the effects of the pill as fairly as possible. i had 5 days of just pure squishy flatness, and no hard masses. after those five days it would periodically fluctuate between no  detectable mass to slight or obvious detectable mass, now im pretty much where i was before the fecal transplant pills where 80% of the time, there is at least some mass detectable in abdominal area, and 60% of the time it is very noticable, and nothing subtle about it. 

therefore, 5 days of consistent reduction in the inflammatory mass, is a unique event for me, only attributable to the ft pill, as nothing else changed in my diet, or anything i ingested. i believe the pills i made contained some beneficial bacteria that momentarily found there niche, yet also the process i took to get it into the pill, changed the flora in the pill in a way that may have been responsible for some of the negative effects i experianced. i have read more about what it takes to handle bacteria properly, and now the second time around i believe there will be much more benefical bacteria in these next pills.


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## kss

Soft bellies are excellent! I went years w/o one.

This is besides the point so not to take away from the value of your experiment at all: I believe it's properly called a stricture as opposed to a mass. I used to have a physician who was about 85 years old who used to try and measure my "mass" with a ruler. When I talked to another physician and explained what he'd been doing she said it's not a mass it's a stricture. And she was like "Did he really call it a mass?" I was like "Yep, every time I see him." She, disapproved.


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## wildbill_52280

kss said:


> Soft bellies are excellent! I went years w/o one.
> 
> This is besides the point so not to take away from the value of your experiment at all: I believe it's properly called a stricture as opposed to a mass. I used to have a physician who was about 85 years old who used to try and measure my "mass" with a ruler. When I talked to another physician and explained what he'd been doing she said it's not a mass it's a stricture. And she was like "Did he really call it a mass?" I was like "Yep, every time I see him." She, disapproved.


so you are saying, inflammation does not present itself by physical visual external examination with noticable swelling in IBD? but yet this is how we can confirm stricturing? i would have thought the term mass would have been a more accurate description, in the sense that, that is as accurate as diagnosis as i could get just by feeling it with my hands. mass would seem the only justifiable term/conclusion at that point, as it could also be a tumor, or something lodged in my intestine.

In way though, i previously and still understand it to be, pretty much one and the same, stricturing occurs due to long standing inflammation, and inflammation typically involves swelling of tissues. so they like happen in the same area, although not always at the same time. i'm really no expert at this though, and this is way far from the questions, concerns and goals i want to focus on. i have a mass, that i have almost always had that is related to my crohns diagnosis, i suppose thats what i am justified to know at this point without giving myself or having someone else give me a colonoscopy.


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## Clash

Stricturing does occur due to inflammation but you can have a stricture also due to scar tissue. 

Feeling my son's belly for softness would be a poor indicator for us, since not all inflammation causes stricturing. But thanks for replying to my question.


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## kss

> so you are saying, inflammation does not present itself by physical visual external examination with noticable swelling in IBD?


Nope, not what I said at all.


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## wildbill_52280

kss said:


> Nope, not what I said at all.


sorry, my previous response was wordy and confusing. i wasn't sure what you meant, so i was trying to clarify.  it sounded like you were trying to say all intestinal masses are strictures. which is probably not what you meant. i believe you may have meant in your particular case, you had a stricture when the doctor was using the general non specific term "mass". 

otherwise, if you were analyzing my reasoning and how i determined the mass was due to inflammation and not something else unrelated to IBD, that's a good thing and i appreciate that.


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## wildbill_52280

bacteria in gut may hold key to many diseases- CBS news, October 18th 2013

http://www.cbsnews.com/8301-204_162-57608072/bacteria-in-the-gut-may-hold-key-to-many-diseases/


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## wildbill_52280

here's an observation that should help establish the safety of fecal transplants even more so.

Fecal Transplant an Option Even in the Immunocompromised-Medscape, October 16, 2013
http://www.medscape.com/viewarticle/812685


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## kss

Wildbill, I just clicked on you link and it take me to the sign-in page. If you take off the "?src=rss" part it will go to the article: http://www.medscape.com/viewarticle/812685


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## wildbill_52280

a testimonial of someone who did a Fecal transplant to treat IBS, supposedly it worked for him.

http://www.ibsgroup.org/forums/topic/165423-fecal-bacteriotherapy-for-ibs-d-success/


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## wildbill_52280

MAJOR NEWS RELEASE: Seattle times, October 26, 2013.

New evidence of Fecal transplants efficacy in crohn's disease in a recently completed study. actually the first study reporting efficacy for crohn's in the U.S.A. This could inspire even more studies for fecal transplant in crohn's disease now. There were only two studys as of date, including this one.




> At Seattle Children’s, Dr. David Suskind has just finished the first FDA-approved studies of fecal transplants in children with inflammatory bowel disease. Those with ulcerative colitis didn’t see much improvement, but *seven of 10 Crohn’s patients went into remission *— results similar to those of drug treatments with more potential side effects.
> 
> Now, Suskind says, “I think there are very many more important questions to answer.”



http://seattletimes.com/html/localnews/2022132117_cdifftransplantxml.html


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## sir.clausin

Thanks for posting


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## wildbill_52280

here is yet, another person, who says he cured his ulcerative colitis with a fecal transplant.

http://www.kztv10.com/news/man-cured-with-fecal-transplant/


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## Searchingforhealth

Thank you everyone for this informative forum on FMT. My 20 year old daughter was diagnosed with IBD in May. She was just in the hospital for 10 days with a severe C-dif infection that caused her to have a bad flare. She is currently on Vancomycin and Flagyl as well as 40 mg of Pred. Her new GI has aggreed to perform a FMT. I hope it is successful in knocking out the C-dif and her UC. He will be putting donor fecal material in her colon via a colonoscopy. Does this work as well as poop pills?


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## rollinstone

Too bad that article is written so poorly, a lot of inaccurate terminology and words used, but the more to the point, atleast it's another win for fmt


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## kss

wildbill, did you ever see the research I did using Crohnology's FMT users? There are not only 6 participants but I also included links for a couple of others I found with vidoes on youtube. And 3 of the 6 had UC.


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## wildbill_52280

Searchingforhealth said:


> Thank you everyone for this informative forum on FMT. My 20 year old daughter was diagnosed with IBD in May. She was just in the hospital for 10 days with a severe C-dif infection that caused her to have a bad flare. She is currently on Vancomycin and Flagyl as well as 40 mg of Pred. Her new GI has aggreed to perform a FMT. I hope it is successful in knocking out the C-dif and her UC. He will be putting donor fecal material in her colon via a colonoscopy. Does this work as well as poop pills?


typically repeated enemas are necessary to make a noticable difference in ibd. like 30-60 enemas sometimes to reach remission, but these are in the worst cases. some have had success with less enemas though. one colonoscopic FMT almost certainly will not be enough, and there is a recent study that even showed this not to be enough in UC.

they have not completed the development of a fecal transplant pill, but they have tried a prototype which was effective in eliminating c difficile.


----------



## wildbill_52280

kss said:


> wildbill, did you ever see the research I did using Crohnology's FMT users? There are not only 6 participants but I also included links for a couple of others I found with vidoes on youtube. And 3 of the 6 had UC.


yes i did see the article before and thought it was great. this time i decided to put a link to it in the first post of this thread in the first section of general information, but also mentioned there were more testimonys in the article as well, and a reference to your screenname.


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## wildbill_52280

I found another study that is planned for fecal transplants in ulcerative colitis, that would total 10 studies planned so far, with 2 being completed already. 8 more to go from now until 2016. 


the most recently completed study on crohn's using fecal transplants was actually estimated to be completed in december 2014, but i found the news releases stating the results. its possible that it will become easier to recruit people to do fecal transplant studies as time goes by and like the recent study, complete these studies early. i kind of hope thats the case. 


http://clinicaltrials.gov/ct2/show/NCT01742754?term=fecal+transplant&rank=15


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## rollinstone

can you post the results? were they promising?


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## wildbill_52280

Joshuaaa said:


> can you post the results? were they promising?


see post # 88 in this thread.


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## rollinstone

its an article that says it helped kids with crohns but I couldn't find any results posted?


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## wildbill_52280

just posting some info on a workshop that the FDA held earlier this year to help further the development of fecal transplants for many diseases, and encourage more research. 

thought it would be nice to let everyone here know that things are moving in the right direction for this treatment so far.

http://www.fda.gov/biologicsbloodvaccines/newsevents/workshopsmeetingsconferences/ucm341643.htm


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## wildbill_52280

i just found another report  of a person with crohn's treated successfully with a fecal transplant, in the medical journal titled The Journal of crohn's and colitis dated november 18 2013.

That would be the 4th official report of Fecal transplants being effective to treat crohn's disease.

http://www.ncbi.nlm.nih.gov/pubmed/24239403

http://www.ecco-jccjournal.org/


----------



## greypup

Add us to the list of crohn's diagnosis after long term use of doxycycline used for acne but never worked.  

Fecal transplant sounds so promising.  I'm a donor-in-waiting!


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## wildbill_52280

greypup said:


> Add us to the list of crohn's diagnosis after long term use of doxycycline used for acne but never worked.
> 
> Fecal transplant sounds so promising.  I'm a donor-in-waiting!



you are correct, there is a link between doxycycline use for acne and development of crohn's. Another antibiotic that is linked is amoxicillin-clavulanic acid A.K.A. the brand name Augmentin.


American Journal of Gastroenterology August 2010.
http://www.nature.com/ajg/journal/vaop/ncurrent/abs/ajg2010303a.html


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## wildbill_52280

Here is some preliminary news of results of the study for fecal transplants on crohn's patients at the Beth Israel Deaconess Medical Center	 in Boston, Massachusetts. the study isn't expected to be done until april 2014 though, but they say so far patients are seeing good results. more info below.

http://www.wcvb.com/Sponsors/bethis...22711666/-/14x6d0o/-/index.html?absolute=true


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## sir.clausin

Wildbill_52280: Page not found


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## wildbill_52280

here it is again then.

Here is some preliminary news of results of the study for fecal transplants on crohn's patients at the Beth Israel Deaconess Medical Center in Boston, Massachusetts. the study isn't expected to be done until april 2014 though, but they say so far patients are seeing good results. more info below.


*Fecal Transplant for Crohn's
Published  3:21 PM EST Nov 25, 2013*



Text Size:AAA
There are lots of different types of transplants for lots of different medical conditions. One of the newest is called a fecal transplant, where the stool of a healthy individual is transferred to the intestines of a person with an intestinal disorder. This treatment has had proven success for clearing infections with Clostridium difficile, a powerful bacteria that is difficult to treat. The strategy is thought to revert the bacterial make-up of a person’s intestines to its normal state, with harmless bacteria displacing pathogenic ones.

A handful of doctors have tried the procedure in the clinic for various conditions such as Crohn’s disease and ulcerative colitis, and numerous patients have tried home remedies using samples from family members or close friends. However, fecal transplants are still considered an investigational, or research, treatment, and it is unproven in patients with Crohn’s or ulcerative colitis.

Dr. Alan Moss, an Associate Professor of Medicine at Harvard Medical School and Beth Israel Deaconess Medical Center, and his colleagues are currently conducting the first registered clinical trial that is testing the potential of fecal transplants in patients with Crohn’s disease. “Fecal transplants have certainly taken off in the last couple of years, and some doctors have anecdotally reported they’ve had success in treating Crohn’s disease this way. But we need clinical trial data to objectively test if it’s safe for these patients, and if it improves their condition,” he says. “There are a lot of unknowns in this field—whether fresh stool is better than frozen, which types of donors are associated with successful outcomes, which types of patients could respond etc.” This study is funded by a grant to the Harvard Institute of Translational Immunology from the Leona and Harry Helmsley Charitable Trust.

One of the patients in Dr. Moss’s trial, who wishes to remain anonymous, jumped at the chance to participate. “I’m against taking medicine since there can be many side effects, including unknown long term ones. I’ve been managing my disease with a very restrictive diet: unable to drink coffee or alcohol, eat salads, cheese, spicy foods, fried foods, chocolate, sugar, seeds, nuts...and these are just a few! The diet is so restrictive that it is difficult to maintain,” she says. “Once I was able to get over the gross details of the study, I became so intrigued by the process and excited about it.”

Pharmaceutical companies are also interested in fecal transplantation because if it’s successful, they might be able to isolate the active compounds in the therapy—such as important strains of bacteria or products of bacteria—that could be developed and commercialized. “Working with stool is cumbersome, to put it mildly,” says Dr. Moss. “So it might be easier to treat patients with only the key components of stool in a pre-packaged format.”

Dr. Moss notes that many people are trying fecal transplants at home with protocols they find online. “The most important thing to consider is the donor, who could carry unknown infections in their stool. A patient might feel safe with a donation from a spouse or other family member , but I really worry about people trusting strangers for untested donations outside of the clinical setting.” He even noted that some ads have been placed on Craigslist. “I certainly would discourage people from relying on home transplants using unscreened donor stool, because many viruses, bacteria, and parasites can be found in stool, ” he says. In clinical trials, donors undergo extensive health questionnaires and stool testing to reduce the risk of their stool harboring infections.

The patient in Dr. Moss’s trial is seeing good results so far. “I see this as a major breakthrough in medicine by treating patients naturally, and it makes perfect sense. I’ve been eating and drinking whatever I want, and the Crohn’s symptoms I typically would have at this time are either minimal or nonexistent—symptoms such as sharp pain in my colon, cramps, bleeding ulcers, lethargy, joint pain, and diarrhea.” She says she looks forward to the day when fecal transplants might be an affordable means of managing Crohn’s disease and perhaps other similar conditions.



Read more: http://www.wcvb.com/Sponsors/bethis...22711666/-/14x6d0o/-/index.html#ixzz2lm61SuX6


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## wildbill_52280

I found another testimony on this website of how a Fecal Transplant put them into a remission that posted earlier this year. 

Here is a link - http://www.crohnsforum.com/showthread.php?t=48939

and a quote from the post-



> Last Fall I went to Sydney Australia on a vacation and while I was there I looked into their programs and research. I found FMT. Fecal Microbiota Transplantation. I was grossed out and said oh hell no. Still, the more I studied and read the more it seemed worth a try. So, I called my doctor here and asked if I could be in one of the clinical studies. Unfortunately there wasn't one here. Only in Portland Oregon. He happened to know the doctor running the study though and offered me another way to treat myself at home. My husbands stool was tested for HIV, Hep A B and C, C Diff, and he passed all the tests with flying colors. So, we bought a retention nozzle, enema bag, tons of Zip lock freezer bags, went through training with our nurses so he could help me complete the series of enemas and my flora was checked and measured by my doctor every other week 7 days after each treatment. I was really sore down there from all the surgeries so instead of 7 days of back to back enemas we changed it to once every other week for 2 months.
> I felt it was my last hope and I wanted to try something because nothing else seemed to work and I just wanted to become a guinea pig if I could. 4 months after my (home treatment) I went in for a scope, except some scarring from the past issues I had no inflammation, no diarrhea, no pain, and had started to work out again. I have felt better this past year than I have since I was 26. I have my life back! I have not been on any meds for 6 mos and after my scope today I was told I was in complete remission. (They still don't know how long it may last or if it will.) Right now I feel normal, no pain, no D and I have energy again!


----------



## wildbill_52280

here is an interview with a doctor that treated his UC with a fecaltransplant.

http://thepowerofpoop.com/fecal-transplant-success-story-8/


----------



## greypup

I'm taking our daughter to Mayo next week.  I'm hoping to get their opinion on fecal transplants and hoping that it's favorable.  Our GI doctor isn't using this therapeutically, therefore, we haven't been able to talk to her much about it.


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## william4

a few days ago some posted ( I think wildbill ) link re;  Japanese study butyrate acid, could that some one repost it , thanks


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## wildbill_52280

here is testimony of a woman's fecal transplant experiance to treat UC.

http://glimpse.bahneman.com/category/fmt/


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## wildbill_52280

i added some info on how to make saline solution to perform a fecal transplant in the main post of this thread for anyone that may plan on doing a fecal transplant.

I will add more instructions as my own time permits, other wise you will still have to read though the linked documents in the main post to get more details, which do not contain any instructions on how to make saline solution.


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## wildbill_52280

Here is an amazing article about the powerful roles intestinal bacteria play in our health, and where the science is headed. This is why restoring healthy bacteria in IBD with a fecal transplant could cure the condition.

PSA is a molecule produced by the good bacteria bacteroides fragilis.



> Now in his own lab at the California Institute of Technology, Mazmanian has learned that PSA induces the development of immune cells called regulatory T cells (Tregs), which tell the immune response when to turn off.3 Dysfunction in Tregs is associated with numerous inflammatory, autoimmune, and allergic disorders in humans, and Mazmanian and his colleagues have shown that feeding PSA to a mouse with inflammatory bowel disease or multiple sclerosis can treat and even cure the ailments.


http://www.the-scientist.com/?artic...81/title/Sarkis-Mazmanian--Microbe-Machinist/

here is another article about the same researcher and how autism may be caused by disruption on intestinal bacteria.
http://news.sciencemag.org/biology/2013/12/gut-microbes-linked-autismlike-symptoms-mice


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## greypup

My daughter and I are finishing her visit to Mayo tomorrow morning.  Our conversation about fecal transplants with the pediatric GI didn't get very far.  The doc said the problem with fecal transplants and crohn's patients is 1) getting it into the small intestine by way of anesthesia on a monthly basis and 2)defining the requirements of the donor.  I shouldn't be surprised at this response.


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## wildbill_52280

Here is an interveiw with Doctor David Suskind who is studying Fecal transplants in Crohn's Disease @ Seattle Childrens Hospital.

http://kuow.org/post/seattle-children-s-studies-fecal-transplants-cure-bowel-disease


below is some information on his study from my original post of this thread-
Crohn’s disease and Ulcerative colitis
Seattle Children's Hospital	
Seattle, Washington, United States, 98105
ClinicalTrials.gov Identifier: NCT01757964
Estimated Primary Completion Date: December 2014


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## rollinstone

Ng tube looks like the way to go


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## wildbill_52280

Joshuaaa said:


> Ng tube looks like the way to go


considering that there was a recent report that one dose of 150 milliliters of solution through nasogastric tube was enough to put a crohn's patient in complete remission, that Highly suggests Oral route either pill or NG tube is the way to go. Doing 30-60 enemas is a serious amount of work to put yourself through to achieve remission like some of the earlier studies have showed. And it would very hard to find a donor that could fit your schedule to meet up and donate 30-60 times, with out them having to quit there job so you could do a fecal transplant.

not to toot my own horn here, but this is what i have been saying in the beginning about my prediction that the oral route would be when we saw real results in crohn's disease. This is why i made the attempt to make a fecal transplant pill which is too much of a technical task for me to achieve at this moment in time.


----------



## rollinstone

Surely there's some sort of way we can petition for more trials. I'd sign it and share it, the more trials they do the more they're going to find that it is helping with people with crohns. Whats frustrating is it's already proven to have put people in remission, even if only 5 of 10 people go into remission that 5 should give enough reason to do more research (which I know they are doing), I guess I'm just impatient! I dream of the day when all of us are cured of ibd


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## greypup

And I'm just saying that I'm a donor in waiting and happy to contribute to research!

I eat well, have no IBD or any other health conditions. I'm 47 years old.  I want my daughter cured!!!


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## wildbill_52280

Here is an article about a company that may be the first to provide the medical industry with a reliable source of frozen stool(a stool Bank) to help people get treated with a Fecal transplant. For starters, to treat people with C. difficile infection and after the research is completed, Fecal Transplants for IBD. 

Article is courtesy of Tracy Mac (shes awesome BTW) from The Power of Poop Website.

http://thepowerofpoop.com/openbiome-interview-first-market-fecal-microbiota/


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## wildbill_52280

Fecal Transplants are getting more attention in the press-

http://www.washingtonpost.com/natio...f36388-724a-11e3-9389-09ef9944065e_story.html

http://www.nbcmiami.com/video/#!//Microbiota-Fecal-Transplant/238917221


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## rollinstone

Bottom link is something to do w the demolition of an airport?


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## greypup

That Washington Post was a great article.  

I really appreciate you maintaining this thread.


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## wildbill_52280

Here is a testimony of a DIY fecal transplant for IBS, very entertaining.

http://www.ibsgroup.org/forums/topic/169278-fmt-diary-for-my-wife-ibs-a/


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## wildbill_52280

more evidence supporting the role of intestinal microbes in regulating inflammation via the substances they produce(various peptides). 

http://www.plosone.org/article/info...losone/PLoSONE+(PLoS+ONE+Alerts:+New+Articles)

makes me think about SCD yogurt, not only are you getting the bacteria in large numbers, but theoretically may be getting other molecules they create which may help reduce inflammation when fermented at 24 hours rather then then 4 hours most commercial yogurt is fermented at, with some brands being exceptions to that rule.

http://www.breakingtheviciouscycle.info/p/science-behind-the-diet/


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## wildbill_52280

here is a study on how the intestinal bacteria may regulate the production of antimicrobial peptides on the intestinal lining, further suggesting the cause of crohns disease is from disruption of the bacterial flora.

https://www.ecco-ibd.eu/publications/congress-abstract-s/item/388.html


----------



## wildbill_52280

From an independant newspaper for GI docs:

*ACG Abuzz With FMT*

Recent studies presented at the American College of Gastroenterology (ACG) 2013 Annual Scientific Meeting demonstrated the potential for fecal microbiota transplantation (FMT). The new data show promise for FMT in the treatment of irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD).

http://www.gastroendonews.com/ViewA...&d_id=187&i=January+2014&i_id=1026&a_id=24741


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## Malgrave

Thank you very much for this interesting thread!

Here is an interesting article that my dear friend just sent me (I didn't see it posted here before but maybe I'm wrong...):

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3819561/


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## greypup

Today I'm going to contact our local newspapers and tv stations to ask them to put do stories on this up and coming treatment.

Any other ideas how we can create heightened awareness w/the pharmaceutical companies and GI doctors to make this happen?

Let's get together and let them hear from us how great it would be to have cures and non-threatening treatment options.


----------



## wildbill_52280

Malgrave said:


> Thank you very much for this interesting thread!
> 
> Here is an interesting article that my dear friend just sent me (I didn't see it posted here before but maybe I'm wrong...):
> 
> http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3819561/


I'm proud to say that this report is included in the original post of this thread in the first section titled: 1. HISTORY OF FECAL TRANSPLANTS- its success so far. This report was originally brought to my attention by fellow forum member sir.clausin .

there is also another report of the successful treatment of crohn's with a fecal transplant from the u.k http://www.ncbi.nlm.nih.gov/pubmed/24239403
Also in section 1 is a link to the first 3 crohn's patients successfully treated by doctor borody of australia which was presented at the American College of Gastroeneterology annual scientific meeting in 2011.

What is amazing is that the complete remissions induced By Fecal transplants can be maintained without any drugs, and strongly suggests these patients may be cured, in a similar fashion to the way Fecal transplants seemed to have cured Ulcerative colitis patients which was reported by borody in 2003.


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## wildbill_52280

news segment on a man who was treated with a fecal transplant which cured his c. difficile infection.

http://www.wgal.com/news/8-on-your-...man/-/17986766/24063744/-/8q8i5t/-/index.html


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## wildbill_52280

Here is an introduction to Denis Burkitt's research around 1960. He proposed the idea that stool quality due to fiber in the diet may explain the dramatic differences in diseases between industrialized and non industrialized societies.

since we now know fiber feeds all the good bacteria in the intestines, and that stool is a result of bacterial fermentation, this supports the new research that restoring a damaged microbiome with a fecal transplant could make sense for treating many of these diseases of industrialzed society, low fiber puts us at risk for damage to the microbiome. 

Professor borody has also observed a patient recover from multple sclerosis from a fecal transplant to treat his constipation symptoms, and fecal transplant are in clinical trials right now to treat a form of diabetes, with many other hopeful appications for the restoration of damaged intestinal flora.

http://nutritionfacts.org/video/dr-...dium=rss&utm_campaign=dr-burkitts-f-word-diet


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## wildbill_52280

Fecal transplant leads to resolution of both c difficile and IBS-D in patient involved in study.

http://www.ibsgroup.org/forums/topic/169761-i-just-had-fecal-transplant-done-thru-hospital/


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## wildbill_52280

just bumping the thread. usually i have new content, but its been slow lately with the news!!


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## wildbill_52280

NEWS: Poop banks already supplying Stool to the medical industry for fecal transplants.


my thoughts: its likely by the time fecal; transplants are proven to work in IBD by the end of this year, some of the infrastructure to enable us to have them done by our GI will be built as they are being used for c difficle at the moment.

http://gizmodo.com/need-a-fecal-transplant-theres-a-poop-bank-for-that-1521772837


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## wildbill_52280

Here is a local news segment on Fecal transplants from FOX news channel Pheonix, Arizona.

http://www.youtube.com/watch?v=q9Vf6Zxg6Z8


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## wildbill_52280

NEWS:

Policy: How to regulate faecal transplants. 
From the journal, nature February 19 2014.

http://www.nature.com/news/policy-how-to-regulate-faecal-transplants-1.14720



> The current situation is one of both under- and over-regulation. FMT for recurrent C. difficile infections can be performed without any mandatory screening, whereas FMT for other indications cannot be performed without an IND, a hurdle that will dissuade some physician–investigators.


My Thoughts: 
Despite 10 studies for fecal transplant in IBD this year, it still may be some time before we can have it through gi, stay tuned to find out how this all pans out.


----------



## hugh

wildbill_52280 said:


> Fecal Transplants are getting more attention in the press-


*Could baby poo in sausages be good for our health?*
@6:50 "we're doing a large trial with UC, which is now reversible with transplants"
http://blogs.abc.net.au/victoria/20...l?site=melbourne&program=melbourne_afternoons
Professor Thomas Borody and Richard Stubbs pick up where they left off.
http://blogs.abc.net.au/victoria/20...l?site=melbourne&program=melbourne_afternoons


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## wildbill_52280

hugh said:


> *Could baby poo in sausages be good for our health?*
> @6:50 "we're doing a large trial with UC, which is now reversible with transplants"
> http://blogs.abc.net.au/victoria/20...l?site=melbourne&program=melbourne_afternoons
> Professor Thomas Borody and Richard Stubbs pick up where they left off.
> http://blogs.abc.net.au/victoria/20...l?site=melbourne&program=melbourne_afternoons


thanks hugh. yea its always great to hear or read borody say it aloud: ulcerative colitis has been cured with a fecal transplant. he has stated this a few times already. It may be the same for crohn's. from what i read and experianced, i believe it will cure crohns too.


----------



## KateW

Hi All, I'm a grad student in science journalism, writing an article about fecal transplants and Crohn's. If anyone is interested in talking about their experiences with the treatment please shoot me an email (wheeling.ca@gmail.com) thanks!


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## wildbill_52280

NEWS:

Here is a new testimony of a women with crohn's who achieved a complete remission with a single Fecal Transplant done with a Nasogastric tube through Doctor Borodys clinic in Australia. She believes she is cured and she very well could be. This is the second report of an astounding success with a single dose of FMT in Crohn's Disease, although not an official report, it definitely counts. Borody may also eventually speak directly about these experiences in the coming months.

http://www.farmingahead.com.au/News...plants-curing-incurable-diseases-like-crohn-s


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## HelenMelb

This link is a story from the Australian ABC website- fecal transplant trials now available in Australia for colitis.

http://www.abc.net.au/news/2014-03-18/sydney-doctor-claims-poo-transplants-curing-diseases/5329836


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## wildbill_52280

HelenMelb said:


> This link is a story from the Australian ABC website- fecal transplant trials now available in Australia for colitis.
> 
> http://www.abc.net.au/news/2014-03-18/sydney-doctor-claims-poo-transplants-curing-diseases/5329836


wait a sec.... she did this fecal transplant 12 years ago!!! and is still in "remission", i suppose that's why Borody suggests that it is a cure for crohn's.

also, this seems to be the same article although the links are different, either way, this may be the original source link of the article, so that's a great find.


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## HelenMelb

sorry for the double-up wildbill! But good to see that a mainstream publisher like the ABC is running with this:smile:


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## wildbill_52280

HelenMelb said:


> This link is a story from the Australian ABC website- fecal transplant trials now available in Australia for colitis.
> 
> http://www.abc.net.au/news/2014-03-18/sydney-doctor-claims-poo-transplants-curing-diseases/5329836


hi everybody, 

please watch the video by following this link, they interveiw the woman who's crohn's may have been cured by recieving a fecal transplant via nasogastic tube, 13 years ago at Dr Borody's GI clinic in Australia.


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## David

Just a headsup, your guide is going to be mentioned in the April 1st newsletter


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## wildbill_52280

David said:


> Just a headsup, your guide is going to be mentioned in the April 1st newsletter



Thanks David!!That would be great!! I will make updates and tidy it up a bit!!


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## greypup

how do we get access to the newsletter?


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## kiny

greypup said:


> how do we get access to the newsletter?


http://www.crohnsforum.com/forumdisplay.php?f=70


----------



## David

And old versions of the newsletter can be found here: http://www.crohnsforum.com/c_news_letter.php

The April 1st newsletter will be emailed to all members unless you opted out.


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## wildbill_52280

Experts on the Microbiome come together to speak about the newly emerging science of beneficial and pathogenic bacteria in health and disease in Miami Florida March 8-9th 2014. follow link to watch video. Use the menu below the video to skip to different parts. 

For instance the most relevant part is the Role of Intestinal Microbiota in IBD, where they talk about specific bacteria responsible for regulating inflammatory response.

http://www.gutmicrobiotaforhealth.com/gmfh2014-webcast-5829


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## wildbill_52280

I just found out there is another clinic willing to give fecal transplants for all different types of conditions in the U.K. They are jumping ahead of normal research it seems, but it is interesting. Dr Thomas J. Borody Has been doing this for mainly GI diseases in Australia for perhaps since 1989. 

http://taymount.com/

http://castroller.com/podcasts/TheHealthySkeptic/3992581


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## hugh

a laid back podcast from Chris Kresser, but lots of good info...
Delete if it's a repeat

All About Fecal Microbiota Transplants
_"In this show we have Glenn Taylor of the Taymount Clinic[1], one of the few places doing fecal microbiota transplants, otherwise known as FMTs."_
http://chriskresser.com/all-about-fecal-microbiota-transplants

and this.....

Study Shows That The Bacteria That Ulcerative Colitis & Crohn’s Disease Patients Lack Can Be Found In FMT
http://taymount.com/blog/study-ulcerative-colitis-crohns-fmt/

[1] http://taymount.com/


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## wildbill_52280

more studys planned for Fecal transplants in IBD, that will now total 14 studies. I think 2 were completed so far.


Crohn's Disease
Gastroenterology department, Saint Antoine Hospital	
Paris, France, 75571
ClinicalTrials.gov Identifier: NCT02097797
Estimated Enrollment:	18
Study Start Date:	March 2014
Estimated Study Completion Date:	February 2016
http://www.clinicaltrials.gov/ct2/show/NCT02097797?term=fecal+transplant&rank=10


IBD both forms
Department of General Surgery, Jinling hosptal,Medical School of Nanjing University	Nanjing, Jiangsu, China, 210002
ClinicalTrials.gov Identifier: NCT02016469
Estimated Enrollment:	30
Study Start Date:	December 2013
Estimated Study Completion Date:	February 2016
http://www.clinicaltrials.gov/ct2/show/NCT02016469?term=fecal+transplant&rank=17


Ulcerative Colitis
University of Chicago Medicine	Recruiting
Chicago, Illinois, United States, 60637
ClinicalTrials.gov Identifier: NCT02058524
Estimated Enrollment:	20
Study Start Date:	June 2013
Estimated Primary Completion Date:	June 2015
http://www.clinicaltrials.gov/ct2/show/NCT02058524?term=fecal+transplant&rank=19


IBD both forms
Wolfson Medical Center, Holon, Israel.
ClinicalTrials.gov Identifier: NCT02033408
Estimated Enrollment:	20
Study Start Date:	January 2014
Estimated Study Completion Date:	January 2016
http://www.clinicaltrials.gov/ct2/show/NCT02033408?term=fecal+transplant&rank=30


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## Searchingforhealth

Has anyone tried a DIY FMT during a bad UC flare? Is it dangerous to do it if your having bloody diarrhea?


----------



## sir.clausin

Searchingforhealth: You should join the FYI FMT on Facebook. PM if you want in.

These studies makes me glad, but after meeting with Professor John Hermon-Taylor and all the talk about MAP, I do Believe that FMT won´t be a solution for Crohns due to the infection. It might keep it at bay for a while but not fix the problem that the immunesystem can´t detect the evil bug.


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## rollinstone

Fmt has already cured people with both forms of ibd, even if it's an infection, the infection is by a bacteria, you gotta realise that fmt is like putting many different "biotics" straight into the gut, it's very much an individual thing, with various causes contributing to inflamation, to give you a better understanding, when they take a biopsy and it reveals microscopic inflamation it's usually an infiltration of inflamatory cells, which can be there for various reasons, map yes, disbiosis yes, my point is there's no reason ppl shouldn't try fmt it's generally harmless if you have a properly screened donor and it does offer a potential cure. Though there may be less success stories than that of UC, it only has to work for 1 person w CD to show that it can work- which it has.


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## hugh

As I understand it there are two main pitfalls with DIY.
1/ Screening is fairly important. The donor may have parasites or bacteria that are kept in balance/under control by their immune system/biota but that may run amuck in a sub-optimal digestive system.
I don't know how often this happens.
2/ Most of the bacteria (90%?) is anaerobic and dies when blended up in a frothy smoothie in your average blender


----------



## wildbill_52280

hugh said:


> As I understand it there are two main pitfalls with DIY.
> 1/ Screening is fairly important. The donor may have parasites or bacteria that are kept in balance/under control by their immune system/biota but that may run amuck in a sub-optimal digestive system.
> I don't know how often this happens.
> 2/ Most of the bacteria (90%?) is anaerobic and dies when blended up in a frothy smoothie in your average blender




I wish i had some references for this but from what I've read about 50% of the bacteria will die in the first 10 minutes after exposure to oxygen. After 20 minutes you may hardly have any left alive. Making the thickest solution possible of saline to stool ratio is one way to achieve a higher concentration of bacteria and ensure you have something after blending. Thicker solutions may be easier to retain as an enema, thinner and your body may have the urge to reject it as if you had diarrhea.

Even more of an issue is that the species that we need, is very low in the stool to begin with, only on the mucosal surface is where they dominate. Making your donor follow a strict diet with high fiber foods to help boost the good bacteria is one thing you can do to help ensure success.

It seems all that is needed to do a fecal transplant is one transplant at a high dose of bacteria  for a very short duration of time, rather then have a low dose spaced apart given over a length of time, because the good bacteria being introduced need to fight off the existing pathogens in the patient first, then re-establish themselves to provide anti-inflammatory signals to the body. Once the inflammation dies down, pathogens can no longer flourish, and the good bacteria have a chance to dominate. Too low of a dose may only get the good bacteria so far, and the remaining inflammation will allow pathogens to dominate once again if the dose of good bacteria is not high enough or spaced too far apart.

Screening is pretty important, and one problem is that gastrointestinal disorders are very hard to diagnose as it is, so if someone has a mild case of IBS, they may not really know it, because they may not associate their gi symptoms with IBS. This may pose a risk as our intestines are very hospitable to pathogens, so it is important to have a good relationship with your donor and trust they are being truthful about the state of the gi health. 

giving a successful fecal transplant is quite a technological hurdle and these are a few reasons for such mixed results. Patients who are already in deep remission from medications will likely require lower doses of bacteria then patients with uncontrolled or severe disease states. This is what the current state of the research suggests but we may learn more as more studies are completed.


----------



## Spooky1

Taymount look very expensive.  Does it matter if you've had lots of intestine removed?  Obviously we don't have as much of a digestive tract as others, therefore, do we lack bacteria?

I've just bought some Bimuno to try, this however is far more for IBS.  I would try anything, and Bimuno is certainly cheaper than Taymount.


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## wildbill_52280

*Restoring the gut microbiome for the treatment of 
inflammatory bowel diseases*
World Journal of Gastroenterology
 2014 April 7; 20(13): 3468-3474
http://www.wjgnet.com/1007-9327/pdf/v20/i13/3468.pdf


----------



## wildbill_52280

Here is a new report in the Journal of Clinical Gastroenterology of a patient with Crohn's Disease achieving a complete remission with only one fecal transplant and without the need for maintenance drugs.

This will now total 6 official reports of fecal transplant inducing remission in Crohn's Disease. (EDIT- That's remission without any maintainance drugs.)

http://www.ncbi.nlm.nih.gov/pubmed/24667590


----------



## wildbill_52280

Let's follow this guy through his fecal transplant experiance. EDIT sorry, i missed that he was doing this for body odor and not inflammatory bowel disease, so this post is not significant.

http://www.youtube.com/watch?v=loyIg3tpQKA
http://www.youtube.com/watch?v=TwZALvUlVdU


----------



## 7vNH

wildbill_52280 said:


> I wish i had some references for this but from what I've read about 50% of the bacteria will die in the first 10 minutes after exposure to oxygen. After 20 minutes you may hardly have any left alive.


Would it be possible to flood the blender with some other gas before mixing takes place, displacing the oxygen?  For instance, in small batch beer brewing there's a device called a 'beer gun' that floods an empty bottle with CO2 before the beer is gently added, preventing oxydation.


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## wildbill_52280

7vNH said:


> Would it be possible to flood the blender with some other gas before mixing takes place, displacing the oxygen?  For instance, in small batch beer brewing there's a device called a 'beer gun' that floods an empty bottle with CO2 before the beer is gently added, preventing oxydation.




Yes carbon dioxide gas is fine. Anaerobic bacteria in the intestine actually utilize this as a food source, so it is non-toxic to them, and many probiotic anaerobic organisms found in the intestines can be cultered(grown) in a high co2 environment, or around 80% co2, so if they can grow under high co2 conditions, they will likely be able to survive exposure to high levels of co2 as well for a short amount of time.

Nitrogen has been used to flush a blender when blending stool samples with saline by pumping it into the cover with an intake and exhaust port, as blending exposes the bacteria to lots of oxygen. so nitrogen or carbon dioxide gas can be used to displace oxygen and preserve the bacteria during the blending process.

Standard anaerobic glove boxes used to culture and study anaerobic bacteria are usually a mix between 85% nitrogen, 10% hydrogen and 5% carbon dioxide. 

I looked up this beer gun tool you were talking about. It works on the principle that co2 gas is heavier then the atmosphere and can flush the oxygen out of a bottle.  he demonstrates this @1:45.
http://www.youtube.com/watch?v=PfqZ_9UCt7s#t=172

Another option for blending stool for a fecal transplant is to mix it in a freezer bag after letting as many air bubbles out of the bag as possible, then clamping it shut with paper clamps so it wont break open while you mix it. this could create an oxygen free blending environment as well.


----------



## 7vNH

wildbill_52280 said:


> Another option for blending stool for a fecal transplant is to mix it in a freezer bag after letting as many air bubbles out of the bag as possible, then clamping it shut with paper clamps so it wont break open while you mix it. this could create an oxygen free blending environment as well.


That sounds like a better idea than trying to displace oxygen in some kind of mixing vessel (blender).  To do it right, you'd probably need to pull a vacuum, then add your nitrogen or CO2.  As you say, CO2 is heavier, so I guess if you added it very gently to the bottom of the vessel (like in your video), it might work without a vacuum.  But the freezer bag just seems like it might be just as effective without the higher equipement burdon (cost and cleaning).


----------



## wildbill_52280

Here is an excerpt from an article reporting on the most recent Study of Fecal Transplants in Ulcerative Colitis. 



> *Case Report of Success*
> 
> The overall study was negative but some patients had a very good response to the treatment. Dr. Moayyedi presented a case that "typifies a few patients in the study."
> 
> The man had a 20-year history of ulcerative colitis and had responded to steroids and 5-aminosalicylic acid for most of his illness. Two years before study entry, the medications became ineffective and he developed severe disease. He refused immunosuppressive therapies and surgery. He was randomized to the placebo group and showed no improvement during the study. He was then offered fecal transplant.
> 
> At 20 weeks, "his Mayo score is 0, his mucosa looks good, and he is fine without medication, after having had severe disease for 2 years," Dr. Moayyedi reported. This patient had a "diverse, unstable" microbiome at baseline. With treatment, his microbiome became enriched with Ruminococcus and began to resemble the donor's.
> 
> Transplants from some donors seemed to be more effective than others, indicating a need to better understand the transplanted microbiome, he said.
> 
> *Length of Treatment and Severity of Disease*
> 
> A number of patients who subjectively reported improvement but did not achieve remission continued on treatment, and approximately one-third achieved remission with extended treatment. This suggests that the study treatment period could have been too short, said Dr. Moayyedi.



http://www.medscape.com/viewarticle/824930#2


----------



## 7vNH

wildbill, what is your opinion of the once a week protocol?  If I had to guess, I'd say that, if the goal is to set-up an altered biome, the treatments would be at least daily.  That would seem to be a better approach to push the previous biome out, to beat it into submission.   A boxing analogy...if a prize fighter gets hit once a day, he can last for years.  But that sam fighter got hit once per minute, he'd be on the canvas after a few blows.


----------



## wildbill_52280

7vNH said:


> wildbill, what is your opinion of the once a week protocol?  If I had to guess, I'd say that, if the goal is to set-up an altered biome, the treatments would be at least daily.  That would seem to be a better approach to push the previous biome out, to beat it into submission.   A boxing analogy...if a prize fighter gets hit once a day, he can last for years.  But that sam fighter got hit once per minute, he'd be on the canvas after a few blows.



In doctor Borody's study of FMT for UC, they did 5 daily FMT enemas and all 6 achieved remission without drugs and confirmed to maintain these "remissions" when followed up 13 years later. http://prdupl02.ynet.co.il/ForumFiles_2/28701499.pdf


I personally wouldn't have altered this protocol too much if i were to design a study myself and intended it to succeed, but there may be a benefit to trying something different just to see how people may respond. Perhaps for convenience we may have discovered the these enemas may be spaced out a bit like weekly or bi-weekly, although that still can be effective, it doesnt seem more effective then consecutive fecal transplants. But it might have been more convenient for patients to have them done once a week, rather then them meeting up with their donor every day of the week to perform a fecal transplant. So consecutive daily Enemas seem to be more effective then weekly enemas, since all 6 patients achieved remission in borodys study, as compared to the most recent study where they were spaced apart and didnt show a high response rate like Borody's study.

but now looking at all the evidence that exists in addition to borody's old study on UC, it just seems that one oral fecal transplant may be all that it will take, if the bacteria is protected from oxygen and perhaps if taken with high fiber meal and if the donor follows a strict high fiber diet. Influencing those 3 variables might be the trick.

http://www.ncbi.nlm.nih.gov/pubmed/24222969?dopt=Abstract
http://www.abc.net.au/news/2014-03-18/sydney-doctor-claims-poo-transplants-curing-diseases/5329836

Lots of variables at play here tho, so it will take alot of studies that try to examine the effects of each one and how they contribute to success so that we can develop a protocol that will give a more reliable response rate for all patients regardless of their severity.


----------



## 7vNH

wildbill_52280 said:


> In doctor Borody's study of FMT for UC, they did 5 daily FMT enemas and all 6 achieved remission without drugs and confirmed to maintain these "remissions" when followed up 13 years later. http://prdupl02.ynet.co.il/ForumFiles_2/28701499.pdf


Wow!  What an awesome paper!  Unless there's another study that did the same thing and it _didn't_ work, I'm not sure why this isn't more popular.

But yeah, five days in a row looks like a way to keep the bad guys on the ropes and/or knock 'em down.



wildbill_52280 said:


> but now looking at all the evidence that exists in addition to borody's old study on UC, it just seems that one oral fecal transplant may be all that it will take, if the bacteria is protected from oxygen and perhaps if taken with high fiber meal and if the donor follows a strict high fiber diet. Influencing those 3 variables might be the trick.


That would be a shattering result...to take a pill with some fiber and have the symptoms disappear.  I still need to read the other papers you posted, but wanted to comment on the Borody paper.

Thanks for your continued focus on this topic!


----------



## sir.clausin

Joshou: Show me papers where it says that FMT _cured_(not remission) people with crohns.


----------



## rollinstone

Cured and remission are subjective terms, would you say 13 years remission is not a cure? How do you know? If they get sick again who's to say they were not reinfected or had an altered Biome, nothing in this life is certain. 

But for the record for those who are interested, Borody still does the 5 day protocol to this day, so it's obviously still showing success, he is a very smart man, not one to beat a dead horse.

Hope you all find wellness and stay there. Peace.


----------



## 7vNH

hugh said:


> 2/ Most of the bacteria (90%?) is anaerobic and dies when blended up in a frothy smoothie in your average blender


I would avoid the blender technique completely!  A zip bag, where the air had been completely expelled, would seem to be a better choice.

But another question about viability....

Are there any references or guides for handling a specimin from a donor?  Optimally, one would start an anarobic preparation immediately, but if this is not possible, how should the sample be treated, and how will the viability decline over time?  This obviously depend upon handling conditions.

At minimum, the sample would be kept in an air tight container, but would refrigeration improve or degrade viability?  What would be the half-life of bacteria at various temperatures?

One might consider modeling the process with a substance that indicates oxydation visually.  If guacamole was similar to a fecal sample, then it appears that the surface oxydizes much faster than the interior.  This is indicated by the discoloration of only the surface, leaving the material in the interior unchanged.

Beyond any modern studies of viability over time, what are the protocols used by traditional Chineese medicine?  One may presume that through trial end error over generations, discoveries were made as to what worked best.  Do these discoveries include consensus on when a sample is "too old"?


----------



## crohnspgh

Thanks for posting this - I'm saving for a trip to Sydney for the 5-day.


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## wildbill_52280

Fecal Transplant studies being planned to treat Autism.

NBC news, MAY 16, 2014
http://www.nbcnews.com/health/health-news/germs-gut-may-affect-autism-study-finds-n107451


Also related is a new study that finds no association with vaccinations and Autism.
http://www.sciencedirect.com/science/article/pii/S0264410X14006367?np=y


----------



## wildbill_52280

crohnspgh said:


> Thanks for posting this - I'm saving for a trip to Sydney for the 5-day.


Keep us updated!!


----------



## wildbill_52280

Here is an interesting article on different ways fecal transplants are being performed.

http://www.psmag.com/navigation/hea...ransplant-fecal-matter-health-hospital-81799/


----------



## 7vNH

wildbill_52280 said:


> Here is an interesting article on different ways fecal transplants are being performed.
> 
> http://www.psmag.com/navigation/hea...ransplant-fecal-matter-health-hospital-81799/


Well, there's one term I hope doesn't stick..."crapsule"...:rof:


----------



## wildbill_52280

DIY Fecal transplant gets the spotlight in lengthy BBC news article.
http://www.bbc.com/news/magazine-27503660

Huffington post simultaneously produces their own article on the same topic.
http://www.huffingtonpost.co.uk/201...-difficile-infection-treatment_n_5395981.html


----------



## wildbill_52280

New video covering a Patients experiance of a fecal Transplant At Dr Borody's GI Clinic in Australia.

http://www.youtube.com/watch?v=rxOuPH2D8pU


----------



## sir.clausin

Not found wildbill :/


----------



## wildbill_52280

sir.clausin said:


> Not found wildbill :/


wow they took that down quick!! it was a good video too!


----------



## wildbill_52280

Im pretty sure the borody video was a segment of this show called the cure, but i cant find the video anywhere anymore.
http://www.aljazeera.com/programmes/thecure/


----------



## wildbill_52280

Heres a blog of someone with crohn's who may be the first person ever to be treated with a fecal transplant pill from a researcher in calgary canada.
blog-
http://lanethoughts14.blogspot.com/2014/05/the-calgary-trip.html

researcher
http://www.ucalgary.ca/microinfect/louie


----------



## 7vNH

Here is a video that lays out equipment, supplies and process for at-home FMT.  There are already many of these on the internet, of course, but most of those use a blender.  This one uses a potato ricer, which, I think, reduces the amount of oxygen the sample is exposed to.

http://youtu.be/KEIYJHnOjHM

    Saline was not used, but could (should?) be substituted for the distilled water.  Other processes had used distilled and it seemed easier than having to mix up something. But since the consensus seems to be that there is an osmotic pressure concern using distilled water, it wouldn't be too much extra work to disolve some salt, or buy saline instead of distilled water.

    A toilet hat would be optimal for collecting the sample, but plastic wrap is disposable. My goal with this process was to use equipment/supplies that could be thrown away rather than cleaned.  And for the equipment/supplies to be found around the house or at a local store.

    The potato ricer is probably something that would need to be purchased specially for the process. The idea was to have this replace the blender  step that many people show in other process documentation. My thinking is that forcing the sample through those small holes oxydizes the sample less than (probably much less than) running it through a blender. The reason I say this is because the blender seems to be whipping air into the sample with a lot of force. So much force that the sample in some videos I've seen looks frothy! All of that air can't be too healthy for anaerobic cells.  The holes in the ricer guarantee particle sizes of 2mm or 2.5mm, so there are no large particles to clog the enema bottle.


----------



## 7vNH

If you look at Probiotic Therapy Home Infusion Protocol from Probiotic Therapy Research, it says that you should take antibiotics for a minimum of 10 days before doing the FMT.  The antibiotics recommended are one or two of the following:

rifampicin: 150mg AM, 150mg PM (2 pills per day)
vancomycin: 250mg AM, 250mg PM (4 pills per day)
flagyl: 400mg AM, 400mg PM (2 pills per day)

But the problem is that my GI doc refused to prescribe these potent antibiotics.  I doubt any US doc would prescribe these antibiotics without a reason, and if you gave the reason that you were going to do a home FMT, they probably would be LESS likely to prescribe it, for fear of getting in trouble with the authorities.

I'm having him run a test for C. Diff and I'm hoping it's positive, because that's the only way I'm going to get the antibiotics!

Given that comes back negative, how does one source these antibiotics?


----------



## rollinstone

You should get in contact w prof borody at the cdd in Sydney, he knows doctors in the US that are like minded. Maybe he can put you onto one. God bless


----------



## wildbill_52280

7vNH said:


> If you look at Probiotic Therapy Home Infusion Protocol from Probiotic Therapy Research, it says that you should take antibiotics for a minimum of 10 days before doing the FMT.  The antibiotics recommended are one or two of the following:
> 
> rifampicin: 150mg AM, 150mg PM (2 pills per day)
> vancomycin: 250mg AM, 250mg PM (4 pills per day)
> flagyl: 400mg AM, 400mg PM (2 pills per day)
> 
> But the problem is that my GI doc refused to prescribe these potent antibiotics.  I doubt any US doc would prescribe these antibiotics without a reason, and if you gave the reason that you were going to do a home FMT, they probably would be LESS likely to prescribe it, for fear of getting in trouble with the authorities.
> 
> I'm having him run a test for C. Diff and I'm hoping it's positive, because that's the only way I'm going to get the antibiotics!
> 
> Given that comes back negative, how does one source these antibiotics?


This document is old.  From the top of my head, I do believe i've read that antibiotics before the Fecal Transplant is not required. The Fecal Transplant should be powerful enough to wipe out all pathogens. I believe ive read researchers say these antibiotics are not needed, dont recall where i read it Though, So just skip it.


----------



## wildbill_52280

Introducing Alex Khoruts, MD Associate Professor, Department of Medicine, 
University of Minnesota. He is working on perfecting the fecal transplant and bringing it mainstream. Here is a video him speaking on the role of Intestinal Bacteria in health and disease. He begins by addressing the revolutionary idea that not all bacteria are bad, and its time to accept that what is going on within the intestinal bacteria is the equivalent to another organ system.

http://www.youtube.com/watch?v=GGR3YkHEfLs


----------



## wildbill_52280

Ex-Merck exec’s new microbiome startup has a pill that works like a fecal transplant against C. diff.

http://medcitynews.com/2014/06/form...startup-developing-ick-free-treatment-c-diff/


----------



## Searchingforhealth

Wildbill_52280- this is very exciting news indeed! Thank you for sharing this and all the other informative links you post!


----------



## 7vNH

This article Malnutrition and the Microbiome does not mention FMT, but it seems that the study is zoning in on a problem that might be solved by FMT.


----------



## chris72

Hi All,

I don't have Crohn's but I recently did a DIY Fecal Transplant Pill procedure in an attempt to cure my IBS. 

If anyone is interested in the process feel free to check out my progress and procedure here: gastrosolutions.org

It's only early days but the results so far are very promising. The pill/capsule treatment is a one shot deal and it may also be another solution for those seeking FMT treatment but aren't up to doing a dozen enemas.


Cheers
Chris


----------



## wildbill_52280

chris72 said:


> Hi All,
> 
> I don't have Crohn's but I recently did a DIY Fecal Transplant Pill procedure in an attempt to cure my IBS.
> 
> If anyone is interested in the process feel free to check out my progress and procedure here: gastrosolutions.org
> 
> It's only early days but the results so far are very promising. The pill/capsule treatment is a one shot deal and it may also be another solution for those seeking FMT treatment but aren't up to doing a dozen enemas.
> 
> 
> Cheers
> Chris



Hi chris, i have seen your website a few days ago about the fecal transplant pill making process based on the method of Dr. Louie in Canada. I try to keep up with your updates on your website, hope things continue to improve and hopefully you are cured of IBS from a fecal transplant pill.

It was my prediction that the pill method or any oral method would be superior to multiple enemas, we now have some evidence that that is the case. see the first post of this thread section #1 for references. In addition to that we also have your testimony now, which is pretty cool.


----------



## chris72

Hi Bill,

Yeah, I hope this treatment does work for people because it is so non-invasive. I was essentially looking for a one-shot solution instead of the enema. Swallowing a couple of dozen capsules is far easier than having 10 enemas!

Each to their own, though!


----------



## Hope345

Is the fecal pill available in the U.S.?    Would it help people with IBD in the colon rather than the stomach or small intestines?

I traveled to Minnesota to get our daughter on the anti map therapy (not fecal transplant).  After being rediagnosed with Ulcerative Colitis, this Doctor would not prescribe those antibiotics for our daughter, and did not advice fecal enemas except for C.Diff.                                         

I still think one day, those antibiotics will be the cure for many.  If not cure, the preferred treatment with very little side effects.


----------



## Searchingforhealth

FMT via colonoscopy or DIY FMT is the preferred method for UC. My daughter had CDiff, hopefully cured with a FMT and has been diagnosed with UC. The GI docs thought she had Crohns but we just got the Promethius IBD test and it all but ruled out Crohns. She is trying LDN, starting at 1.5 mg and it seems to be helping. I am making my own kefir for her and keeping DIY FMT on the back burner. She is down to 16 mg. Pred. Check out the website The Power of Poop for more info.


----------



## Searchingforhealth

Hope345, can you recommend a good GI in Eugene? My daughter will be going to school there next year?


----------



## chris72

Hope345 said:


> Is the fecal pill available in the U.S.?    Would it help people with IBD in the colon rather than the stomach or small intestines?
> 
> I traveled to Minnesota to get our daughter on the anti map therapy (not fecal transplant).  After being rediagnosed with Ulcerative Colitis, this Doctor would not prescribe those antibiotics for our daughter, and did not advice fecal enemas except for C.Diff.
> 
> I still think one day, those antibiotics will be the cure for many.  If not cure, the preferred treatment with very little side effects.



Hope345: I know of only two clinics in the US offer the FMT capsule treatment commercially - Mark Davis, ND at Bright Medicine Clinic (brightmedicineclinic.com) and Bruce Hirsch, MD at Symbiotic Health (symbioticbio.com/team/).

I'm not sure if they treat non-C.diff, however. Probably worth a phone call or email though.

Best of luck.


----------



## wildbill_52280

chris72 said:


> Hope345: I know of only two clinics in the US offer the FMT capsule treatment commercially - Mark Davis, ND at Bright Medicine Clinic (brightmedicineclinic.com) and Bruce Hirsch, MD at Symbiotic Health (symbioticbio.com/team/).
> 
> I'm not sure if they treat non-C.diff, however. Probably worth a phone call or email though.
> 
> Best of luck.


The Bright medical clinic is only giving the Fecal transplant via pill form for C. Difficile infections because the FDA only approved it for this Disease in some circumstances.


----------



## njprrogers

Hi all,

I think I am going to give this a shot - maybe DIY style at home.

I've had Crohn's Colitis for 32 years. Originally, I was diagnosed with UC but that was changed to Crohn's when I got fistulae 8 years ago. Not doing too bad at the moment but would love to be able to eat what I wanted or even have a glass (bottle) of wine. Not to mention that recent stresses have exacerbated things.

I have two potential donors - my lovely wife (I asked and she said she's up for it) and my two and a 1/2 year old daughter (I asked and she said 'Peppa pig' which I am taking as a resounding yes).

Which of these two potential donors do you think would be a better fit?

Thanks

Nick


----------



## Searchingforhealth

Nick, good luck on th DIY FMT. I have heard young children up to age 4 don't have enough good microbes developed to be a viable donor. That leaves your lovely wife Has she had testing done to rule out any unwanted viruses? When I became a donor for my daughter, I was tested for hep.c, h pylori, c diff etc.
My donor stool got rid of my daughter's CDiff.but she didn't do enough of them to affect her UC. She is trying LDN and having good results and I am making kefir for her. Next she will add fermented cabbage which is supposed to have trillions of good bacteria.


----------



## wildbill_52280

njprrogers said:


> Hi all,
> 
> I think I am going to give this a shot - maybe DIY style at home.
> 
> I've had Crohn's Colitis for 32 years. Originally, I was diagnosed with UC but that was changed to Crohn's when I got fistulae 8 years ago. Not doing too bad at the moment but would love to be able to eat what I wanted or even have a glass (bottle) of wine. Not to mention that recent stresses have exacerbated things.
> 
> I have two potential donors - my lovely wife (I asked and she said she's up for it) and my two and a 1/2 year old daughter (I asked and she said 'Peppa pig' which I am taking as a resounding yes).
> 
> Which of these two potential donors do you think would be a better fit?
> 
> Thanks
> 
> Nick



Do not use your young daughter use your wife.

 Do not mix the saline and stool together in a blender, put it into a freezer bag and close it off with some paper clamps. Try to get all the air bubbles out, this will create an oxygen free environment which will protect the bacteria from dieing. after mixing for a while this should encourage the bacteria to form spores after that they can be exposed to oxygen. it is the seperation of the bacteria from any nutrients which will be a signal for which the bacteria will form spores.


If you choose to use a blender use a low setting and blend as least as possible and do the enema within 10 minutes of mixing, as after that 90% of the bacteria may already be dead and the potency of the enema will be weak.

Good luck!!


----------



## wildbill_52280

here is a great article on fecal transplants published in april

http://www.bbc.com/future/story/20140429-medicines-dirtiest-secret?ocid=global_future_rss


----------



## wildbill_52280

Scientists have been able to sequence and assemble the complete genome of 238 intestinal bacteria, 75% of which were previously unknown. 
July 7, 2014

http://www.sciencedaily.com/releases/2014/07/140707092426.htm

this is kind of related .


----------



## Spooky1

Does anyone know where I can get this done in the UK as I don't have healthy relatives and I don't fancy doing home DIY stuff either.  But the info is so promising, Thanks Bill.


----------



## wildbill_52280

Spooky1 said:


> Does anyone know where I can get this done in the UK as I don't have healthy relatives and I don't fancy doing home DIY stuff either.  But the info is so promising, Thanks Bill.



http://taymount.com/faecal-microbiota-transplant-fmt/


----------



## Spooky1

Ah yes, I remember visiting their site.  They say it can take up to six treatments and cost a fortune each time.  I couldn't help but think that they want to milk people for what they're worth. They charge from £3,000 to £16,000. A lot of the info you have posted with links, Bill, gives great success.  They don't suggest they need a huge amount of treatments which gets me thinking they are in it for mass profit. I often have C-diff (usually after visiting gastroenterology) and its a sod on top of Crohns.  Am gonna have to beg the NHS to get on with it for free.  Don't think big pharma like this one.


----------



## wildbill_52280

Fecal-transplant startup Rebiotix is raising $25 million Jul 9, 2014.

they are developing a fecal transplant pill.

http://www.bizjournals.com/twinciti...ansplant-startup-rebiotix-stool-delivery.html


----------



## Spooky1

gosh, this does look good! I feel, other than trying medical marijuana, that this might just help knock my Crohns, with all the other things like C-diff, Rotavirus, etc, on the head.  I just need to be able to get on with life as i'm not getting any younger.  Thanks, Bill.

P.S I wonder if they have crowdfunding by kickstarter?


----------



## wildbill_52280

Fecal transplants let packrats eat poisonous plants

http://www.sciencecodex.com/fecal_transplants_let_packrats_eat_poison-137873


----------



## wildbill_52280

old article but a good one:

Why we need to learn to love the microbe
The Globe and Mail
Published Friday, Dec. 06 2013, 6:04 PM EST

http://www.theglobeandmail.com/life...to-learn-to-love-the-microbe/article15812471/


----------



## hugh

“Messieurs, c'est les microbes qui auront le dernier mot." (Gentlemen, it is the microbes who will have the last word.)”

― Louis Pasteur - "father of microbiology"


----------



## 7vNH

Is there any evidence to suggest that the presence of mesalamine would inhibit, enhance, or have no effect on the establishment of a newly introduced microbiome?


----------



## wildbill_52280

7vNH said:


> Is there any evidence to suggest that the presence of mesalamine would inhibit, enhance, or have no effect on the establishment of a newly introduced microbiome?


The more suppressed the inflammation is or rather the more controlled ones disease is,the more likely the transplant will take hold and new bacteria will restablish themselves. one reason for this is that one way pathogens are able to dominate in the intestines is because of the by products of inflammation nitrate and nitrite which feed mainly bad bacteria.


Host-derived nitrate boosts growth of E. coli in the inflamed gut. Feb 2013
http://www.ncbi.nlm.nih.gov/pubmed/23393266

There are other mechanisms which allow pathogens to thrive, such as the overall concept of colonization resistance provided by an intact intestinal microbiome. This is a bit seperate from just byproducts of chronic inflammation. There is also the possibility that missing bacteria do not utilize sugars that some bacteria create, this would now provide a new niche for other species to feed on.


As for the substance mesalamine, I'm not aware of it having and negative effect on bacteria itself, but if it is helping to suppress inflammatory response then we can assume/theorize it may only help a fecal transplant rather then hurt.


----------



## wildbill_52280

Fecal-transplant startup Rebiotix closes on $25M for trials
Aug 4, 2014, 11:07am CDT 

http://www.bizjournals.com/twinciti...nsplant-startup-rebiotix-clinical-trials.html


----------



## rollinstone

Well iv just had my second day of FMT, yesterday was the scope infusion, found mild inflammation in a few parts of the large intestine, had the enema infusion today, was a mild bit of a mental challenge but actually quite easy now that it's done, 3 more days of it. (Five in total) I'm going to try stick to a strict real food diet to maximise my chances of success. Fingers crossed this works for me. Will keep you all posted and update about the full procedure.


----------



## Spooky1

Josh, are you in the US then?  I sincerely hope it goes well


----------



## rollinstone

I'm in aus, doing it at prof. Borody's clinic, thank you for your well wishes!


----------



## wildbill_52280

Joshuaaa said:


> I'm in aus, doing it at prof. Borody's clinic, thank you for your well wishes!


 Feel free to share all the details!! such as:

did they supply a donor or did you bring your own?

you mentioned the first treatment was infusion of donor stool through a gastroscope/colonoscopy? is that correct?

are you doing  4 more days of enemas?


----------



## rollinstone

Using their donors, they screen them meticulously, been on rifaximin and flagyl for a while, ceased just before the scope/1st infusion, have 3 more days of infusions via enema, havnt had a bm since the morning of b4 the infusion though because they give you immodium so the new bacteria stays in there for a while and takes ahold in its new host.. Stomachs pretty sore but that's probably because Iv been so constipated, will keep you updated w symptom improvements etc hoping it works.


----------



## Mommabear

Wow! I so hope you find success!!! Anxious to hear more!


----------



## rollinstone

Well apparently cure/ prolonged remission rate is 1 in 30 for crohns, so I have my fingers crossed and have said my prayers haha.. Time will tell


----------



## hugh

Joshuaaa said:


> I'm going to try stick to a strict real food diet to maximise my chances of success. Fingers crossed this works for me.


Hope that's a paleo-based real food diet, rather than a whole-grain based real food diet


----------



## HelenMelb

Joshuaaa, I hope this is your miracle treatment. Please keep us posted on your progress. Wishing you much luck and ongoing remission. Dr Borody is a brilliant man.


----------



## M West

Joshuaaa,

Got my fingers crossed for you and prayers asked.

Good luck and keep us posted!

Best,
Miles


----------



## 7vNH

Joshuaaa said:


> Well apparently cure/ prolonged remission rate is 1 in 30 for crohns, so I have my fingers crossed and have said my prayers haha.. Time will tell


I see that you had some pretty powerful antibiotics before the FMT, presumably to knock out large numbers of your existing microbiome.  Do you know if antibiotics are used in the protocol for UC (as opposed to CD) in Dr. Borody's clinic?

Those are pretty long odds, but I hope you are the one!  Talking of odds, do you know what the success rate is for prolonged remission in UC at that clinic?

Five infusions?  That doesn't seem like many.  Does the patient choose the number based on how much they want to spend?


----------



## rollinstone

7vNH said:


> I see that you had some pretty powerful antibiotics before the FMT, presumably to knock out large numbers of your existing microbiome.  Do you know if antibiotics are used in the protocol for UC (as opposed to CD) in Dr. Borody's clinic?
> 
> Those are pretty long odds, but I hope you are the one!  Talking of odds, do you know what the success rate is for prolonged remission in UC at that clinic?
> 
> Five infusions?  That doesn't seem like many.  Does the patient choose the number based on how much they want to spend?


Sorry I meant to press quote but I'm on my phone, first, just want to say thanks to all of you for your well wishes. Ok, so it is quite costly for 5 days but even 1 in 30 is worth it for me, my crohns isn't that bad so it might raise my chances a bit. The antibiotics are the same for UC prep, and the success rate is quite a bit higher for UC. The reason I actually decided to do FMT is because when I saw Prof B the first time I was in complete remission, which was weird because one month prior I was in another hospital w a flare up... Could very well have been remicade that hid the disease as I still didn't feel right.. Could also have been the large amount of cannabis extract I ate (not recommending it as it gave me a panic attack and I can't smoke it anymore coz of the said anxiety it causes.. Anyway long story short, my diagnosis was elusive they've thought some sort of IBD chronic colitis but weren't sure what it was because the patterns have changed w various scopes so he thought I'd be a good candidate for FMT. However on the last scope the skip lesions looked like crohns and a diagnosis is made on what you see so the histology doesn't really come into it here. Moving forward he said had we known this before the FMT we woulda gone straight onto anti-map treatment, but the way I see it is I'm doing the process of elimination, if my disease is caused by a disbiosis then this thing will fix me up, if it's caused by some unknown pathogen this thing will also likely fix me up, if it's not then the chances that it's caused by map go up even higher which means anti-map is the way to go.

Sorry for the essay, just needed to put out where I am.


----------



## wildbill_52280

Joshuaaa said:


> Sorry I meant to press quote but I'm on my phone, first, just want to say thanks to all of you for your well wishes. Ok, so it is quite costly for 5 days but even 1 in 30 is worth it for me, my crohns isn't that bad so it might raise my chances a bit. The antibiotics are the same for UC prep, and the success rate is quite a bit higher for UC. The reason I actually decided to do FMT is because when I saw Prof B the first time I was in complete remission, which was weird because one month prior I was in another hospital w a flare up... Could very well have been remicade that hid the disease as I still didn't feel right.. Could also have been the large amount of cannabis extract I ate (not recommending it as it gave me a panic attack and I can't smoke it anymore coz of the said anxiety it causes.. Anyway long story short, my diagnosis was elusive they've thought some sort of IBD chronic colitis but weren't sure what it was because the patterns have changed w various scopes so he thought I'd be a good candidate for FMT. However on the last scope the skip lesions looked like crohns and a diagnosis is made on what you see so the histology doesn't really come into it here. Moving forward he said had we known this before the FMT we woulda gone straight onto anti-map treatment, but the way I see it is I'm doing the process of elimination, if my disease is caused by a disbiosis then this thing will fix me up, if it's caused by some unknown pathogen this thing will also likely fix me up, if it's not then the chances that it's caused by map go up even higher which means anti-map is the way to go.
> 
> Sorry for the essay, just needed to put out where I am.


joshuaa, thanks for the update and i  hope all goes well. If you have the chance, ask someone at the clinic or Borody himself why they are not using FMT pills or nasogastric tube yet for crohn's? It would very interesting to hear what they are thinking.


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## rollinstone

Pills will be used soon I think as a maintenance procedure in people who respond to FMT, as for NG tube as far as I know, risk of complications is higher with NG tube and colonoscope delivery is supposed to be the best method. I'll keep you guys updated as I go, apparently it can take a while to get the full benefits of FMT, the bacteria has to adapt to you and take place etc.. I'm hopeful, like I said by process of elimination I feel like I'll get this thing conquered one way or the other, it's important to realise the unknowns in IBD are vast, a diagnosis of cd is made from the appearance of skip lesions of inflammation, what causes that inflammation in person a) is entirely possible to be different to what causes it in person b) but that being said with all the research that's been done IMO there are 3 potential culprits, 1) map, 2) AEIC 3) unknown pathogen caused by a disbiosis, so ATM I'm tackling no.3 with hopes I'll be successful, if not I've narrowed down the list of suspects even further.


----------



## 7vNH

Joshuaaa said:


> Sorry for the essay, just needed to put out where I am.


The longer the better; although it is n=1, a first hand account is worth loads to me (and I presume other like me).


----------



## wildbill_52280

I added another reference to first post of this thread, to support the claim of the women who has had no sign of crohn's disease for 12 years after receiving a fecal transplant through a nasogastric/jujenal tube, Professor borody believes she may be cured.

here are the links i added-

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3868025/figure/F2/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3868025/?report=classic


----------



## rollinstone

An update, unfortunately I had to start pred again yesterday, it seems I wasn't the lucky 1 in 30, but hey I woulda kicked myself wondering "what if" if I hadn't of tried it. However I gotta say on the days of receiving the FMT enemas I felt remarkably better, unfortunately it's way too much of a mission to do every single day. One would think capsules could be some sort of solution to this the only problem being amount, you'd need a shit load of capsules (no pun intended ;p), and they'd have to be freshly supplied making it quite an effort. Do I still think there's hope for FMT in cd? If if works in even 
1 in 30 yeah it's worth a shot, but it doesn't seem to be a hard and fast cure for the majority of cd patients, unless you can continue w it for maybe a month straight every other day I think it'd be enough to put you in remission, but like I said it's quite an ordeal to go through...


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## Spooky1

So, Joshua, how many transplants did you have in the end?  Obviously if you're straight back on pred then things must have been bad.  So no real effect then? Have you had any resections of intestine?  Just wondering.  I think you saved me a long trip and a load of money too.  I'm very sad that it didn't work for you.  Well done for going through the procedure though.


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## rollinstone

I had five all up, one during the scope, four retention enemas (not fun for any man to endure). Iv never had any resections, disease has always been in the sigmoid area now it's in the descending colon also, no disease in the small intestine. Iv been prescribed anti-map but I'm going to try go back on remicade before I commit to two years minimum of anti biotics, sad thing is I was in 100% histological remission during my scope in feb (probably from the remicade) that they thought it was probably some sort of chronic colitis rather than CD, hence going on the FMT.. Thing is I never felt like I was in remission even while the scope suggested otherwise, hence the trip to the CDD in the first place. It's been a long expensive endeavour and I kinda feel like I'm back in square one, though at least iv replaced some good bacteria and I guess I'd always wonder what if, if I hadn't of given it a shot.

What's your current state spooky? Med/disease history etc


----------



## Spooky1

Thanks for the info Joshua.  It must be disappointing to have it fail, not to mention that in February you were fine.  I understand what you're saying about not feeling well despite no indication.  I'm wondering if you have arthritis at all.  This shows up in the blood and can make you feel very poorly.  But its not from bowel disease.  In a way it's good the remicade might have been what helped.  Two years of anti biotics is amazing!   I'm not sure many go on that dose.  Anti biotics send me to the loo far more.  

I've had crohns  for 40 years.  Never really goes into remission unfortunately.  I've given up on surgeries because the disease comes back within weeks at the point of the joined intestine.  I also have it in the mouth and through stomach and duodenum.  I also have gastric dumping syndrome.  I have a liquid feed 20 hours a day through a PEG.  It's liquid in and liquid out too.  Possibly due to amount of intestine removed.  I too feel very poorly most of the time.  Loo visits are ongoing day and night.  I just wish there was a cure.
Cos I couldn't afford the FMT I've decided to try high dose probiotics.  I'm on immuprobio, its 50billion good bacteria per capsule.  Rather expensive too.  Not had much effect yet.  I spoke to my dietician about it and she said her last hospital did a trials of VSL# which has 450billion good bacteria.  It was only on IBS people not IBD patients.  they did a double blind trial and found it did nothing.  But i'm going to try for 3 months just to get some good gut flora in my intestine.  I also have colesevelam as an anti diarrhoea med.  Doesn't help much and gripes a bit too.  I also buy cheap immodium from the supermarket.  These together do gripe a lot and do sometimes help reduce loo visits.  If the gastric dumping is bad then absolutely everything dashes through, including loads of bile which rips the skin off my butt, burns the skin right off and continues to burn.  loads of barrier cream helps (cavilon).
I hope you find remission with something, pred, remicade.


----------



## rollinstone

Ah boy, it sounds like you've been through the absolute ringer, have you done much research into MAP as a cause of CD, or AIEC? The reason I ask is because for those who have tried absolutely everything under the sun those are the two things I would recommend looking at, Qu biologics is currently doing a trial for their SSI vaccine which has the genius mechanism of addressing macrophage deficiency, (which more and more evidence is looking like that May be the underlying cause to crohns), anyway it's still early days with that but I can honestly say iv never seen any results as good as their compassionate use program (granted it only had 10 ppl in it), hence the need for them to do the trial now. As for anti-map now that is the cocktail of antibiotics aimed at killing or suppressing the mycobacterium believed to cause Crohn's disease, (it's actually been proven to be the cause of a subset of crohns, I don't have the numbers, some say 50% recent papers have suggested 80%) there are threads for both treatments. I'm sorry you've had to suffer with disease for so long, that truly does suck. Are you on any psychological meds to help you cope?


----------



## rollinstone

But I have to mention, given that you have it in so many places it certainly sounds infection based... I'm on my phone so I can't link you to the MAP thread but please search for it..


----------



## Searchingforhealth

Joshuaaa, I'm sorry to hear that FMT wasn't a cure for you! Have you tried LDN? It seems to benefit people with UC and crohns. Also you mentioned Cannibis oil, have you used a strain with all CBD and very low THC? It causes no high and may not cause anxiety. 
The other thing that comes to mind is getting a blood test, Prometheus, to get a more conclusive UC/ crohns  diagnosis. My daughter had the same skip pattern and the GIs were talking crohns but the blood test markers were all UC. It's expensive but they have a sliding scale payment.


----------



## wildbill_52280

joshuaaa, do you know any more details about the protocol they followed? you already mentioned there was antibiotics before the FMT, and the first infusion was through the colonoscope/endoscope followed by 4 days of enemas. Were the enemas from fresh stool or frozen stool? I remember that borody didnt make any attempts to mix the fmt solution in an anaerobic environment, did he since change his methods?The issue is this-

Current Microbiology
July 1989, Volume 19, Issue 1, pp 39-43
*Oxygen tolerance of anaerobic bacteria isolated from human feces*
Tullio Brusa, Enrica Canzi, Novella Pacini, Raffaella Zanchi, Professor Annamaria Ferrari

Abstract
The large bowel intestinal flora of mammals is made up mostly of O2-intolerant anaerobic microorganisms which are irreversibly damaged by brief exposure to air. The aim of our work was to investigate the effect of atmospheric O2 on human intestinal anaerobic microorganisms. Thirty O2-intolerant bacterial strains that reached 100% mortality after 120 min of air exposure were isolated. Ten of these strains were tested for their atmospheric O2 sensitivity as a function of air exposure time; all tested microorganisms showed a similar mortality trend on exposure to air. In fact, 50% of cells survive, on the average, after 4–5 min of atmospheric O2; this percentage decreases to 3–5% after only 20 min, and after 40 min only one cell in a thousand survives; all strains reached 100% mortality in a time range of 100–120 min. The strains examined were identified as belonging to the genera Eubacterium, Peptostreptococcus, and Coprococcus.
http://link.springer.com/article/10.1007/BF01568901


So basically after 20 minutes after being exposed to oxygen 95-97% of the bacteria are all dead. if it's administered within 4-5 minutes you would probably be ok but still 50% are already dead. Coordinating all this with a donor, patient and doctor must be real tough, its easy to assume that many times, they cannot plan this out perfectly. these are just some of the issues with the protocols that need to be addressed. maybe they solved these problems i don't know hopefully you have more info to share with us, that would be great.you have already done alot by sharing your experiance though and I appreciate it!!


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## rollinstone

Yep it was fresh not frozen, he's well aware of the effects of exposing the bacteria to oxygen they take every caution, they've been doing this for the last 25 years, each time trying to perfect the process, he will openly tell you before you go in he doesn't know how or why it works in some people, the thought is that if your inflammation is being caused by an unknown species of pathogenic bacteria, maybe multiple then the new bacteria acts as a potent anti biotic and kills those pathogenic bacteria, hence we see some instant dramatic improvement in some people.

I think however, if ones problem goes beyond the bacteria in the gut, and moreover is to do with an immune deficiency, I.e faulty macrophages or intracellular MAP infection, you're not going to see the benefits from FMT... Never know if you don't try though.


----------



## wildbill_52280

Joshuaaa said:


> Yep it was fresh not frozen, he's well aware of the effects of exposing the bacteria to oxygen they take every caution, they've been doing this for the last 25 years, each time trying to perfect the process, he will openly tell you before you go in he doesn't know how or why it works in some people, the thought is that if your inflammation is being caused by an unknown species of pathogenic bacteria, maybe multiple then the new bacteria acts as a potent anti biotic and kills those pathogenic bacteria, hence we see some instant dramatic improvement in some people.
> 
> I think however, if ones problem goes beyond the bacteria in the gut, and moreover is to do with an immune deficiency, I.e faulty macrophages or intracellular MAP infection, you're not going to see the benefits from FMT... Never know if you don't try though.


thanks joshuaaa, I was hoping you could be more precise about what it is exactly and precisely they do though. I could assume he would know 99% of the bacteria in the gi tract are extremely oxygen sensitive, but when doing science, we have to make as few or little assumptions as possible, so I'm searching for knowledge on what he is doing with a high degree of certainty. So I want to go a little beyond just making that assumption. It's ok though if you didn't really observe every detail of the process.

We may be laymen here on a website independent of the highly trained world of acedemia, but it is my goal to hold myself to a similar standard, or at least try my best.   So lets for a moment assume every precaution was taken to preseve the donors stool from oxygen, then my nexts best guess to explain such variability in results would be the ph of the donors stool, as some of the bacteria we need are highly sensitive to ph fluctuations. PH can be positively affected by the donors diet days prior to sample collection. But there going to be a limit to what I can EVER know without throwing myself back in school to be apart of the research myself!! haha. 

So glad you went to borody's clinic to do this, it was definitely worth a shot and may be worth another shot as well. Its truly just the beginning of a new science, we have only recently (perhaps a decade) applied DNA techniques to reveal the secrets of the world of bacteria, and only 2 years since mapping the microbiome. FDA clinical trials on Fecal Transplants began this year 2014 so yea this is the beginning,  You are a leader and a pioneer in scientific medicine Joshuaaa.


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## wildbill_52280

Here is a very good video made by Crohn's & Colitis Foundation of America on fecal transplants. Gives good info on recent studies on fecal transplants.
https://www.youtube.com/watch?v=1ZjTSNyoH3k


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## wildbill_52280

Here is a Recent paper released discussing the variability in results of fecal transplants, or why its efficacy is sometimes dramatic and other times slow going or takes no effect at all. Finally they talk about donor stool quality as a variable to efficacy, something i have been waiting for people to address more. 

My own thoughts are we are not trying to control all the variables that exist such as donor diet or patient diet, so we don't know how that may affect the outcomes. Hopefully some researchers will try to examine this in the coming years, but at least they talk about it a little bit here. the quantitys of bacteria in stool can vary from one donor to another, and one sample to another in the same donor, so the potency can vary quite a bit.

http://journals.lww.com/jcge/Fullte...Disease_Ready_for_Fecal_Microbiota.6.aspx#R12


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## wildbill_52280

I found two new studies for Fecal Transplants in Crohn's disease, that will total 15 studies planned in the U.S and around the world. Momentum is still going strong for this treatment, so hang in there!! A few have been completed already but I don't recall which ones. Whats great is i think we have enough suggestive evidence to keep things moving, so things aren't going to slow down anytime soon, and are more likely to pick up with more studies to come.

https://clinicaltrials.gov/ct2/show...+ibd&rcv_s=01/01/2014&rcv_e=08/08/2014&rank=6

https://clinicaltrials.gov/ct2/show...+ibd&rcv_s=01/01/2014&rcv_e=08/08/2014&rank=1


----------



## wildbill_52280

news segment on KZTV10 Corpus Christi Texas about successful treatment of man with U.C. with a Fecal Transplant.
http://www.kztv10.com/player/?video_id=38827


----------



## 7vNH

This is an execerpt from a book called "Think Like a Freak" by Levitt and Dubner (earlier books "Freakonomics" and "Super Freakonomics").  None of these books are medical in nature, they simply view problems through data rather than dogma.

Borody and FMT come near the end.

The point of this quote is that this comes from a NY Times top selling book...the word is getting out into the general media.



> You might think that medicine, with such strong doese of science and logic, is on field in which root cases are always well understood.
> 
> Alas, you would be wrong.  The human body is a complex, dynamic system about which a great deal remans unknown.  Writing as recently as 1997, the medical historian Roy Poerter put it this way: "We live in an age of science, but science has not eliminated fantasies about health; the stigmas of sickness, the moral meanings of medicine continue."  As a result, gut huncheas are routinely passed off as dogma while conventional wisdom flourishes even when there is no data to back it up.
> 
> Consider the ulcer.  It is essentially a hole in your stomach or small intestine, producing a searing and surging pain.  Bu the early 1980s, the acuses of an ulcer were said to be definitively known: they were inherited or caused by psychological stress anspicy food, either of which could produce an overabundance of stomach acid.  To anyone who has ever eaten a pile of jalapenos, this seams plausible.  And as any doctor could attest, a patient with a bleeding ulcer was likely to be stressed out.  (A doctor might just as seasily not that shooting victims tend to bleed a lot, but that doesn't mean the blood caused the gunshot.)
> 
> Since the causes of ulcers were known, so too was the treatment. Patients were advised to relax (to cut down on stress), drink milk (to soothe the stomach), and take a Zantax or Tagamet pill (to block the production of stomach acid).
> 
> How well did this work?
> 
> To put it charitably: so-so.  The treatment did hel manage a patient's pain, but the condition wasn't cured.  And an ulcer is more than a painful nuisance.  It can easily becom fatal due to peritonitis (caused by a hole going clear through the stomach wall) or complications from bleeding.  Some ulcers required major surgery, with all the attendant complications.
> 
> Although ulcer patients didn't make out so well under the standard treatment, the medical community did just fine.  Millions of patients required the constant service of gastroenterologists and surgeons, while pharmaceutical companites got righ: the antacides Tagamet and Zantak were the first true blockbuster drugs, taking in more than $1 billion a year.  By 1994, the global ulcer market was worth more than $8 billion.
> 
> In the past, some medical researcher might have suggested that ulcers and other stomach ailments, including cancer, had a different root cause-perhaps even bacterial.  But the medical establishment was quick to point out the glaring flaw in this theory: How could bacteria possibly survive in the acidic cauldron of the stomach?
> 
> And so the ulcer-treatment juggernaut rolled on.  There wasn't much of an incentive to find a cure-not, at least, by the people whose careers depended on the prevailing ulcer treatment.
> 
> Fortunately the world is more diverse than that.  In 1981, a young Australian medical resident named Barry Marshall was on the hunt for a research project.  He had just taken up a rotation in the gastroenterology unit at Royal Perth Hospital, where a senior pathologist had stumbled onto a mystery.  As Marshall later described it: "We've got 20 patients with bacteria in their stomach, where you shouldn't have bateria living because there's too much acid."  The senior doctor, Robin Warren, was looking for a young researcher to heal "find out what's wrong with these people."
> 
> The squiggly bacteria resembled a species called Campylobacter, which can cause infection in people who spend time with chickens.  Were these human bacteria indeed Campylobacter?  What kind of diseases might they lead to?  And wy were they so concentrated among patients with gastric trouble?
> 
> Barry Marshall, as it turns out, was already familiar with Campylobacter, for his father had worked as a refrigeration engineer in a chicken-packing plant.  Marshall's mother, meanwhile, was a nurse.  "We use to have a lot of arguments about what was really true in medicine," he told an interviewe4r, the esteemed medical journalist Norman Swan.  "She would 'know' things because they were folklore, and I would say 'That's old-fashioned.  There's no basis for it in fact.' 'Yes, but people have been doing it for hundres of years, Barry.'"
> 
> Marshal was excited by the mystery he inherited.  Using samples from Dr. Warren's patients, he tried to culture the squiggly bacteria in the lab.  For months, he failed.  But after an accident-the culture was left in the incubator three days longer than intended-it finally grew.  It wasn't Campylobacter; it was a previously undiscovered bacteria, henceforth known as Helicobacter pylori.
> 
> "We cultured it from lots of people after that," Marshall recalls.  "The we could say, 'We know which antibiotic kills these bacteria.'  We fitured out how they could live in the stomach, and we could play around with it in the test tube, do all kinds of useful experiments.... We were not looking for the cause of ulcers.  We wanted to find out what these bacteria were, and we thought it would be funt to get a nice little publication."
> 
> Marshall and Warren continued to look for this bacteria in patients who came to see them with stomach trouble.  The doctors soon made a startling discovery: among 13 patients with ulcers, all 13 also had the squiggly bacteria!  Was it possible that H. pylori, rather than merely showing up in these patients, was actually causing the ulcers?
> 
> Back in the lab, Marshall tried infecting some rats and pigs with H. pylori to see if they developed ulcers.  They didn't.  "So I said, 'I have to test it out on a human.'"
> 
> The human, Marshall decided, would be himself.  He also decided not to tell anyone, even his wife or Robin Warren.  First he had a biopsy taken of his stomach to make sure he didn't already have H. pylori.  All clear.  Then he swallowed a batch of the bacteria that he had cultured from a patient.  In Marshall's mind, there wer two likely possibilities:
> 
> 1. He would develop an ulcer. "And then, hallelujah, it'd be proven."
> 2. He wouldn't develop an ulcer.  "If nothing happened, my two years of research to taht point would have been wasted."
> 
> Barry Marshall was probably the only person in human history rooting for himself to get an ulcer.  If he did, he figured it would take a few years for symptoms to arise.
> 
> But just five days after he gulped down the H. pylori, Marshall began having vomiting attacks.  Hallelujah!  After ten days, he had another biopsy taken of his stomach, "and the bacteria were everywhere."  Marshall already had gastritis and was apparently well on his way to getting an ulcer.  He took an antibiotic to help wipe it out.  His and Warren's investigation had proved that H. pylori was the true cause of ulcers-and, as further investigation woudl show, of stomach cancer as well.  It was an astonishing breakthrough.
> 
> Granted, there was much testing to come-and an enormous pushback from the medical community.  Marshall was variously ridiculed, pilloried, and ignored.  Are we to seriously believe that some loopy Australian found the cause of ulcers by swallowing a batch of some bacteria that he says he discovered himself?  No $8 billion industry is ever happy when its reason for being is under attach.  Talk about gastric upset!  An ulcer, rather than requiring a lifetime of doctor's visits and Zantac and perhaps surgery, could not be vanquished with a cheap dose of antibiotics.
> 
> It took years for the ulcer proof to fully take hold, for conventional wisdom dies hard.  Even today, many people still believe that ulcers are caused by stress or spicy foods.  Fortunately, doctors now know better.  The medical community finally came to acknowledge that while everyone else was simply treating the symptoms of an ulcer, Barry Marshall and Robin Warren had uncovered its root cause.  In 2005, the were awarded the Nobel Prize.
> 
> The ulcer discovery, stunning as it was, constitutes just one small step in a revolution that is only beginning to unfold, a revolution aimed toward finding the root cause of illness rather than simpley swatting away the symptoms.
> 
> H. pylori, it turns out, isn't some lone-wolf bacterial terrorist that managed to slip past security and invade th stomach.  In recent years, enterprising scientists-aided by newly powerful computers that facilitate DNA sequencing-have learned that the human gut is home to thousands of species of microbes.  Some are good, some are bad, and others are situationally good or bad, and may have yet to reveal their nature.
> 
> Just how many microbes to each of us host?  By one estimate, the human body contains ten times as many microbial cells as human cells, which pust the number easily in the trillions and perhaps in the quadrillions.  This "microbial cloud," as the biologist Jonathan Eisen calls it, is so vast that some scientists consider it the largest organ in the human body.  And within it my lie the root of much human health...or illness.
> 
> In labs all over the world, researchers have begun to explore whether the ingredients in this sparwling microbial stew-much of which is hereditary-may be responsible for diseases like cancer and multiple sclerosis and diabetes, even obesity and mental illness.  Does it seem absurd to think that a given ailment that has haunted humankind for millennia may be cause by the malfunction of a micro-organism that has been merrily swimming through our intestines the whole time?
> 
> Perhaps-just as it seemed absurd to all those ulcer doctors and pharmaceutical executives that Barry Marshall knew what he was talking about.
> 
> To be sure, these are early days in microbial exploration.  The gut is still a frontier-think of the ocean floor or the surface of Mars.  But already the research is paying off.  A handful of doctors have successfully treated patients suffering from intestinal malidies by giving them a transfusion of healthy gut bacterial.
> 
> Where to these healthy bacteria come from, and how are they sluiced into the sick person's gut?  Before going further, let us offer two notes of caution:
> 
> 1. If you happen to be eating as you read this, you may wish to take a break.
> 
> 2. If you are reading this book many years after it was written (assuming there are still people, and they still read books), the method described below may seem barbarically primitive.  In fact we hope that is the case, for ti would mean the treatment has proven valueable but that the delivery methods have improved.
> 
> Okay, so a sick person needs a transfusion of healthy gut bacteria.  What is a viable source?
> 
> Doctors like Thomas Borody, and Australian gastroenterologist who drew inspiration from Barry Marshall's ulcer research, have identified one answer: human feces.  Yes, it appears that the microbe-rich excrement of a healthy person may be just the medicine for a patient whose own cut bateria are infected, damaged, or incomplete.  Fecal matter is obtained from a "donor" and blended into a saline mixture that, according to one Dutch gastroenterologist, looks like chocolate milk.  The mixture is then transfused, often via an enema, into the gut of the patient.  In recent years, doctors have found fecal transplants to be effective in wiping out intestinalinfections that antibiotics could not.  In one small study, Borody claims to have used fecal transplants to effectively cure people who were suffering from ulcerative colitis-which, he says, was "previously an incurable disease."
> 
> But Borody has been going beyond mere intestinal ailments.  He claims to have successfully used fecal transplants to treat patients with multiple sclerosis and Parkinson's disease.  Indeed, while Borody is careful to say that much more research is needed, the list of ailments that may have a root cause living in the human gut is nearly endless.
> 
> To Borody and a small band of like-minded brethren who believe in the power of poop, we are standing at the threshold of a new era in medicine.  Borody sees the benefits of fecal therapy as "equivalent to the discovery of antibiotics."  But first, there is much skepticism to overcome.
> 
> "Well, the feedback is very much like Barry Marshall's," says Borody.  "I was initially ostracized.  Even now my colleagues avoid talking about this or meeting me at conferences.  Although this is changing.  I've just had a nice string of invitations to speak at national and international conferences about fecal transplantation.  But the aversion is always there.  It'd be much nicer if we coulde come up with a non-fecal-sounding therapy."
> 
> Indeed.  One can imagine many patients being turned off by the words fecal transplant or, as researchers call it in the academic papers, "fecal microbiota transplantation."  The slang used by some doctors ("shit swap") is no better.  But Borody, after years of performing this procedure, believes he has finally come up with a less disturbing name.
> 
> "Yes," he says, "we call it a 'transpoosion.'"
> 
> --Book: Think Like a Freak (2014)
> --Authors: Steven D. Levitt & Stephen J. Dubner


I hand typed this.  I did not include italics.  Sorry for any typos, there are probably plenty...I didn't go back an proof it.


----------



## 7vNH

wildbill_52280 said:


> Here is a very good video made by Crohn's & Colitis Foundation of America on fecal transplants. Gives good info on recent studies on fecal transplants.


I don't know anything about ccfa, but I see that they are funded primarily by pharmaceutical companies: AbbVie, Actavis, Covidien, Janssen, Pfizer, Prometheus, ReddHill, Salix, Shire, Takeda.

What would happen to the revenues of these companies if there were an "H. pylori" set of breakthroughs, one for UC and one for CD?

Sorry for being skeptical, but my default is to "follow the money", and I'd say most of these companies would take a serious hit if a real cure happened to be discovered.

I'm only 20 minutes into the presentation (so far it's all fluff), but just looking at the title, I'm a little put-off by the fact that they lumped dietary change in with FMT.  The former has been tweaked and tested for a hundred years and we know that it's not going to be a cure for anything.


----------



## wildbill_52280

7vNH said:


> I don't know anything about ccfa, but I see that they are funded primarily by pharmaceutical companies: AbbVie, Actavis, Covidien, Janssen, Pfizer, Prometheus, ReddHill, Salix, Shire, Takeda.
> 
> What would happen to the revenues of these companies if there were an "H. pylori" set of breakthroughs, one for UC and one for CD?
> 
> Sorry for being skeptical, but my default is to "follow the money", and I'd say most of these companies would take a serious hit if a real cure happened to be discovered.
> 
> I'm only 20 minutes into the presentation (so far it's all fluff), but just looking at the title, I'm a little put-off by the fact that they lumped dietary change in with FMT.  The former has been tweaked and tested for a hundred years and we know that it's not going to be a cure for anything.


Well I like some aspects of the way you think and if i ever need a typist ill know who to call since you claim to have typed the entire last post, haha.The idea of intestinal bacteria being the cause of disease has existed way before barry marshall and his h pylori experiments, elie mecthnikoff book in the early 1900's developed a theory of aging and disease implicating intestinal bacteria and a concept of endotoxemia aka autointoxication.
http://books.google.com/books?id=XJ...=elie metchnikoff prolongation of life&f=true

here is his book full text http://books.google.com/books?id=XJ...=elie metchnikoff prolongation of life&f=true

And John harvey kellogg who started kellogg cereals was a doctor who tried applying these theories by giving yogurt enemas to patients. 
http://en.wikipedia.org/wiki/John_Harvey_Kellogg#Battle_Creek_Sanitarium
http://books.google.com/books?id=kbMwAQAAMAAJ&pg=PA254&source=gbs_toc_r&cad=4#v=onepage&q&f=false

Also my thoughts on Barry Marshalls "proof" that H.pylori was the cause of ulcers I'm wondering where he ever thought people were coming into contact with large amounts of h pylori in the first place to develop an ulcer, as his experiment may never simulate realistic conditions. and how do we know he needed antibiotics to clear this infection or if his body would have eventually recovered on its own? its a start, but that wouldn't be sufficient to prove this is how people developed ulcers in real life, but its a good observation to build a theory. Obviously we now see how barry's conclusions may not have been justified in light of the new techniques we have to study bacteria, and that he simply had a theoretical model which probably should have been refined, well now its being refined as we see.


As far as the skepticism of any company developing a cure, it seems the fecal transplant pill would be the cure all, only if it is based on the full microbiota and not selected bacterial species. There are patents that exist and money to be made off this for sure and they are working on this right now, but as far as i recall its not a full flora, that's the one we will want, but a selection of the right bacteria would do alot for us, but people may have damage all over the place.


----------



## 7vNH

There is a free course on coursera.org about the microbiome.  The course is from the people who are heading the american gut project.  The course starts in October.

Gut Check: Exploring your Microbiome


----------



## 7vNH

wildbill_52280 said:


> As far as the skepticism of any company developing a cure, it seems the fecal transplant pill would be the cure all, only if it is based on the full microbiota and not selected bacterial species. There are patents that exist and money to be made off this for sure and they are working on this right now, but as far as i recall its not a full flora, that's the one we will want, but a selection of the right bacteria would do alot for us, but people may have damage all over the place.


In my horrific skepticism, I see anything that is used once for a cure as a nightmare for any of the pharmaceutical companies that have a "take for the rest of your life" drug on the market.

I'm no lawyer, nor have I concentrated very hard on the topic of patent protection, but I thought I heard somewhere that living things can not be patented?  If there are companies out there that are trying to isolate various gut microbes to use in a non-full flora cure, maybe that would be patentable.  The good news about some patented mix of microbes: the insurance companies would see that even if treatment with this magic juice was really expensive, it would be cheaper than paying for these insanely priced biologics for the rest of one's life, not to mention the surgery when the drugs quit working.  We just have to hope that they don't engineer the magic juice to stop working after a few months (i.e. the don't create a cure, instead they come up with something they'd like better: a cash cow for them that would require patients to use it for the rest of their days).


----------



## wildbill_52280

7vNH said:


> In my horrific skepticism, I see anything that is used once for a cure as a nightmare for any of the pharmaceutical companies that have a "take for the rest of your life" drug on the market.
> 
> I'm no lawyer, nor have I concentrated very hard on the topic of patent protection, but I thought I heard somewhere that living things can not be patented?  If there are companies out there that are trying to isolate various gut microbes to use in a non-full flora cure, maybe that would be patentable.  The good news about some patented mix of microbes: the insurance companies would see that even if treatment with this magic juice was really expensive, it would be cheaper than paying for these insanely priced biologics for the rest of one's life, not to mention the surgery when the drugs quit working.  We just have to hope that they don't engineer the magic juice to stop working after a few months (i.e. the don't create a cure, instead they come up with something they'd like better: a cash cow for them that would require patients to use it for the rest of their days).


yea i recall that bacteria are not patentable, or at least probiotics. the mixture that you develop and the method of encapsulation or even the concept of human feces derived bacteria for the use of treating a specific ailment, might be patentable though and i recall Dr Borody holds some patents on this. So there are these concepts of the uses they have that people can patent, THAT is what makes it an invention, but don't quote be verbatim. There may be a way to actually isolate the right bacteria learn to culture them(good luck!!) but you would never legally be allowed to advertise them with the use intended unless you put them through fda clinical trials for the defined ailment, so doing that would merely be a personal project and not a business.

here are some patents that exist
http://www.sumobrain.com/patents/wi...ral-transplantation-methods/WO2012016287.html
http://www.sumobrain.com/patents/wipo/Encapsulated-intestinal-flora-extracted-from/WO2011033310.html

As far as the  money to gain from a once use drug think about the recently proven treatment for hepatitis c, the price is really high top of my head 80,000 for a 12 week treatment to cure hep c. so they would probably just raise the price. this is really not my area of expertise though, so just off the top of my head.


there are companies that are making the type of drugs that are based on the metabolites of the good bacteria, rather then the good bacteria itself, so this would be more along the lines of a continuous treatment for life rather then the possibility of a cure. all sorts of stuff going on nobody knows how things will pan out, im pretty certain for IBD we replace the bacteria and were done for life, seems the evidence is slowly pointing in that direction especially with borodys word for word quote in recent medical journals stating some patients seem cured of UC and Crohn's.


----------



## Spooky1

I've got some Coursera moocs on the go.  Bet that one will get my brain in a fluff, lol.


----------



## Mommabear

Fecal Microbiota Transplantation Induces Early Improvement in Symptoms in Patients With Active Crohn's Disease
Byron P. Vaughn, Dirk Gevers, Amanda Ting, Joshua R. Korzenik, Simon C. Robson, Alan C. Moss
http://www.gastrojournal.org/article/S0016-5085(14)62143-0/pdf

The question is: can the remission be sustained?


----------



## wildbill_52280

Mommabear said:


> Fecal Microbiota Transplantation Induces Early Improvement in Symptoms in Patients With Active Crohn's Disease
> Byron P. Vaughn, Dirk Gevers, Amanda Ting, Joshua R. Korzenik, Simon C. Robson, Alan C. Moss
> http://www.gastrojournal.org/article/S0016-5085(14)62143-0/pdf
> 
> The question is: can the remission be sustained?



Read the first post of this thread for reports of sustained remission up to 12 years in crohn's disease. This prompted Professor Borody to suspect the patient may have been cured. what is new about the report you provided is that i believe this is one of the first times a crohn's patient achieved a remission with a single colonoscopic FMT. The 12 years remission occured with a nasoduodenal tube.


----------



## rollinstone

Borody says 1 in 30 itl sustain remission for CD, if it doesn't then it's probably because your cd isn't primarily caused by a disbiosis but rather an infection, probably AEIC or MAP, if it is caused by a disbiosis then you'll probably see the results your after. But it's still early early days, hopefully they'll discover how to make it more successful
For cd soon


----------



## wildbill_52280

A recent news article on the regulation of fecal transplants.

http://www.theatlantic.com/health/archive/2014/09/when-feces-is-the-best-medicine/379491/


----------



## wildbill_52280

So one of my original intentions for this thread was for people who wanted to find donors to do a fecal transplant, could help each other do this, so I'm bringing this issue back up i guess, any comments or ideas? 

With 15 f.d.a. clinical trials underway and official documented cases being cured, I'd think it's pretty clear this idea is real and has promise. I suppose some people are fine with waiting 3-5 years for this treatment to be available, while some are not.


----------



## 7vNH

I understand that there are clinics that will be opening in travel destinations near, but not within th US.  

In other words, you take a vacation and work-in adopting a new micribiome!


----------



## wildbill_52280

Hot off the Press!!
23 out of 30 patients achieve remission with fecal transplant via naso-duodenal tube( aka mid gut).note also that these were all the worst cases of crohn's disease resistant to medications(refractory). Also note this was achieved with one dose of oral FMT rather then 30-60 enemas or colonoscopic FMT. 



J Gastroenterol Hepatol. 2014 Aug 28. doi: 10.1111/jgh.12727. [Epub ahead of print]
*Fecal microbiota transplantation through mid-gut for refractory Crohn's disease: Safety, feasibility and efficacy trial results.*

Abstract
BACKGROUND AND AIM:
The gut microbiota plays a pivotal role in the intestinal diseases. Fecal microbiota transplantation (FMT) might be a rescue therapy for refractory inflammatory bowel disease. This study aimed to evaluate the safety, feasibility and efficacy of FMT through mid-gut for refractory Crohn's disease (CD).
METHODS:
We established standardized laboratory protocol and clinical work flow for FMT. Only refractory CD patients with Harvey-Bradshaw Index (HBI) score ≥ 7 were enrolled for this study. All included patients were treated with single FMT through mid-gut and assessed during follow-up.
RESULTS:
Metagenomics analysis showed a high concordance between feces sample and purified fecal microbiota from same donors. Standardized fecal microbiota preparation and clinical flow significantly simplified the practical aspects of FMT. Totally 30 patients were qualified for the present analysis. The rate of clinical improvement and remission based on clinical activity at the first month was 86.7 % (26/30) and 76.7 % (23/30) respectively, which was higher than other assessment points within 15-month follow-up. Patients' body weight increased after FMT, and the lipid profile improved as well. FMT also showed a fast and continuous significant effect in relieving the sustaining abdominal pain associated with sustaining CD.
CONCLUSIONS:
This is a pilot study with the largest sample of patients with refractory CD underwent single FMT. The results demonstrated that FMT through mid-gut might be a safe, feasible, and efficient rescue therapy for refractory CD.
This article is protected by copyright. All rights reserved.


----------



## Spooky1

Oh, WOW!  I want a FMT!  Get me well NHS.  this is so promising.  I so want to achieve remission.


----------



## wildbill_52280

An  link to the september issue of the journal of the san francisco medical society which is focused on microbiome science.

http://issuu.com/sfmedsociety/docs/september_cb3d1486510565?e=0/9352192#/signin


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## wildbill_52280

a scientist gives himself a fecal transplant from a donor in remote african tribe to increase his microbial diversity.

http://www.popsci.com/article/scien...al-transplant-try-hunter-gatherers-microbiome

http://humanfoodproject.com/rebecoming-human-happened-day-replaced-99-genes-body-hunter-gatherer/


----------



## Jennifer

wildbill_52280 I see that you haven't done this a second time. Have you spoken to your GI about trying it? What did they say? You also never mentioned (or at least I didn't see it) how you got into contact with your first donor.


----------



## nogutsnoglory

Mixed results in trials. It's interesting but far from definitive. 
http://m.gastroendonews.com/Article...ust+2014&i_id=1094&a_id=27918&tab=MostEmailed


----------



## wildbill_52280

nogutsnoglory said:


> Mixed results in trials. It's interesting but far from definitive.
> http://m.gastroendonews.com/Article...ust+2014&i_id=1094&a_id=27918&tab=MostEmailed


this link isnt working but i think i read this article already.
there's going to mixed results for some time. check out post #260 of this thread. there are also other examples of success, these protocols are not perfected yet. the fact that some studies have shown little effect does not make other more successful studies less true, its a matter of explaining why some are successfull and some are not, it doesn't negate the results of other studies, they are BOTH true. Sometimes it works and sometimes it doesn't, more studies are need to determine why, but it's working that's a fact.


----------



## wildbill_52280

frozen fecal transplant pills

http://www.npr.org/blogs/health/201...ampaign=npr&utm_term=nprnews&utm_content=2035


----------



## HelenMelb

That's brilliant. Hopefully, trials using these for Crohn's/IBD aren't too far away.

Thanks for the article wildbill.


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## wildbill_52280

http://www.boston.com/health/2014/1...ou-per-dump/FMMhBXMKyFNTRXKoThmnpM/story.html


----------



## Malgrave

Has diversion colitis ever been treated with FMT?


----------



## nogutsnoglory

Malgrave said:


> Has diversion colitis ever been treated with FMT?


I don't know but I could see that being very beneficial in that circumstance. If they don't already do it, they should try.


----------



## wildbill_52280

a scientific revolution and theory of all diseases!!
http://qz.com/283189/how-millennials-will-save-us-all/


----------



## wildbill_52280

http://www.abc.net.au/news/2014-10-25/gut-microbiota-linked-to-health-autism-schizophrenia/5841264


----------



## wildbill_52280

https://www.youtube.com/watch?v=fTcxYp6BJP4#t=102


----------



## wildbill_52280

Just a friendly reminder that the first post of this thread still has alot of good information in it, for those that have never seen it. Although i would love to take time and improve it sometime.


----------



## wildbill_52280

> Published on Oct 24, 2014
> This talk was given at a local TEDx event, produced independently of the TED Conferences. We are more obsessed with cleanliness than ever: we use antibacterial cleansers, we keep our children away from dirt, and we give out antibiotics with little regard for long-term effects. But in the process we are altering our microbiota, the microbes that live on and inside us. And it's causing us to be more sick.
> 
> Claire M. Fraser, PhD, is a world-renowned scientist who launched a new field of study – microbial genomics and, through her ground-breaking research and pioneering leadership in this field, has fundamentally changed our understanding of the diversity and evolution of microbial life on Earth. Her collective work over two decades, has made sustained and transformational changes to our understanding of microbial biology.


https://www.youtube.com/watch?v=GSRGlbXkJs4#t=983


----------



## 7vNH

wildbill_52280 said:


> https://www.youtube.com/watch?v=GSRGlbXkJs4#t=983


Every person on this forum should go to the "american gut project" and order kit...the more samples of IBD, the better!


----------



## rollinstone

7vNH said:


> Every person on this forum should go to the "american gut project" and order kit...the more samples of IBD, the better!


Is that possible for those outside the US?


----------



## wildbill_52280

A new study planned for FMT on UC.

http://clinicaltrials.gov/ct2/show/NCT02291523


----------



## 7vNH

rollinstone said:


> Is that possible for those outside the US?


Anyone can participate, but the shipping would add some expense for you.  If you happen to be in the UK, there's a British Gut Project! Look on FundRazr.com, or google human food project.


----------



## 7vNH

What is the latest science (or conjecture) concerning pre-FMT antibiotics?

I see that the published document from Dr. Borody had specific types, amounts, and timings, but that document was published a long while back so the thinking may have changed. Any more recent documents that I can read on this topic?

For the readers of this thread...if you were going to get a professional (ie expensive) FMT, would you opt in , or opt out of pre-FMT antibiotics and why?


----------



## wildbill_52280

> Part of the work highlighted in the paper shows the rapid recovery of a young man with Crohn’s colitis whom Kao is treating. “We gave him fecal transplant and then within a week his symptoms started to improve.” She adds the real shock came at the follow-up colonoscopy four weeks later for another transplant, as the symptoms had disappeared entirely from his bowel. “I was absolutely shocked to see that the inflammation had completely healed. I wasn’t expecting it to look like that.”


http://www.med.ualberta.ca/news/2014/november/fecal-microbial-transplant


----------



## Crohn2357

I suggest looking into healingwell ulcerative colitis forum:
http://www.healingwell.com/community/default.aspx?f=38&r=x
Lots of personal experiment, some succes stories, lots of topics about FMT. Just use the search button.


----------



## 7vNH

Crohn2357 said:


> I suggest looking into healingwell ulcerative colitis forum:
> http://www.healingwell.com/community/default.aspx?f=38&r=x
> Lots of personal experiment, some succes stories, lots of topics about FMT. Just use the search button.


A lot of talk over there about biofilms. Back to my question, it sounds like antibiotics (and 5-ASA) make the biofilm less dense, but of course doesn't get rid of it. If the idea of an FMT is to have a new set of gut micribes take hold, it would seem to me that weakening rhe biofilm would be a good idea. So pre-fmt antibiotics would be indicated?


----------



## Crohn2357

I don't know the answer.


----------



## wildbill_52280

Podcast about fecal transplants.

http://www.newyorker.com/culture/culture-desk/out-loud-podcast-fecal-transplants


----------



## wildbill_52280

A super long article on Fecal Transplants. 
The New Yorker December 1st 2014.

http://www.newyorker.com/magazine/2014/12/01/excrement-experiment


----------



## 7vNH

7vNH said:


> What is the latest science (or conjecture) concerning pre-FMT antibiotics?


rollinstone, Can you tell me when your last dose of antibiotics were before your first FMT?  I had heard 2 or 3 days of no antibiotics before FMT, but I wanted to know what your experience was.


----------



## 7vNH

wildbill_52280 said:


> A super long article on Fecal Transplants.
> The New Yorker December 1st 2014.


Nothing new to us in that article, but I'd say the author did a great job of covering the history and current status, including a good summary of the FDA actions (stool as a drug vs a tissue), and even a bit of speculation of what is to come if big pharma comes up with a cultured C. Diff enema (might force a shutdown of the non-profit OpenBiome).


----------



## wildbill_52280

Fecal Transplant may treat diabetes.
http://www.startribune.com/lifestyle/health/284227581.html


----------



## wildbill_52280

An update on my latest fecal transplant experience-

*EDIT- I forgot to mention that most of my symptoms were under control before doing the FMT, more precisely I have one bm per day, so most of improvements could not be measured by how much diarrhea I have, so i measured the FMT efficacy by other symptoms*

8 weeks ago I attempted to do another fecal transplant. This time instead of trying to make pills, I drank 8 ounces of apple juice mixed with stool so about 1 measured cup. My donor was young and his stool sample was very firm and not an ideal sample to use for a fecal transplant because it likely had very little good bacteria in it. I used the sample anyways because its been so hard to find a donor. His stool was so hard that it barely broke up even in the blender! My health has improved about 15% despite all the imperfections, so i do not regret it. 

So my BMs have been healthier looking, they are larger and softer BUT I still have quite a few symptoms of disease so ill have to do it again using a better stool sample. The biggest improvement has been a dramatic increase in weight, I've gained a pound a week since the transplant so 8-9 lbs.  I have gained all this weight without increasing my caloric intake, so that demonstrates that it was the fecal transplant and not simply increasing my calories. Now I'm considered to be at a healthy weight. I believe what is happening is that i gained some new bacteria and I'm now extracting more energy from the same amount of food it seems. Studies show that sterilized mice with no gut bacteria require more calories to maintain their weight when compared to mice with gut bacteria. This is a most likely explanation of my experiance with FMT.

My symptoms of anxiety are much lower now and my brain works a little better too, keep in mind I am a severe case and my bodily dysfunction is profound. All in all, I'm so glad i did it , there were only minor side effects that went away after the second week which were a slight increase in mucus and one or two days of really small dry stools and some floating stools from fat malabsorption. I will have to do it again and hope that my next donor will correctly follow the proper diet to give me a healthy sample with a high enough bacteria dose where I might obtain the correct strains that will fix the inflammatory response. I believe the benefits are permanent since the side effects left 6 weeks ago and I'm still reaping the benefits. My next fecal transplant is in about 2 weeks from now ill let you know how that goes. I will be doing the procedure in a similar way by drinking the solution but I'm using saline instead of apple juice . later!


----------



## wildbill_52280

Gut microbiota and Parkinson’s disease: Connection made

http://www.sciencedaily.com/releases/2014/12/141211081120.htm


----------



## Spooky1

that's interesting.  I'm trying homemade sauerkraut at the moment.  I'm hopeful the probiotics in this will help me to replenish the gut flora.  It's cheaper and more potent than bought pills, and yogurt.


----------



## mf15

By drinking poo there is a possibility that one reason it works is induction of oral
immune tolerance to the bacteria, which may be lost in IBD.  Loss of tolerance is an old IBD theory.
Old Mike


----------



## Jennifer

Are you vaccinated against typhoid fever wildbill_52280? How do you know your donors aren't carriers? 

"Persons with typhoid fever carry the bacteria in their bloodstream and intestinal tract. In addition, a small number of persons, called carriers, recover from typhoid fever but continue to carry the bacteria. Both ill persons and carriers shed Salmonella Typhi in their feces (stool)." http://www.cdc.gov/nczved/divisions/dfbmd/diseases/typhoid_fever/


----------



## wildbill_52280

Jennifer said:


> Are you vaccinated against typhoid fever wildbill_52280? How do you know your donors aren't carriers?
> 
> "Persons with typhoid fever carry the bacteria in their bloodstream and intestinal tract. In addition, a small number of persons, called carriers, recover from typhoid fever but continue to carry the bacteria. Both ill persons and carriers shed Salmonella Typhi in their feces (stool)." http://www.cdc.gov/nczved/divisions/dfbmd/diseases/typhoid_fever/


That is useful to know. I'm generally familiar with my donors though, although it's possible for me to expose myself to risks, I do what i can to make sure they are healthy and cross my fingers. No matter what we do in life some risk is unavoidable. So far so good. One donor has taken extensive blood tests. It was HIV, Hep C and undiagnosed IBD I'm most concerned about. from the link it sounds like they are just advising people to see their doctor as they recover from the illness as they may not have recovered 100% even though they seemed to be recovered, im not sure this means they carry the bacteria forever though its just not that clear from this site alone whether this is the case. I think they are saying to let a doctor run some tests to make sure you are 100% recovered so you do not infect anyone else.


----------



## wildbill_52280

Update on my second Fecal transplant-

2 days ago i drank another mixture of stool and this time i mixed with saline rather then apple juice. I almost threw up this time!! but held it down. zero negative effects so far and nothing positive yet. Unlike the  last time i did not have intense intestinal gurgling followed by a bloody bm 3 hours later,  this may be from using saline this time instead of apple juice which the high sugar content would have resulted in more diarhea symptoms,  in that sense the new method is an improvement. Based on the experiance i have gained from all this if i do this again i will mix stool with distilled water instead, as i think the saline may have inspired the inclination to throw up, rarely do humans encounter such a salty fluid and i did not have any urge to throw up when mixing it with apple juice. The saltiness may have been a problem or the presence of an actual food like apple juice been protective against an urge to throw up.

The donors stool was softer this time, but a little too soft. It's hard to know yet whether this was a good or bad thing,  generally speaking though it looked within a normal healthy range to me, based on what I know about what a healthy stool sample should look like so not perfect but not bad either.  Ill be back with an update in about a week or so.if you can do what i just did 2x, MAYBE you can call yourself a man, ha.


----------



## NothingL

I really appreciate what you are doing wildbill, make sure you don't leave us hanging. 

I think drinking the fecal matter is much more effective than having an enema, a lot of the imbalance is also within the small intestine. 

You should have much better results than others who had it done through an enema.


----------



## wildbill_52280

NothingL said:


> I really appreciate what you are doing wildbill, make sure you don't leave us hanging.
> 
> I think drinking the fecal matter is much more effective than having an enema, a lot of the imbalance is also within the small intestine.
> 
> You should have much better results than others who had it done through an enema.


That's what I am hoping for. My biggest concern is having the donor follow the correct diet, its been hard to get them to comply. the variability of bacterial composition in any given stool sample is supposedly pretty high, so with only one chance to get it right,  multiple transplants could be more beneficial, even though just one  could be enough. The only official reported cured crohn's patient used 3 donors at one time. This way it's like doing it 3x,  it really increases the chances of getting the strains you need. If i do fail, i believe it's because of the donors diet. but ill do it again and make sure they understand the importance. its been hard enough just to convince them to help me, let alone follow a strict diet. They now see that im not dead and in fact improved in many ways and therefore i have succeeded in showing them it's generally safe. now perhaps ill get a chance to really understand how this all works.


----------



## NothingL

IBD and IBS take YEARS to develop, as a result, fecal therapy has to be very rigorous in order to fix the damage that has been done. 

I like to think of it as a workout. If you are obese and out of shape, a single exercise session is not going to do much. You need to exercise routinely and continuously to see any improvements.


----------



## NothingL

wildbill, can you update us on your status. Are you seeing any results?


----------



## wildbill_52280

NothingL said:


> wildbill, can you update us on your status. Are you seeing any results?


I promised to update and its been over a week so I apologize. There have been no dramatic improvements for this second oral FMT, it's been 2 weeks post procedure, I was actually waiting a few more days to wait and see if i could notice at least any minor improvements because the last time it took me 2-3 weeks before i could say with confidence i had improved in any way, so it's still a little early to say, but what i can say is there have been no dramatic improvements, it's looking like ill be doing it again, this time with strict diet guidelines for my donor. I suspect having the donor follow a strict diet high in fiber is critical now, even though I always felt this way, The donor i'm dealing with isn't very keen on taking advice or following directions, so i didn't push the demands too hard, if I use the same donor again ill have to really push the issue. 

For the record me as the patient i am following an extremely high fiber diet for example 3 cups of cooked broccoli and cauliflower , 300 calories of whole rolled oats, 600 calories of whole wheat this is what i eat daily made from scratch so im not eating "whole wheat" bread which is actually only 50% whole wheat and 50% refined wheat, im making foods products from 100% whole wheat which is about 6x higher in fiber.

Also, I've experienced very little negative side effects this second time compared to the first time, so i can only speak for my own experiences here but its generally been safe for me, that's not to say anyone should enter doing this without some knowledge or taking precautions, buts that another benefit of hearing about my experiences, to make it easier for other people to do it safely, diminish fears and in my own little way, advance our knowledge about restoring the microbiome with a fecal transplant.

There is still a slight chance i may have experienced some benefits from this recent oral FMT, I seem to be able to sleep longer but ill have to review my notes over the past 4 weeks to see what my averages are, but that's about it. But what i was hoping for was an ultra-efficiently performed fecal transplant with one orally administered dose leading to a dramatic turn around enabling me to digest normal foods again without increasing disease symptoms, a return of normal energy levels. I promise you i will find a way to do this and I'm much closer then ever before.


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## NothingL

Thanks for keeping us updated, I suffer from digestive problems myself and will be doing an FMT soon.


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## Spooky1

Good luck with that, Nothing.  keep us informed please.


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## 7vNH

wildbill_52280 said:


> ...
> 
> But what i was hoping for was an ultra-efficiently performed fecal transplant with one orally administered dose leading to a dramatic turn around enabling me to digest normal foods again without increasing disease symptoms, a return of normal energy levels. I promise you i will find a way to do this and I'm much closer then ever before.


Your protocol does not include pre-treating with antibiotics, right?  I was thinking that might be a good idea...knock DOWN (it's impossible to knock OUT) the current set of gut bacteria so the introduced set can get a foot hold.  I know Borody's protocol includes antibiotics, and other protocols use 'rinsing' techniques including 14 doses of MiraLAX in just a few hours as well as colonic lavage.  It seems like the idea is to drop the numbers of the existing microbiome as low as possible before the new microbiome is introduced.


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## wildbill_52280

7vNH said:


> Your protocol does not include pre-treating with antibiotics, right?  I was thinking that might be a good idea...knock DOWN (it's impossible to knock OUT) the current set of gut bacteria so the introduced set can get a foot hold.  I know Borody's protocol includes antibiotics, and other protocols use 'rinsing' techniques including 14 doses of MiraLAX in just a few hours as well as colonic lavage.  It seems like the idea is to drop the numbers of the existing microbiome as low as possible before the new microbiome is introduced.


I do recall borodys FMT protocol for the first study on U.C. was similar to what you just described, I'm aware of all these things. I'm not sure how easy it is to obtain antibiotics from a doctor to do something that isn't regarded as a medical necessity, that may be considered malpractice in a doctors eyes, and they wouldn't take part unless they were specifically conducting research on FMT. So obtaining antibiotics for this purpose is kind of an unrealistic goal to achieve and seems difficult, but i haven't tried who knows what a doctor would say. For the time being I'm siding with the theory that the donors diet is very important to ensure a quantity of required bacteria to be restored with a FMT. My next attempt at an oral FMT will emphasize this variable. For the record I will remind everyone that my health improved about 15% form my first oral FMT but not the 2nd. Hopefully the end result of all this experiance, careful observations and reasoning will result in an effective protocol to share with others. 

Miralax laxative would seem to be an easy option to add to the protocol though. Our bm's are separated by 24 hours time anyway so emptying the bowels may not be unnecessary as these bacteria would not be in the same vicinity with each other, the ingested dose of new bacteria would not come into contact the previous days meals. But i haven't thought about the idea of a laxative and whether or not that would be necessary or not. I think this would be more of a necessity if we were giving FMT enemas, because in this case the new bacteria would very likely come into contact with high numbers of the bad bacteria and cleaning out the colon with a lavage/enema before the FMT enema would make sense, but what I'm doing is an ORAL FMT so maybe this is a little different. I wanted to find an easier more convenient way to do FMT without doing 5-60 enemas, which is next to impossible to coordinate between two people that work and have families and busy schedules and such, doing an oral FMT one time is something we need to figure out especially when it comes to crohn's disease which seems the hardest to treat with FMT. I would have loved to find a way to make the pills but i had to give up on that.


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## wildbill_52280

This is what we have been waiting for. A company has the money to further develop a mixture of clostridia species of bacteria to replenish the loss of diversity in the intestinal microbiome to treat and possibly cure both forms of IBD. This could replace the existing methods of doing a Fecal Transplant. They have $241 million to do this. This is Awesome. Thanks again to our fellow member william4 for giving us the heads up on this news story. Now we will wait for human trials.


News Release-Tuesday, January 13, 2015
http://www.xconomy.com/boston/2015/...marks-big-pharma-milestone-in-the-microbiome/


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## NothingL

I was under the impression that it would take AT LEAST 10 years for microbiome based therapies to hit the market, but now I am certain that we will have microbiome based therapies IN 10 years or less. 

We must also take into consideration that fecal transplants will probably become standard practice in order to prevent gastrointestinal problems. This shouldn't take longer than few years. 

The  Second Genome is also recruiting patients for their microbiome based drug to treat IBD.

January 12, 2015: 

http://www.xconomy.com/san-francisc...nning-drug-trial-based-on-microbiome-secrets/


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## wildbill_52280

NothingL said:


> I was under the impression that it would take AT LEAST 10 years for microbiome based therapies to hit the market, but now I am certain that we will have microbiome based therapies IN 10 years or less.
> 
> We must also take into consideration that fecal transplants will probably become standard practice in order to prevent gastrointestinal problems. This shouldn't take longer than few years.
> 
> The  Second Genome is also recruiting patients for their microbiome based drug to treat IBD.
> 
> January 12, 2015:
> 
> http://www.xconomy.com/san-francisc...nning-drug-trial-based-on-microbiome-secrets/



One aspect moving things along is that these bacteria ALREADY exist in healthy people, which massively support their safety profile, so the bacterial preparation will move quickly to human trials. Well, this is one thing I read in an interview anyways. I'm generally aware that it takes quite a while to get to human trials but I'm no expert in this area.


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## wantok

First, thank you wildbill 52280 for making the effort to collect all of this info on FMT.

As much of the research info is a while back, and intimated that by now there might be some results.  Any info on what is the current status of some of this research for Crohn's and FMT, and/or why it never did conclude?

Also, for myself, I think a pill would be the best route to go as my terminal ilieum is the site where the Crohn's is and going the other direction (up rather than down) would be likely more problematic.  Any info on where/how one gets one's hand on a pill if one is doing this without a doctor?

Again, many thanks.


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## wildbill_52280

wantok said:


> First, thank you wildbill 52280 for making the effort to collect all of this info on FMT.
> 
> As much of the research info is a while back, and intimated that by now there might be some results.  Any info on what is the current status of some of this research for Crohn's and FMT, and/or why it never did conclude?
> 
> Also, for myself, I think a pill would be the best route to go as my terminal ilieum is the site where the Crohn's is and going the other direction (up rather than down) would be likely more problematic.  Any info on where/how one gets one's hand on a pill if one is doing this without a doctor?
> 
> Again, many thanks.



Thanks for asking. Most of my posts in this thread cover the latest updates.  In the initial first post of this thread I update section 2: History of fecal transplants with new information.

The conclusions of the studies so far are that fecal transplants are inducing remission in some patients with IBD without any need for drug therapy to maintain these remissions. In addition, there is good evidence to suggest some people are cured. But proving someone is cured with absolute certainty takes a while. To prove this logically, you would have to follow up multiple patients for their entire lives. So far we have been able to verify no sign of disease for up to 25 years with an ulcerative colitis patient and 12 years with a crohn's patient's whom had fecal transplants. So they have either achieved a very good remission or a cure, either one is fabulous in terms with what some patients have faced with this disease. So things are looking good for fecal transplants so far.

We have some knowledge about which bacteria are missing from the IBD patients which need to be restored, and we don't currently have the means to grow all of these species seperately to make a pill that contains only these species, so we are getting these bacteria from healthy donors stool sample. Doing it this way, its hard to predict what the actual dosage of bacteria the patient will recieve, and this is one factor that makes getting a fecal transplant a little unreliable although it seems to work from time to time. There is a way to put the whole range of fecal bacteria into a pill by filtering it and concentrating it with a centrifuge and one researcher has done this to treat  c.difficle with success. I hope there will be more studies on IBD using this method of making a FMT pill. Otherwise there is a company that is developing a pill using 17 strains of clostridia which seem to be the most important bacteria that regulate inflammation and are missing ind IBD patients. http://www.xconomy.com/boston/2015/...marks-big-pharma-milestone-in-the-microbiome/ 

Until either of these things happen we wont have a FMT pill. You could try making one yourself I could share some ideas with you if you are interested in messaging me, other wise the simplest way to get the bacteria from a donors stool sample is to drink it, this is what I did 2x with some positive results and I'm doing it very soon again until I get it right.


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## 7vNH

Since this is a "FMT Guide" thread, I thought I would add something that might make the task easier and maybe result in a more effective treatment.

Some FMT practitioners suggest doing a cleanse before FMT.  I guess the idea is to eliminate as much of the competition as possible, since you want the new set of bugs to "win".  If the FMT is delivered via colonoscope, then your scope operator (aka doctor) will be able to tell you the exact process, and perhaps, write a prescription for the colonoscopy preparation supplies.  This post is about if you don't want to go through the trouble of a doctor visit, just to get the prescription.  The supplies below are all over the counter (in the US, at least). I would clear this with your doctor before hand, but that should just be an email.

If you google "university of michigan colonoscopy preparation" you should see a link to the Miralax/Gatorade Prep (www.med.umich.edu/1libr/MPU/UMHS_Colonoscopy_Miralax_Gatorade_Prep.pdf). You must use the "G2" variety of Gatorade (no substitutions), but you can probably get away with the store-brand Miralax.  The bottom line is the day before your FMT, first you take a couple of 5mg bisacodyl tablets, then wait for some "action".  Then you mix 119g of PEG3350 (Miralax) with one bottle of G2, and chug it over a couple of hours (max).  You can have clear liquids, after this, but only clear liquids. Given that your FMT is in the afternoon, the morning of your FMT, you mix another 119g into your other bottle of G2 and chug that over a couple of hours (max), making sure the last gulp (of G2 or anything) was at least couple of hours before your FMT.  Being a little thirsty is good!


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## 7vNH

Since this is a "FMT Guide" thread, I thought I would add something that might make for a more effective treatment.

Some FMT practitioners suggest using prebiotics to help feed the beneficial types of bacteria within the introduced microbiome.  This is thought to help the new set of bugs "win" over the bugs that could be furthering the disease process.  Although galactooligosaccharide prebiotic compounds are found in some foods, larger amounts may be found in commercial supplements.  These supplements are made through bacterial action on dairy, so could be a problem for lactose interant people.  Also, I'd say these supplements were purposefully "high-FODMAP" (the "O" stands for oligosaccharide), so someone requiring a Low FODMAP Diet would not be a candidate. Studies I have read used 2.5g or 5.0g per day.  Not only can one feed the introduced microbiome by ingesting a prebiotic, I understand that some practitioners feed the infusion solution with a small amount (1g?) of prebiotic before infusion.  Bimuno is made in the UK by Clasado, but they will ship to the US.  Galactomune is sold in the US by Klaire Labs, but this product is not supposed to be direct to consumer (although it still seems to be available that way).  Although both are galactooligosaccharides, they probably differ in their structure.  I have researched Bimuno and discovered it was beta 1-3 structure with a good bit of low polymerization (DP2 and DP3).  I have not yet found data on Galactomune, but I suspect it's the more common beta 1-4 structure.


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## mf15

Since you are discussing poop pills,here is some info.
Another side of this is that opposed to rectal infusion, what if oral tolerance is a mechanism that also induces remission.
Anyhow drinking poo also might have some additional danger,such as aspiration into the lungs, where pills seem somewhat safer.

I have UC not crohns,anyhow as an aside, has anyone tried taking baking soda for crohns,since one of the problems with crohns is thick mucus in the crypts,not flushing bacteria from the crypts. One of the reasons that the mucus is overly thick is the lack of bicarbonate transport into the bottom of the crypts,which is needed to expand the mucus out of the crypts.
Old Mike
Overcapsulated with gel caps.


https://idsa.confex.com/idsa/2013/webprogram/Paper41627.html


http://thepowerofpoop.com/epatients...ctions/how-to-make-fecal-transplant-capsules/


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## Spooky1

Hi MF,
I take bicarb of soda, admittedly with a teaspoon of sugar, each day.  Not so much for the Crohns but to perhaps stave off cancer after having a few cancer scares.  I still take it and am not sure whether it helps crohns at all.

It was interesting to read both the links and also for the extra knowledge on bicarb and crohns.
thanks


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## wildbill_52280

mf15 said:


> Since you are discussing poop pills,here is some info.
> Another side of this is that opposed to rectal infusion, what if oral tolerance is a mechanism that also induces remission.
> Anyhow drinking poo also might have some additional danger,such as aspiration into the lungs, where pills seem somewhat safer.
> 
> I have UC not crohns,anyhow as an aside, has anyone tried taking baking soda for crohns,since one of the problems with crohns is thick mucus in the crypts,not flushing bacteria from the crypts. One of the reasons that the mucus is overly thick is the lack of bicarbonate transport into the bottom of the crypts,which is needed to expand the mucus out of the crypts.
> Old Mike
> Overcapsulated with gel caps.
> 
> 
> https://idsa.confex.com/idsa/2013/webprogram/Paper41627.html
> 
> 
> http://thepowerofpoop.com/epatients...ctions/how-to-make-fecal-transplant-capsules/


thanks for the first link, I should really put that one in the initial post of this thread.
But unfortunately the power of poop website makes the claim of the small intestine supposedly being sterile, THIS is not true and they provided no references to support this claim anyways. although the ileum and large intestine contains the highest amount of bacteria, the small intestine still contains an astounding amount, and they are SUPPOSED to be there to maintain good health. Love to provide my own references for this claim,but i can only spend so much time upkeeping this thread as ive already dedicated so much, look it up!!


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## wildbill_52280

don't forget to follow the donor selection criteria before doing an FMT!! or this could happen!! its important, i suppose that's why i made the guide, its safe but ONLY if you follow the guidlines. its not clear though that the fecal transplant caused this but considering her donor was known to be overweight, something which the medical professionals should have advised against, this happened. so much for the DIY fecal transplant being dangerous, medical professionals arent even taking enough precautions. ive used 3 donors and have had no bad side effects so far, but that's because i'm only selecting people who are healthy. 

http://www.upi.com/Health_News/2015...ansplant-from-overweight-donor/1581423067944/


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## wildbill_52280

On a more positive note, a doctor does a DIY Fecal Transplant for her U.C, says its helped alot and would do it again when she finds another donor.

http://diagnosey.blogspot.com/2015/02/my-experience-with-diy-fecal-transplant.html


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## mf15

WB As far as I know the small intestine is not sterile, has some bacteria of course not the amounts in the colon.
With crohns,dysbiotic bacteria at early onset, with higher than normal counts.
As I said above part of the problem is not flushing the bacteria from the crypts with
thin expanded mucus,which is what should happen.
How FT might fix this, I have no idea,perhaps getting rid of dysbiotic bacteria fixes other
functional problems,don't know,or is it oral tolerance induction.
Been studying IBD now for about 35 years, still cant fix my UC, but at some point might go all in with FT. Eventually it is going to kill me one way or the other FT might be a solution for some.

Yea that doc is on the healing well UC forum I normally hang out at, but we have also had people who did Rectal FT and got very sick,with what was believed to be quality donors.
Old Mike


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## Spooky1

Wildbill, we do appreciate the efforts and information.  It means a lot to some of us.  I wish I knew a healthy person and I'd do home trial.  Bit peculiar about getting fat from fat donor or skinny too.  Was just reading in the paper how a man received a transplant from someone killed on his bike, he now can't resist cycling.  I suppose even a gut flora transplant is a link to the previous person.  Bit scarey thinking about it.  Have you any new hobbies that you didn't have prior to FMT?


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## 7vNH

Spooky1 said:


> ...  Have you any new hobbies that you didn't have prior to FMT?


Lol!  I totally get the fat/skinny thing is real.  I'd rather be fat than sick, though.  

My theory is that each of us has a set of microbes that have found a specific "détente" between microbial "armys".  So when there's wheat around, you guys from army "A" bloom, and when there's fiber, you other guys from army "B" bloom, but nobody ever gets a total defeat.  Obviously it's much more dynamic than two armys, but you get the idea.

So each of us has our own set of "armys", developed over our life times, and it's settled out into this "détente" arrangement.  It's a stand-off that is probably very stable.  The reason I say that is when people have PCR (genetic fingerprint of the microbiome) done multiple times over a long span of time, it doesn't change much (if left undisturbed by antibiotics or something).  So while I certainly agree that there probably sets of microbial armys that are stable and that cause a person to consume more calories (by playing with hunger) or extract more calories from food, I have a hard time believing that someone who gets a new set of "bugs" would have any kind of personality shift.


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## 7vNH

Previously I presented two ways that could be used to enhance the effectiveness of FMT...introducing a new microbiome (cleaning out the old with a DIY "prep", and also providing the right kind of food to feed the new microbiome).  As a third topic to enhance the "FMT Guide" aspect of this thread is the possibility of doing even MORE to clean-out the old before brining in the new: Colonic Lavage, aka Colon Hydro Therapy.

If you've never heard of this, it's basically a system where warm water is introduced to the colon, then allowed to drain out.  It's repeated many times and the large intestine is typically massaged to release as much matter as possible.  Both the introduction and removal of water is done through one, single-use plastic device placed in the rectum, so it's not typically very messy or smelly.

In Charlotte, there were many practitioners that are certified by the international association of colonhydrotherapy to choose from.  If you are currently in any kind of flare, you probably shouldn't do this, and I doubt that when you report the specifics of your condition to the therapist (which you must), they would advise to continue anyway.

Of course we don't have any studies that prove that a new microbiome's chances of "sticking" are improved by colonic lavage (or doing a "prep", or feeding the new bugs, for that matter), but on the face of it, all three seem like, if precautions are followed, they couldn't hurt and probably would help to increase the chances of a successful replacement of a microbiome.


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## Spooky1

thanks for that, 7b, course wildbill hasn't responded yet as he's now fixated on knitting or something


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## 7vNH

> ... I promise you i will find a way to do this and I'm much closer then ever before.


I just searched this thread for "enteric" and didn't get any hits.  I'm not sure I've been watching this thread super closely, so sorry if you've already covered this but...

Have you thought much about filling enteric coated capsules, with the idea being, get past the hydrochloric acid of the stomach?  The way I figure it (just an engineer, not even a chem-e, and certainly not a doctor), you take a bunch of bugs and run them through some acid, you're going to "select for" acid resistant bugs.  That might leave the good ones, it might leave the bad ones, it might leave a mix.  But the result will probably not be the same mix that you started with, since the ones that couldn't take the acid would be goners.  I kind of presume that you want a mix that was like the ones you started with, since those are the guys that like the environment of the large intestine.

Again, wild speculation here, but on the premise that the stomach acid is protecting the rest of your GI tract, getting bugs that "should have" been neutralized into the small intestine, could that be "bad"?  I have heard the term "bacterial overgrowth" in regard to the small intestine, but really don't know much about that at all.  Just a thought on a possible risk associated with enteric coating.

I wonder if you could get-by with smaller amounts of bugs in the first place by taking an enteric approach, since many fewer would be killed-off by the stomach acid.  Did I read somewhere that someone was coating the insides of gelatin capsules with raw coconut oil (solid at room temperature) to protect the gelatin from dissolving before it could be consumed?  Because I see that as one of the problems with this; gelatin would begin to dissolve immediately upon getting filled, and could become a mess.  That's probably less of an issue with you, since you, as I understand it, performed an almost super human feat: consumed the slurry unadorned.  But I understand that if the do-nothing consequences of disease are bad enough, one will put-up with risks and inconveniences, even if the chance of payoff is not assured.


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## wildbill_52280

7vNH said:


> I just searched this thread for "enteric" and didn't get any hits.  I'm not sure I've been watching this thread super closely, so sorry if you've already covered this but...
> 
> Have you thought much about filling enteric coated capsules, with the idea being, get past the hydrochloric acid of the stomach?  The way I figure it (just an engineer, not even a chem-e, and certainly not a doctor), you take a bunch of bugs and run them through some acid, you're going to "select for" acid resistant bugs.  That might leave the good ones, it might leave the bad ones, it might leave a mix.  But the result will probably not be the same mix that you started with, since the ones that couldn't take the acid would be goners.  I kind of presume that you want a mix that was like the ones you started with, since those are the guys that like the environment of the large intestine.
> 
> Again, wild speculation here, but on the premise that the stomach acid is protecting the rest of your GI tract, getting bugs that "should have" been neutralized into the small intestine, could that be "bad"?  I have heard the term "bacterial overgrowth" in regard to the small intestine, but really don't know much about that at all.  Just a thought on a possible risk associated with enteric coating.
> 
> I wonder if you could get-by with smaller amounts of bugs in the first place by taking an enteric approach, since many fewer would be killed-off by the stomach acid.  Did I read somewhere that someone was coating the insides of gelatin capsules with raw coconut oil (solid at room temperature) to protect the gelatin from dissolving before it could be consumed?  Because I see that as one of the problems with this; gelatin would begin to dissolve immediately upon getting filled, and could become a mess.  That's probably less of an issue with you, since you, as I understand it, performed an almost super human feat: consumed the slurry unadorned.  But I understand that if the do-nothing consequences of disease are bad enough, one will put-up with risks and inconveniences, even if the chance of payoff is not assured.


They were coating the inside of a gelatin capsule with beeswax, which I'm not sure is a good idea because beeswax may have some antibacterial properties. I highly doubt there is any scientific data on how human GI microbiota would interact with beeswax. But you could simply try it and find out if it works for you. But its better to have some scientific basis behind it. The reason for coating the capsule with beeswax was so that the gelatin capsule would not break down so quickly, the beeswax wasn't intended on protecting the bacteria from the stomach acid.

Nature has been inoculating our intestines with the required bacteria for a long time despite stomach acid, it's likely this is a non issue for FMT's.  Dr louie at university of calgary canada has used regular gelatin caps to give people fecal transplants with c difficile infection with good results so far, so for those reasons, it doesn't seem like a big issue as to whether the good bacteria can survive an oral route trough the stomach acid and into the lower gi tract. In all likelihood, the good bacteria will survive the journey, if they are there in the first place, if they are alive in the first place, if they are high enough in quantity in the first place.


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## mf15

I guess I have a question I am not sure about.
People get sick with a coliform infection from swimming pools, and sewage leaks into the ocean. They are always checking coliform levels.
So if you eat pure poo, many/none perhaps do not get sick, so what is going on.
We also know that some with UC and with rectal FT do get worse
Old Mike


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## 7vNH

OM, My interpretation of why ingesting a large-intestine microbiome doesn't usually cause symptoms is because there are not high quantities of pathogenic bacteria in the FMT.  Since healthy donors are selected, although they have billions of E.coli, those donors don't have high counts of E.coli pathotypes (the ones that cause disease). The most commonly identified "bad E.coli" in North America is E. coli O157:H7.


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## wildbill_52280

Inflamm Bowel Dis. 2015 Mar;21
(3):556-63. doi: 10.1097/MIB.0000000000000307.

*Fecal microbial transplant effect on clinical outcomes and fecal microbiome in active Crohn's disease.*
Abstract

BACKGROUND:
Crohn's disease (CD) is a chronic idiopathic inflammatory intestinal disorder associated with fecal dysbiosis. Fecal microbial transplant (FMT) is a potential therapeutic option for individuals with CD based on the hypothesis that changing the fecal dysbiosis could promote less intestinal inflammation.

METHODS:
Nine patients, aged 12 to 19 years, with mild-to-moderate symptoms defined by Pediatric Crohn's Disease Activity Index (PCDAI of 10-29) were enrolled into a prospective open-label study of FMT in CD (FDA IND 14942). Patients received FMT by nasogastric tube with follow-up evaluations at 2, 6, and 12 weeks. PCDAI, C-reactive protein, and fecal calprotectin were evaluated at each study visit.

RESULTS:
All reported adverse events were graded as mild except for 1 individual who reported moderate abdominal pain after FMT. All adverse events were self-limiting. Metagenomic evaluation of stool microbiome indicated evidence of FMT engraftment in 7 of 9 patients. The mean PCDAI score improved with patients having a baseline of 19.7 ± 7.2, with improvement at 2 weeks to 6.4 ± 6.6 and at 6 weeks to 8.6 ± 4.9. Based on PCDAI, 7 of 9 patients were in remission at 2 weeks and 5 of 9 patients who did not receive additional medical therapy were in remission at 6 and 12 weeks. No or modest improvement was seen in patients who did not engraft or whose microbiome was most similar to their donor.

CONCLUSIONS:
This is the first study to demonstrate that FMT for CD may be a possible therapeutic option for CD. Further prospective studies are required to fully assess the safety and efficacy of the FMT in patients with CD.


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## mf15

No or modest improvement was seen in patients who did not engraft or whose microbiome was most similar to their donor.

What is going on with a similar microbiome to the donor, I wonder.

Old Mike


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## rollinstone

mf15 said:


> No or modest improvement was seen in patients who did not engraft or whose microbiome was most similar to their donor.
> 
> What is going on with a similar microbiome to the donor, I wonder.
> 
> Old Mike


Perhaps the donors that have a similar microbiome do not have the host genetic defect, either way exciting that the ones where the donors microbiome did engraft reached remission.


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## Spooky1

I am so hopeful that this will become an option for treatment soon, and I hope it works.


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## 7vNH

Too bad we can't read the whole study. I'd like to know if it was just a one time NG treatment, and if the end of the NG tube was past the stomach. Only nine "kids" too...the details of the study might add credibility. If it was just one NG treatment, then super easy to get another if the first one didn't "stick".  The suggestion that a non-similar donor is more likely to yield the best results is something I had heard before...nice to have this bit of proof on that.  Makes it less easy for DIY'ers, but if they try it with an SO and it doesn't help, they shouldn't give up...they need to try again with a dissimilar microbiome.


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## wildbill_52280

An article written by Professor Alexander Khoruts, he is one of the pioneering researchers of fecal transplants.

http://www.kevinmd.com/blog/2015/02/4-reasons-fecal-transplants-arent-mainstream-yet.html


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## Malgrave

Is there anybody who can help me...
My son has had a temporary ileostomy for 4,5 years now. His colon is bleeding very badly and he has CD and maybe also diversion colitis. Now his GI proposes FMT. I am quite scared what will happen when we inject the transplant into the colon that hasn't been used in 4,5 years and that is badly inflammated! Has anybody any experience in this? Any cases studies available?

Thanks a lot in advance!


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## wildbill_52280

Malgrave said:


> Is there anybody who can help me...
> My son has had a temporary ileostomy for 4,5 years now. His colon is bleeding very badly and he has CD and maybe also diversion colitis. Now his GI proposes FMT. I am quite scared what will happen when we inject the transplant into the colon that hasn't been used in 4,5 years and that is badly inflammated! Has anybody any experience in this? Any cases studies available?
> 
> Thanks a lot in advance!


I havent heard of FMT used yet in this specific situation so i cant say anything with absolute certainty, but in all probability, if the donor selected is screened very well to be healthy and free of diseases, and also follows a high fiber diet before donating, there isn't any reason to be scared of fecal transplants, safety profile is very good so far but ONLY if you follow screening procedures well.

I encourage you to view section 5 in the initial post under the section HOW TO SELECT A DONOR and view the two links and maybe print them out where Dr Borody and Dr Khoruts created a very strict donor selection screening process. Choose a healthy family member or a friend who is superbly healthy then work with your doctor to screen them properly. These guidelines are pretty strict and not all of them are absolutely necessary, but just so you know how strict you could be in the donor selection process to make it as safe as possible and limit your risks. Let us know how things go and we wish you the best!


----------



## wildbill_52280

A recent article in Scientific American about gut bacteria and the possible cause of IBD.
http://www.scientificamerican.com/article/among-trillions-of-microbes-in-the-gut-a-few-are-special/


----------



## Lady Organic

hi Malgrave, 

there are currently several clinical trials of FMT for pediatric IBD:

https://clinicaltrials.gov/ct2/results?term=crohns+fecal&Search=Search

However, considering your son's particular situation, I think it could be more difficult for him to be accepted. Have you reviewed these trials? You can always contact the researchers and ask them what they think or know about a case like your son's.


----------



## xeridea

This site lists research papers by Prof. Sonnenburg at Stanford Dept. of Microbiology and Immunology. He's one of the main sources referenced in the Scientific American article. His research evolves around the various mechanisms of symbiotic relationship between the host and its microbiome. Very interesting reading.


----------



## wildbill_52280

Somehow I found the full version of the most recent study on FMT. I have yet to read it though.


Inflammatory Bowel Diseases:
March 2015 - Volume 21 - Issue 3 - p 556–563

Fecal Microbial Transplant Effect on Clinical Outcomes and Fecal Microbiome in Active Crohn's Disease
http://journals.lww.com/ibdjournal/...icrobial_Transplant_Effect_on_Clinical.7.aspx


----------



## greypup

I especially appreciate that the above study was published in the CCFA Journal.  Very hopeful!


----------



## Lady Organic

Thats great news!

it seems multiple or maintenance treatments will be needed, as fecal calprotectine rose in most patients 12 weeks after treatment. 

In the conclusion, they discuss about E coli :''Another possible predictor of disease activity and duration of efficacy seems to be the appearance or resurgeonce of E. coli. We notice a trend of increasing calprotectins with an increase in E. coli abundance. Although this finding may be a helpful predictor of efficacy of therapy, there is no clear casual affect. However, in patients with significant dysbiosis with E. coli, therapy targeted at its suppression followed by FMT could be another potential therapeutic trial in the future.''


----------



## xeridea

I've cited this Scientific American article before, where they talk about some of the advances on microbiome research (including reference to Vedanta Biosciences proprietary "super-citizen" bacterial strains, which Janssen -- of Remicade fame -- just picked up for a cool $250 million). 

In the article, Prof. Sonnenburg, a microbiologist from Stanford Medical Lab talks about how once the unhealthy microbiome establishes itself, an inertia sets in that is hard to overcome. This may be why FMT doesn't seem to take in Crohn's. He sees that treatment paradigm may evolve where you simultaneously treat the host and the microbiota, say using antibiotics to clear the slate, use immunotherapy to quell the inflammation, and then reintroduce the healthy strains that can take hold and re-establish homeostasis. 

Exciting times!



Lady Organic said:


> Thats great news!
> 
> it seems multiple or maintenance treatments will be needed, as fecal calprotectine rose in most patients 12 weeks after treatment.
> 
> In the conclusion, they discuss about E coli :''Another possible predictor of disease activity and duration of efficacy seems to be the appearance or resurgeonce of E. coli. We notice a trend of increasing calprotectins with an increase in E. coli abundance. Although this finding may be a helpful predictor of efficacy of therapy, there is no clear casual affect. However, in patients with significant dysbiosis with E. coli, therapy targeted at its suppression followed by FMT could be another potential therapeutic trial in the future.''


----------



## wildbill_52280

xeridea said:


> I've cited this Scientific American article before, where they talk about some of the advances on microbiome research (including reference to Vedanta Biosciences proprietary "super-citizen" bacterial strains, which Janssen -- of Remicade fame -- just picked up for a cool $250 million).
> 
> In the article, Prof. Sonnenburg, a microbiologist from Stanford Medical Lab talks about how once the unhealthy microbiome establishes itself, an inertia sets in that is hard to overcome. This may be why FMT doesn't seem to take in Crohn's. He sees that treatment paradigm may evolve where you simultaneously treat the host and the microbiota, say using antibiotics to clear the slate, use immunotherapy to quell the inflammation, and then reintroduce the healthy strains that can take hold and re-establish homeostasis.
> 
> Exciting times!


Thanks xeridea,  I did not realize Janssen made Remicade.

Just a reminder, the women with crohn's who seems to have been cured after FMT at borody's clinic which was verified with a follow up colonoscopy 12 years post FMT, received a large volume oral dose from 3 donors. Getting 3 donors stool at once would increase the probability of getting the right bacteria she needed. http://www.abc.net.au/news/2014-03-18/sydney-doctor-claims-poo-transplants-curing-diseases/5329836 

It seems to be true that once severe dysbiosis sets in it is quite resistant to correction. low doses of good bacteria spaced over a long period of time is probably not an effective dosing schedule, and many studies have suggested that. 30 to 60 enemas is pretty inefficient compared to one oral dose or soon to come, a pill. 

They are trying to standardize the dosages, but even if they give the same amount of stool to saline ratio to patients, the donors microbiota could still vary by alot depending on their diet. manipulating other variables like the patients microbiome with antibiotics before FMT and suppression of inflammation or immune system would help, but if we cant get the right amount of the right kind of bacteria in the dosage, those other variables just don't matter that much yet. If we ENSURE the right bacteria(whichever they are) in the high enough dosage then success would likely occur every time for everyone.After this is addressed, we don't have to put any effort into manipulating the other variables at all, but we could just to make things even faster, but addressing this prime variable precedes all others. Another variable is the diet of the patient. I always prefer the most natural manipulations before we start throwing in antibiotics again, haven't we learned our lesson yet? http://martinblaser.com/


----------



## xeridea

Mr. Bill, in the Discussion section of the study you cite above, they point out: "There was a significant difference in clinical outcome between the patient with the least and most microbial similarity between recipient and donor. This could indicate that *the more divergent* a Crohn's patient is from his donor the more the potential benefit of transplantation." (emphasis mine) 

You seem to be spot on. It's not just a matter of samples from a healthy donor. It has to be the *right* and perhaps complementary bacteria. With the 16s RNA sequencing becoming readily accessible in the clinical setting, this may become easier and easier to fine tune. And I think there are companies now that can provide targeted samples. And outfits like OpenBiome, or perhaps other commercial ventures, may soon be able to provide donor matching based on such guidelines.


----------



## wildbill_52280

Lady Organic said:


> Thats great news!
> 
> it seems multiple or maintenance treatments will be needed, as fecal calprotectine rose in most patients 12 weeks after treatment.
> 
> In the conclusion, they discuss about E coli :''Another possible predictor of disease activity and duration of efficacy seems to be the appearance or resurgeonce of E. coli. We notice a trend of increasing calprotectins with an increase in E. coli abundance. Although this finding may be a helpful predictor of efficacy of therapy, there is no clear casual affect. However, in patients with significant dysbiosis with E. coli, therapy targeted at its suppression followed by FMT could be another potential therapeutic trial in the future.''


This wouldn't be the first observation of this relationship between ecoli and inflammation. But it seems that it's the inflammation that may precede the bloom of e coli as they can feed on nitrate.http://www.ncbi.nlm.nih.gov/pubmed/23393266

The idea of an e coli bloom further reinforcing the inflammatory response by another mechanism is also a possibility. http://en.wikipedia.org/wiki/Positive_feedback


----------



## wildbill_52280

"There's a person who got a fecal transplant with ALS(amyolaterosclerosis) that a doctor confirmed had ALS, that a doctor confirmed got up out of his wheelchair and walked after a fecal transplant which we've never seen with any other treatment for ALS."

Richard Bedlack, MD, PhD
Duke ALS Clinic

http://www.wndu.com/home/headlines/...native-therapies-to-battle-ALS-295954201.html


----------



## boax

I will be travelling to the UK and the Taymount clinic in early May to do 10 days of FMT. Thought I'd share the preparation protocol and some of the details I have received of their methods.

I have Crohn's colitis, dx last year and have pretty much been in remission since then although I still struggle some days. Currently only on Pentasa, which I'm not sure even does anything. My calprotectin levels were in normal range (below 50) for almost six months but started creeping up around Christmas and is now at around 150. 

The minimum amount of FMT transplants available at Taymount is 10 days, which means you have to spend two weeks there. They use samples from several donors, and also try to match so that donor samples are different from yours and can "fill in the gaps". You have to provide Genova stool testing before undergoing the treatment to check you gut health and see what your gut flora looks like. After the treatments are finished, they provide you with two samples to take home and administer at home. They also show you how to do this. If you want to buy further samples for home treatment, this is also available.

Taymount has developed a method to extract the microbiome, including the anaerobe bacteria. They do freeze it, so the samples are not fresh.

They are very strict about the preparation procedure you have to follow. Four weeks before the treatments begin you are supposed to start taking something called Oy-klenz, which is basically magnesium peroxide which re-hydrates your bowel. You are to increase your dose until you have very soft stool. This is to completely evacuate the bowel of any hardened material that may be stuck to the bowel wall, which otherwise takes up precious time in clinic. Two weeks before treatment, you need to have a colonic irrigation, and then finally 2-3 days prior to travelling you are to take a laxative similar to what you take for a colonoscopy prep (without the low residue diet). They don't propose a special diet before the treatments, although they do give advice on diet once you are there, but particularly afterwards.

Since you are a group of people that have looked into FMT alot, I'd also like t ask some questions.

1. I'm currently debating whether to increase my supplements of soluble fibers (inulin, GOS, acacia, psyllium, glucomannan) to try to improve my microbiome or completely stop fibers and go on a very low fiber diet (to starve my microbiome). Any idea which might be more beneficial for the FMT to be successful?

2. Have you read anywhere about the influence of diet on success of FMT? I suspect that some people who do the FMT don't feed their new microbiome properly, which might lead to a worse outcome.

I hope the above information was of some interest!


----------



## Lady Organic

I personally would fallow the clinic guidelines regarding diet.  

Do you know already what is the diet they advice after FMT and for how long it has to be maintained or it is a lifelong diet? Im curious about that.

Good luck :thumleft:


----------



## 7vNH

Boax, I think the recommendation would be to keep your diet stable with foods and supplements that have agreed with you in the past.  I'm no expert, but I seroiusly doubt that you can do much to alter a gut disbiosis with supplements.

If you want to deliver a one two punch to knock out your current microbiome, you could take a week or ten days of an antibiotic cocktail...that is, 3 to 5 antibiotics to reduce the numbers of your current microbiome.  I would NOT do this unless I was scheduled for an FMT. I would stop taking the antibiotics 36 to 48 hours before the first treatment. I don't think Taymount recommends this, though. But since they are not doctors, I think they want to stay away from prescribing drugs. If you search, you can find studies where the specific set of antibiotics and dosages are defined. You could get your local doc to prescribe them (just show them the paper). 

I believe that your number 2 is absolutely true. The go-to good gut bacteria food is thought to be galactooligosaccaride prebiotics .


----------



## Lady Organic

7vNH said:


> The go-to good gut bacteria food is thought to be galactooligosaccaride prebiotics .


could you expand on this please? what do you consume for prebiotics? I consume lots of onions and raw saukrates as proposed in the IBD-AID diet: ''strong emphasis on the ingestion of pre- and probiotics (e.g.; soluble fiber, leeks, onions, and fermented foods) to help restore the balance of the intestinal flora''


----------



## 7vNH

Lady Organic said:


> could you expand on this please? what do you consume for prebiotics? I consume lots of onions and raw saukrates as proposed in the IBD-AID diet: ''strong emphasis on the ingestion of pre- and probiotics (e.g.; soluble fiber, leeks, onions, and fermented foods) to help restore the balance of the intestinal flora''


You are on the right track with root veggies. I wrote a wiki page here: http://www.crohnsforum.com/wiki/Prebiotics

This forum site should be making the word "Prebiotics" into a link to that wiki, but for some reason, it has stopped doing that.

I consume one packet of Bimuno every day to feed the good guys.


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## Spooky1

One packet?  that works out expensive doesn't it?


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## wildbill_52280

Here is a new article on the latest FMT study on crohn's disease, which is in post #339 of this thread.

http://pulse.seattlechildrens.org/s...ld-be-effective-treatment-for-crohns-disease/


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## Lady Organic

From the above article dr Suskind:

''To test the effectiveness of treating IBD with fecal microbiota transplant, Suskind designed a study that included patients with Crohn’s disease as well as patients with ulcerative colitis, all of whom were experiencing flare-ups of their symptoms. Each patient received a single treatment of stool (donated by their parent) mixed with saline, via a nasogastric tube.
While patients with ulcerative colitis did not improve significantly, the majority of those with Crohn’s did'' 

I guess he didnt publish those results yet...?
So now I am discouraged since my colitis is indeterminate and looks more like a UC...


----------



## wildbill_52280

Lady Organic said:


> From the above article dr Suskind:
> 
> ''To test the effectiveness of treating IBD with fecal microbiota transplant, Suskind designed a study that included patients with Crohn’s disease as well as patients with ulcerative colitis, all of whom were experiencing flare-ups of their symptoms. Each patient received a single treatment of stool (donated by their parent) mixed with saline, via a nasogastric tube.
> While patients with ulcerative colitis did not improve significantly, the majority of those with Crohn’s did''
> 
> I guess he didnt publish those results yet...?
> So now I am discouraged since my colitis is indeterminate and looks more like a UC...


Don't worry, there is the 2003 study which showed FMT is effective in U.C, in fact these were the first reports of people seeming to be 100% cured, but they used multiple enemas which could possibly be slightly more effective for U.C.  Refer to the first post of this thread.


----------



## boax

Lady Organic said:


> I personally would fallow the clinic guidelines regarding diet.
> 
> Do you know already what is the diet they advice after FMT and for how long it has to be maintained or it is a lifelong diet? Im curious about that.
> 
> Good luck :thumleft:


Thanks 

The diet they recommend after FMT seems to be loosely based around Paleo and well aligned with the diet proposed in the book Grain Brain by Dr David Perlmutter. In their brochure they acutally have a few recommended books on diet: 
The High Fat Diet - Zana Morris
Eat The Yolks - Liz Wolfe
Grain Brain
Wheat Belly - Dr William Davis.

Now, keep in mind that this is for ALL patients, I have not yet received any special recommendations for Crohns or IBD and likely won't until I'm at the clinic. But basically they seem to recommend to avoid gluten and refined starches, sugar and all kinds of processed foods. Eat animal proteins, a large variety of vegetables including raw, increase intake of fats such as ghee, coconut oil, olive oil. I'll ask them about adherence to diet, but I assume that they will want you to stay on such a diet through life. It's not very restrictive and probably good for you in many other ways if you can handle it.

I think the IBD-Aid diet which you follow is quite similar but more tailored to IBD obviously. IBD-AID is also very tailored to each patient with different diet for each stage, so quite different from most other diets.


----------



## boax

Lady Organic said:


> could you expand on this please? what do you consume for prebiotics? I consume lots of onions and raw saukrates as proposed in the IBD-AID diet: ''strong emphasis on the ingestion of pre- and probiotics (e.g.; soluble fiber, leeks, onions, and fermented foods) to help restore the balance of the intestinal flora''


There's so much to say about prebiotics. I really recommend you read through the FIBER series on the blog vegetablepharm (and also somewhat on drbganimalpharm). He has a TON of interesting info there, and don't forget to also read the comments - this is were some of the most interesting information is.

Basically, prebiotics are foods for your benefical gut flora. There are many and can be found in a lot of vegetables, roots etc. E.g. leeks and onions contain a lot of inulin, whereas beans contain a lot of GOS. A typical person on a western diet eats around 15g of fermentable fiber per day at best. If you look at more rural societies such as the Hazda tribe in Africa and from petrified stool samples they have in excess of 100g of fermentable fiber day and suffer none of these kinds of conditions. There are plenty of interesting studies on prebitiocs and they seem very beneficial, particularly for UC.


----------



## boax

Lady Organic said:


> From the above article dr Suskind:
> 
> ''To test the effectiveness of treating IBD with fecal microbiota transplant, Suskind designed a study that included patients with Crohn’s disease as well as patients with ulcerative colitis, all of whom were experiencing flare-ups of their symptoms. Each patient received a single treatment of stool (donated by their parent) mixed with saline, via a nasogastric tube.
> While patients with ulcerative colitis did not improve significantly, the majority of those with Crohn’s did''
> 
> I guess he didnt publish those results yet...?
> So now I am discouraged since my colitis is indeterminate and looks more like a UC...


As Wildbill said, there's plenty of studies showing 100% cures of UC. Actually, UC in most procedures seem to actually respond better to probiotics, prebiotics and FMT than Crohn's which seems to be a more difficult disease. For example right now professor Borody of Australia is recruiting people for a big UC FMT trial. I'm sure that's because he has seen very strong results from his case studies, otherwise he probably wouldn't do it this way.


----------



## 7vNH

Spooky1 said:


> One packet?  that works out expensive doesn't it?


I order directly from the manufacturer and with international shipping it comes to under a buck a day.  If one spends the time, money, energy to get a replacement of their micribiome, that's pretty cheap insurance to keep those new guys as happy as possible.
EDIT: the price is actually $0.37/day,delivered from the UK. That is taking advantage of a buy 2 get 1 free promotion that the manufacturer is running.


----------



## 7vNH

Lady Organic said:


> From the above article dr Suskind:
> 
> ''To test the effectiveness of treating IBD with fecal microbiota transplant, Suskind designed a study that included patients with Crohn’s disease as well as patients with ulcerative colitis, all of whom were experiencing flare-ups of their symptoms. Each patient received a single treatment of stool (donated by their parent) mixed with saline, via a nasogastric tube.
> While patients with ulcerative colitis did not improve significantly, the majority of those with Crohn’s did''
> 
> I guess he didnt publish those results yet...?
> So now I am discouraged since my colitis is indeterminate and looks more like a UC...


Another reason why not to be discouraged is that many of these studies do FMT "wrong". NG tube is probably OK, but they don't do it more than once, and they don't get a good donor (healthy, young, eats paleo or otherwise few refined foods), and the donor should not be from your household unless the donor micribiome is proven to be highly divergent from the recipient.


----------



## wildbill_52280

boax said:


> Thanks
> 
> The diet they recommend after FMT seems to be loosely based around Paleo and well aligned with the diet proposed in the book Grain Brain by Dr David Perlmutter. In their brochure they acutally have a few recommended books on diet:
> The High Fat Diet - Zana Morris
> Eat The Yolks - Liz Wolfe
> Grain Brain
> Wheat Belly - Dr William Davis.
> 
> Now, keep in mind that this is for ALL patients, I have not yet received any special recommendations for Crohns or IBD and likely won't until I'm at the clinic. But basically they seem to recommend to avoid gluten and refined starches, sugar and all kinds of processed foods. Eat animal proteins, a large variety of vegetables including raw, increase intake of fats such as ghee, coconut oil, olive oil. I'll ask them about adherence to diet, but I assume that they will want you to stay on such a diet through life. It's not very restrictive and probably good for you in many other ways if you can handle it.
> 
> I think the IBD-Aid diet which you follow is quite similar but more tailored to IBD obviously. IBD-AID is also very tailored to each patient with different diet for each stage, so quite different from most other diets.


I'm going to have to disagree with the claim that wheat is bad for our guts specifically because of this study. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3023594/

GMO wheat on the other hand may present some issues, or wheat that contains some herbcide residues like glyphosate. http://www.ncbi.nlm.nih.gov/pubmed/23224412

Also, high animal protein diets have been linked to the development of IBD. I would restrict the meat to fish only and 2-3 times a week. You may also remove meat and eggs completely from the diet. http://www.npr.org/blogs/thesalt/20...d-dairy-alters-gut-bacteria-a-lot-and-quickly

high fat diets are also not very good on the gut bacteria.
Good bacteria love polysachrides or complex carbs/starches/fiber. Basically plant foods, whole grains, tubers,legumes,nuts, fruits and veggies.


----------



## 7vNH

The problem with wheat isn't the effect on the gut microbiome, its the fact that in many of us, the proteins are potent antigens. Reading "Grain Brain" is worth the time.

The raw foods on the recommended diet are supposed to be organic and full of a wide variety of microbes. The recommendation includes lots of fermented foods (kraut, kefir, etc). 

I'll take something a paleo person could have somehow got their hands on rather than ANYTHING that is refined!! No matter what a narrow study might suggest.

I'm sure there are people with genomes and microbiomes that do not tolerate raw foods and meat of the paleo diet, so I wouldn't say its for everyone.


----------



## wildbill_52280

7vNH said:


> The problem with wheat isn't the effect on the gut microbiome, its the fact that in many of us, the proteins are potent antigens. Reading "Grain Brain" is worth the time.
> 
> The raw foods on the recommended diet are supposed to be organic and full of a wide variety of microbes. The recommendation includes lots of fermented foods (kraut, kefir, etc).
> 
> I'll take something a paleo person could have somehow got their hands on rather than ANYTHING that is refined!! No matter what a narrow study might suggest.
> 
> I'm sure there are people with genomes and microbiomes that do not tolerate raw foods and meat of the paleo diet, so I wouldn't say its for everyone.



So I considered the information you suggested and did some more information and found this.
http://www.ncbi.nlm.nih.gov/pubmed/6502368

It doesn't mean that wheat is bad for humans though, just means that wheat might be bad for those with small intestinal issues. I'm wondering if this relationship isn't similar to other foods that affect other symptoms of IBD, like lactose and sucrose and select polysacharides which is all the basis for the specific carbohydrate diet. not in the sense that they all stimulate antibodies, but in the sense that they influence certain symptoms. There is good reason that all of these relationship between food and certain diseases symptoms are related to the bacteria in the gut. This is another reason why restoring the missing bacteria with fecal transplant is planned for the use in many diseases, there are FDA studies for FMT in diabetes and autism, and some reports of recovery from ALS and multiple sclerosis.


----------



## Crohn2357

Does anyone have concerns over fmt procedure? There are so many unknowns. We don't know what to expect, just hoping to get better. We can get worse; even unknowingly. For example, I have concerns over fmts effects on mental and neurological health. We know it can change them. Genetics play role on gi flora and how body handles the microorganisms. One's gut flora may make himself/herself healthy but can make another one sick or change him/her physically, mentally. We don't know how we are going to react to another one's microorganisms.

http://www.ucsf.edu/news/2014/08/116526/do-gut-bacteria-rule-our-minds
http://www.medicalnewstoday.com/articles/290747.php
http://ofid.oxfordjournals.org/content/2/1/ofv004.full
http://www.pri.org/stories/2014-09-...influence-both-our-physical-and-mental-health


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## wildbill_52280

Crohn2357 said:


> Does anyone have concerns over fmt procedure? There are so many unknowns. We don't know what to expect, just hoping to get better. We can get worse; even unknowingly. For example, I have concerns over fmts effects on mental and neurological health. We know it can change them. Genetics play role on gi flora and how body handles the microorganisms. One's gut flora may make himself/herself healthy but can make another one sick or change him/her physically, mentally. We don't know how we are going to react to another one's microorganisms.
> 
> http://www.ucsf.edu/news/2014/08/116526/do-gut-bacteria-rule-our-minds
> http://www.medicalnewstoday.com/articles/290747.php
> http://ofid.oxfordjournals.org/content/2/1/ofv004.full
> http://www.pri.org/stories/2014-09-...influence-both-our-physical-and-mental-health


Yes a few people have become worse after FMT, and this may be related to donor selection/ donor health. More to learn, this is why lots of studies are planned through end of 2016. But with many studies already done, we can say with some confidence that we know something about FMT for its use in crohn's disease, most of the time, it helps dramatically. the potential of developing a new disease is there and has occured, although very rare and that was in c. difficile patients that had FMT, not IBD patients. There was also the recent event a c. difficile patient developed obesity after fmt from a donor that was overweight.


----------



## 7vNH

wildbill_52280 said:


> Yes a few people have become worse after FMT, and this may be related to donor selection/ donor health. More to learn, this is why lots of studies are planned through end of 2016. But with many studies already done, we can say with some confidence that we know something about FMT for its use in crohn's disease, most of the time, it helps dramatically. the potential of developing a new disease is there and has occured, although very rare and that was in c. difficile patients that had FMT, not IBD patients.


I am usually very critical of how some of these studies are structured, but was pleased to see that in the recent pediatric study we have been talking about here, they did a before and after gut microbiome "fingerprint" to ascertain if the old microbiome was replaced, or if it reasserted itself.  The entire cohort might be used to see if getting a new micribiome has any statistically relevant correlation to negative outcomes. 

With respect to what bad outcomes are possible, and maybe some of those are subtle, I did think a bit about that. My decision was to go on chemicals that would compromise my immune system, or give it a try on the immune system improvement side. There were so many cases where the maintenance of the disease with existing therapies was a constant downhill slide, and I'm not that old, so if I went and knocked down my immune system, I'd hit bottom. And with so many documented C.Diff cases with basically no really bad outcomes, it was an easy decision for me; when a very bad outcome is on the horizon with the traditional approach, a new solution that appears safe, but not all is known, looks much better.


----------



## 7vNH

wildbill_52280 said:


> So I considered the information you suggested and did some more information and found this.
> http://www.ncbi.nlm.nih.gov/pubmed/6502368
> 
> It doesn't mean that wheat is bad for humans though, just means that wheat might be bad for those with small intestinal issues. I'm wondering if this relationship isn't similar to other foods that affect other symptoms of IBD, like lactose and sucrose and select polysacharides which is all the basis for the specific carbohydrate diet. not in the sense that they all stimulate antibodies, but in the sense that they influence certain symptoms. There is good reason that all of these relationship between food and certain diseases symptoms are related to the bacteria in the gut. This is another reason why restoring the missing bacteria with fecal transplant is planned for the use in many diseases, there are FDA studies for FMT in diabetes and autism, and some reports of recovery from ALS and multiple sclerosis.


Celiac, aka small intestine issues, is the worst way that a gluten sensitive individual is effected. Continual exposure to those proteins over a time span can manifest into symptoms that are recognized by tradition medicine practitioners. But others may also be reacting to gluten (ie an immune response), that is not manifested in the small intestine. There seem to be many cases where going gluten free had a huge positive effect on a wide variety of diseases., as you say. Now that more detailed gluten sensitivity tests are available, the research community will be able to better connect the dots. My guess is that in the future we will use someones genetics plus gut microbiota profile and maybe exposure to a pathogen will have some predictive power for disease susceptibility. You can't change genetics, but you can control gene expression to some extent, and once we learn how, we will be able to purposefully manipulate the gut bugs. And also we are getting better at finding pathogens (ie MAP virus). The future is bright, if you can live long enough for the research to be done.


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## Lady Organic

I found this Prebiotic formula for US and canada: Prebiotin : https://www.prebiotin.com/product/bone-health/

40$+ free shipping for 288g. 
What do you guys think? 
This is the one enriched with calcium and Vit D (the one I'd take).
I wonder from what plant the inulin is extracted and if it is organic?
I'll try to call tomorrow to inquire.


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## xeridea

consider adding sunchoke/Jerusalem artichoke and dandelion greens as excellent sources of inulin. or cold baked potatoes as an excellent form of resistant starches which are super foods for bacteria. add gradually though as metabolism of these prebiotic forms by bacteria do produce a bit of gas.


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## wildbill_52280

This is an interesting article



> Because the safety of FMT has not been fully established, FMT anarchy is a problem from a public health perspective. DIY instructions are available online on websites such as The Power of Poop, but armchair practitioners still risk conducting FMT using poorly screened fecal specimens, suboptimal techniques and unhygienic equipment.
> 
> The status quo should also be disconcerting to the scientific community, which has been forced by the FDA to watch an abundance of potential DIY patient data pass by.
> 
> Given this uncertainty, it may be worthwhile to develop a network of supervised FMT clinics that bypasses regulatory requirements. Although far from being directly analogous, the concept of sites for supervised heroin injections could serve as a model for such a system.
> 
> Supervised FMT clinics could provide DIYers with educational resources and instruction on proper technique, while serving as access points through which people can obtain screened and standardized fecal specimens


http://www.gastroendonews.com/ViewA...=Blog&d_id=558&i=March 2015&i_id=1160&tab=RSS


----------



## wildbill_52280

WOW! Here is one reason why bacterial changes may not be the full story on IBD, and why trying to make a synthetic Fecal Transplant Pill may not fix everything in IBD. We may the need the full natural flora that includes all microorganisms that may be essential to health.
http://www.sciencedirect.com/science/article/pii/S0092867415000033


----------



## wildbill_52280

FMT wasn't used for IBD, but this is just a touching story.

Biomed Rep. 2015 Mar;3(2):173-175. Epub 2014 Dec 15.
*Pediatric severe pseudomembranous enteritis treated with fecal microbiota transplantation in a 13-month-old infant.*

Abstract
Fecal microbiota transplantation (FMT) is a procedure used to restore the intestinal microbiota of a diseased individual using indigenous intestinal microorganisms from a healthy donor. The current case report presents the first case of a 13-month-old male with severe pseudomembranous enteritis (PME) treated with FMT. The infant was admitted to Shanghai Children's Hospital with a 2-month history of diarrhea, and a 1.5-month history of retractable edema, hypoalbuminemia, electrolyte disturbance and malnutrition. Besides necessary nutritional support, the patient was treated twice with oral metronidazole combined with or without vancomycin. Diarrhea was partially remitted. However, the infant had bloody or dark-green feces, and a distended abdomen. On day 96 from the initiation of the disease, a single FMT via a nasal jejuna feeding tube was performed. From day 2 until 4 months post-FMT, the patient presented with no diarrhea, normal feces and a satisfactory weight. To the best of our knowledge, this is the first pediatric PME treated with FMT. The current data show that FMT is an efficient choice for recurrent clostridium difficile infection and PME in adults and a few pediatric cases. Due to a lack of safety and effectiveness data, treatment should be cautiously applied in the pediatric population.


----------



## wildbill_52280

*Link between lifestyles of indigenous communities, gut microbial ecologies discovered*


> "In our study, we show that these lost bacteria are in fact multiple species that are likely capable of fermenting fiber and generating short chain fatty acids in the gut. Short chain fatty acids have anti-inflammatory properties. This raises an important question, could these lost Treponema be keystone species that explain the increased risk for autoimmunce disorders in industrialized people?


http://www.sciencedaily.com/releases/2015/03/150325132615.htm


----------



## Lady Organic

Clinical, microbiological, and immunological effects of fructo‐oligosaccharide in patients with Crohn's disease:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1856087/

From the research:
Patients received 15 g/day of FOS (Prebio 1; Nestlé, Switzerland) for consumption as a dietary supplement for three weeks. FOS contained a mixture of oligofructose (70%) and inulin (30%) provided in 15 g sachets to be dissolved in water or food.

I just bought Prebiotin : http://www.prebiotin.com/product/bone-health/


----------



## 7vNH

Lady Organic said:


> Clinical, microbiological, and immunological effects of fructo‐oligosaccharide in patients with Crohn's disease:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1856087/
> 
> From the research:
> Patients received 15 g/day of FOS (Prebio 1; Nestlé, Switzerland) for consumption as a dietary supplement for three weeks. FOS contained a mixture of oligofructose (70%) and inulin (30%) provided in 15 g sachets to be dissolved in water or food.
> 
> I just bought Prebiotin : http://www.prebiotin.com/product/bone-health/


The ingredients say "oligofructose enriched inulin", which makes me wonder how much the inulin has been enriched. The oligosaccharides are made, I think, from culturing milk with specific bacteria (ie not cheap to make), wheras inulin can be extracted from chicory (ie cheap to make).  I'd rather take the various ingredients separately myself, so I know more precisely what I was getting, and not getting stuff I don't need or want. But maybe these folks have found the magic ratio of these ingredients.


----------



## Lady Organic

they've told me Prebiotin is from chicory root. At this time, i am more comfortable taking vegetal extract, as I no longer consume animal milk products. I cant find on Bimuno website the ingredients they use.

On Bimuno website, I found only this explanation: '' Fortunately, prebiotics can be extracted and concentrated from these natural sources. Examples include inulin from chicory and FOS (Fructo-oligosaccharides) which can either be extracted from plant sources or produced commercially.

A newer much more advanced form of prebiotics is now also available known as GOS (Galacto-oligosaccharides). GOS prebiotics are produced by combining the sugars present in milk in a way that mimics the structure of highly beneficial prebiotics naturally present in mother’s milk.''

but I cant find anywhere where they list the later ingredient in the composition of their products...?


----------



## 7vNH

The inulin in Prebiotin would most likely come from chickory root, that sounds about right.  As confirmed by your quote from the Bimuno site, FOS products (but not Bimuno) are derived from plants, whereas GOS products are made starting with milk sugar.  You could look and see if you could find the GRAS (generally regarded as safe) application for Prebiotin, that might tell you more.

I think that all the GOS products (not FOS, like Prebiotin) start with food-grade lactose, which is manufactured from sweet whey (a by-product during the manufacture of cheese).  Then they use an enzyme (beta-galactosidase) to catalyze the transgalactosylation reaction.  And although they all start out with lactose, the various manufacturers might use different microorganisms (bifodobacterium bifidum, bacillus circulans, sporobolomyces singularis, etc) to get the enzyme.  That effects the fractions of mono, di, tri, and higher saccharides as well as the degree of polymerization and beta configurations.

I just bought more Bimuno for myself.  I was wrong about the price before.  I bought a 9 month supply (to save on shipping from the UK) and it came to $0.37/day.  I'm not sure it's doing anything good for me, but it was recommended by folks I trust, so it's cheap insurance.

And finally, the link back to this FMT thread, for those that are skimming this stuff, is that there is a theory that one may alter the composition of the gut microbiota towards a healthier composition by feeding the good "bugs" something they like to eat.  So if you do any kind of FMT, whether from the top or bottom, it might be wise to give those new good bugs something they like to eat.


----------



## wildbill_52280

I didn't think i experienced any benefits from my last fecal transplant attempt, but i actually gained 5 more pounds since december! I'm still on the same caloric intake and physical activity levels. Haven't weighed this much in 7 years. In total i gained 15 pounds in about 6 months without doing anything except FMT. haha I dont regret drinking it!! cant wait to improve upon my protocol for the next FMT!


----------



## Spooky1

Bill that's really encouraging.  Sounds like it needs time to work and not just immediate results.  Thanks for keeping us informed.


----------



## wildbill_52280

Spooky1 said:


> Bill that's really encouraging.  Sounds like it needs time to work and not just immediate results.  Thanks for keeping us informed.


Yes time and also the donor has to follow a strict diet so it increases the quantity of the bacteria I need to control inflammation. if you read the first post and all the studies that have been done so far some cases have taken very little time at all to turn around, until we get a consistent quantity of bacteria in an FMT like a pill for example, the results will be more consistent as well. 

EDIT: it is almost entirely certain that I replaced some bacteria in my gut that had been missing since taking antibiotics in 2008 right before my health declined, and it is helping to extract more energy/calories from my food, which is helping me maintain a normal weight.


----------



## wildbill_52280

Fecal transplants getting more press.

http://on.aol.com/video/the-future-of-poop-transplants-518748792


----------



## Spooky1

I for one so appreciate your efforts and info on this thread, Bill, that it does give me hope.  for some reason I really feel there is now a silver lining in the stormy skies for people like me.  I genuinely believe it is the way forward.  they are also looking to FMT for diabetes, motor neurone and MS.  I really believe, as 75% of the immune system is in the gut lining, that we need better gut flora.  I'm so sure this will cure us and allow us out our houses and to do what normal people take for granted.

Thanks so much for all the info.  And the best of luck with your own travels with FMT.


----------



## wildbill_52280

A testimony of a guy who did a fecal transplant. he also says he developed UC after antibiotic in 2008, which is how I also seemed to develop crohn's.

https://www.youtube.com/watch?v=B8-2Fcy-d18


----------



## mf15

Ok here is something brand new, and not good on FMT, sad. At least for UC.

Cannot get the paper but can get supplement info which pretty much tells the whole story.

I cant help but wonder if the donor stool prep kills off important anaerobes.

These 3 people got up to 30 rounds of FMT, but all relapsed eventually.
But while taking the FMT, were doing well.

Old Mike

Serial Fecal Microbiota Transplantation Alters Mucosal Gene Expression in Pediatric Ulcerative Colitis

Came out this AM.



here is the supplement link just click on the doc

http://www.nature.com/ajg/journal/v110/n4/suppinfo/ajg201519s1.html


----------



## wildbill_52280

mf15 said:


> Ok here is something brand new, and not good on FMT, sad. At least for UC.
> 
> Cannot get the paper but can get supplement info which pretty much tells the whole story.
> 
> I cant help but wonder if the donor stool prep kills off important anaerobes.
> 
> These 3 people got up to 30 rounds of FMT, but all relapsed eventually.
> But while taking the FMT, were doing well.
> 
> Old Mike
> 
> Serial Fecal Microbiota Transplantation Alters Mucosal Gene Expression in Pediatric Ulcerative Colitis
> 
> Came out this AM.
> 
> 
> 
> here is the supplement link just click on the doc
> 
> http://www.nature.com/ajg/journal/v110/n4/suppinfo/ajg201519s1.html


Thanks!! I will read this later when I have time, but for now I would like to say in this thread we are always interested in examining any evidence of fmt, whether it contradicts or supports the theory that it could cure the disease, as in any issue, we will have evidence that seems to support and contradict certain facts, and we sort it all out to hopefully get to the truth of the matter. and just a reminder, in the beginning of the thread there are 2 cases of both forms of IBD that have been 100% free of IBD symptoms ranging from 13-25 years post FMT, as reported in medical journals by top researchers in the field of scientific medicine.


----------



## mrjustaguy

Has anyone ever heard of a FMT used following anti-MAP treatment? It seems to me a FMT would be useful in preventing re-infection, provided the bacteria hold.


----------



## wildbill_52280

mrjustaguy said:


> Has anyone ever heard of a FMT used following anti-MAP treatment? It seems to me a FMT would be useful in preventing re-infection, provided the bacteria hold.


In alot of these studies they give antibiotics to the patient before hand to suppress/eliminate the existing microbiome which will have lots of bad bacteria. Its doubtful if its the same antibiotics that would be used for anti-map therapy though, but this is similar strategy to what you are suggesting, which is killing the existing bad bacteria before restoring the good bacteria with an FMT. It probably help the new bacteria take hold in the gut although I don't recall any specific studies that tried to answer this question. Perhaps antibiotics before hand aren't necessary, but i believe only when we have a fecal microbiota transplant pill will we get to that point because when the desired bacteria is in a high enough concentration, all the pathogens would likely be obliterated anyway.


----------



## mrjustaguy

My understanding of this is limited, but I think that MAP may give the bacteria from any FMT a more difficult time in colonizing the ileum, and that removing MAP specifically may see better results from FMT, at least in those of us with Crohn's in the ileum.


----------



## wildbill_52280

mrjustaguy said:


> My understanding of this is limited, but I think that MAP may give the bacteria from any FMT a more difficult time in colonizing the ileum, and that removing MAP specifically may see better results from FMT, at least in those of us with Crohn's in the ileum.



So far it seems IBD GI microbiome is very resistant to being corrected with a fecal microbiota transplant when compared to doing FMT for C. Difficile infection. Maybe one of the reasons is because of the type of pathogens that we harbor may be different like Intracellular MAP or AIEC, or perhaps just because there tends to be more inflammation involved with IBD.


----------



## sir.clausin

This is EXACTLY what I´m planing to do. 

1) AntiMAP-therapy - antibiotics
2) FMT

Results? Hopefully very good

Why? Because of this:
_____________

Dear Sebastian

XXX remounted the path block which had been displaced in the post to us and it went fine.

We ran the MAP test on the 2 skin biopsies obtained from your left lower leg (DDC1103/13 and DDC2083/13)

and the one from your scalp (522/13) and examined them today.

Result:

In the leg samples MAP infection was widely present in cells of the epidermis with scattered sub-epidermal foci.

The appearances in both biopsies were very similar.

In the scalp sample MAP infection within cells in the epidermis and sub-epidermis was conspicuous and much more prominent

than in the leg. Involvement of hair follicles and what looked like sebaceous glands was also seen.

Conclusion:

Together with my previous report (below) on your gut biopsies, this indicates you had a severe MAP infection of your gut

with systemic dissemination and metastatic skin involvement.


----------



## mrjustaguy

sir.clausin said:


> This is EXACTLY what I´m planing to do.
> 
> 1) AntiMAP-therapy - antibiotics
> 2) FMT
> 
> Results? Hopefully very good
> 
> Why? Because of this:
> _____________
> 
> Dear Sebastian
> 
> XXX remounted the path block which had been displaced in the post to us and it went fine.
> 
> We ran the MAP test on the 2 skin biopsies obtained from your left lower leg (DDC1103/13 and DDC2083/13)
> 
> and the one from your scalp (522/13) and examined them today.
> 
> Result:
> 
> In the leg samples MAP infection was widely present in cells of the epidermis with scattered sub-epidermal foci.
> 
> The appearances in both biopsies were very similar.
> 
> In the scalp sample MAP infection within cells in the epidermis and sub-epidermis was conspicuous and much more prominent
> 
> than in the leg. Involvement of hair follicles and what looked like sebaceous glands was also seen.
> 
> Conclusion:
> 
> Together with my previous report (below) on your gut biopsies, this indicates you had a severe MAP infection of your gut
> 
> with systemic dissemination and metastatic skin involvement.


Best of luck to you! Keep us posted, please


----------



## mrjustaguy

Just one pesky little hole I have to poke in this idea...

I can't find the article ATM, but I remember reading that people without Crohn's also have an abundance of MAP, and in the study the people without Crohn's had significantly more MAP than people with Crohn's, which the study posited was due to existing immunosuppressants possessing anti-MAP qualities.

Perhaps the Faecalibacterium prausnitzii found in healthy poo might cancel out the MAP, but it seems to me a FMT might actually have a chance of reinfecting the recipient.


----------



## rollinstone

sir.clausin said:


> This is EXACTLY what I´m planing to do.
> 
> 1) AntiMAP-therapy - antibiotics
> 2) FMT
> 
> Results? Hopefully very good
> 
> Why? Because of this:
> _____________
> 
> Dear Sebastian
> 
> XXX remounted the path block which had been displaced in the post to us and it went fine.
> 
> We ran the MAP test on the 2 skin biopsies obtained from your left lower leg (DDC1103/13 and DDC2083/13)
> 
> and the one from your scalp (522/13) and examined them today.
> 
> Result:
> 
> In the leg samples MAP infection was widely present in cells of the epidermis with scattered sub-epidermal foci.
> 
> The appearances in both biopsies were very similar.
> 
> In the scalp sample MAP infection within cells in the epidermis and sub-epidermis was conspicuous and much more prominent
> 
> than in the leg. Involvement of hair follicles and what looked like sebaceous glands was also seen.
> 
> Conclusion:
> 
> Together with my previous report (below) on your gut biopsies, this indicates you had a severe MAP infection of your gut
> 
> with systemic dissemination and metastatic skin involvement.



Seb, can you please pm me how you got the tests done, it really interested in getting some tests done, Though Borody himself told me I'd have little chance of getting anyone to do tests for me..


----------



## wildbill_52280

sir clausin, 

another additional option is to take autophagy inducers, like resveratrol and lithium. This will killl the intracellular bacteria by activating autophagy. My experiments with these substances led to a momentary increase in symptoms and then slight improvement afterwards, highly suggesting something was killed off. i take about 2.5 mg of lithium once a week and resveratrol everyday. every 2 weeks i increase my dosage of resveratrol to the maximum dose, to again clear bacteria i may have accumulated over that length of time. I also believe higher doses of b12 methylcobalamin have a similar effect, but im not sure if its enhancing autophagy or just killing more bacteria in a different way but the experiance is similar to resveratrol and lithium so perhaps the biological mechanism is the same.


----------



## sir.clausin

Rollinstone: You can´t, it´s not open to the public yet. It will become available further down the road. 

wildbill_52280: That´s interesting, I will look into it. Thanks. 

mrjustaguy: Nah, don´t think so, since a normal functioning immune system will clear out the MAP, not saying that healthy people have none. It´s just that it´s the main thing here, massively infection of MAP that can´t be killed of by our faulty immune system since it´s blind to it. Also, find the source please for your claim.


----------



## xeridea

sir.clausin said:


> Rollinstone: You can´t, it´s not open to the public yet. It will become available further down the road.


Sir Clausin, with the report mentioning metastic skin involvement, would I be wrong to assume you had visible lesions on your lower leg and scalp that were biopsied? I'm curious whether CD presents with skin lesions so far removed from the GI tract like this. Did they exclude leprosy, also a mycobacterial infection but more typically involves the skin?


----------



## wildbill_52280

video on recent study on loss of bacterial diversity in modern societies.

https://www.youtube.com/watch?v=ocyEdosTcE0


----------



## mrjustaguy

Bah! Having trouble finding that article, I'll post it as soon as I do.

I think it was on one of the main advocacy sites for the MAP vaccine, but I can't seem to get it.


----------



## sir.clausin

xeridea said:


> Sir Clausin, with the report mentioning metastic skin involvement, would I be wrong to assume you had visible lesions on your lower leg and scalp that were biopsied? I'm curious whether CD presents with skin lesions so far removed from the GI tract like this. Did they exclude leprosy, also a mycobacterial infection but more typically involves the skin?



That is correct, I did have a big lesion on my leg (Pyoderma Gangrenosum) and scalp lesions (Scarring folliculitis). These were diagnosed by swedish doctors and they treat me as an EXTREMLY rare case. Most GI-doctors I´ve seen never have CD-patients with skin involvement. Nevertheless it´s not unheard of http://www.ccfa.org/resources/skin-complications-of-ibd.html

EDIT: MAP is not found in leprosy, just got it confirmed so the answer is no. I do crohns, not leprosy.


----------



## wildbill_52280

http://fresno.craigslist.org/wan/4990155519.html


----------



## Spooky1

The time will come when we all advertise to repair out health.


----------



## xeridea

This article talks about researchers looking at the role of dysbiosis in inflammation of the gut and how that inflammation cascades into other events including diminished effectiveness or even death of paneth cells, a key defense component in the epitheleal lining of the intestine. 

They hope their research can uncover how to make fecal transplants more effective for CD and UC treatment.


----------



## wildbill_52280

xeridea said:


> This article talks about researchers looking at the role of dysbiosis in inflammation of the gut and how that inflammation cascades into other events including diminished effectiveness or even death of paneth cells, a key defense component in the epitheleal lining of the intestine.
> 
> They hope their research can uncover how to make fecal transplants more effective for CD and UC treatment.


great article. And I'm glad you are contributing to this thread.
I read about lysozymea and it's supposed antibacterial properties and how it is supposedly high in egg whites. There was a period of time after I took antibiotics where I had no symptoms of crohn's but 8 months after I developed it and i believe the antibiotic caused my crohn's. I wondered if anything I was consuming during that time possibly had delayed the development of the disease, so far resveratrol supplement I was taking seemed to reduce my symptoms so at least that was correct, but i was also eating lots of eggs for breakfast so now I'm wondering if that was another factor contributing due to lysozyme content and its broad ability to breakdown bacterial cell walls. Perhaps it makes sense that the egg would need to be protected by this outer wall from pathogens, and lysozyme is one major way the egg does this. i'll have to try adding eggs back into my diet and see how it affects my symptoms, maybe it's restoring lysozyme levels or something.

here is a study that found egg yolks to reduce inflammatory response, so the idea that eggs may have been somehow contributing to the supression of my symptoms, may have some merit, looks like it might be the yolks and the whites. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4113762/

another shows eggs reduced CRP but not tnf-a http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2265719/

egg white derived lysozyme effect on e coli-
http://pubs.acs.org/doi/abs/10.1021/jf4029199


----------



## wildbill_52280

A new book that just came out 4/21/15 related to microbiome diversity being related to modern diseases.

http://www.amazon.com/The-Good-Gut-Control-Long-term-ebook/dp/B00OZ0TOV2


----------



## wildbill_52280

xeridea said:


> This article talks about researchers looking at the role of dysbiosis in inflammation of the gut and how that inflammation cascades into other events including diminished effectiveness or even death of paneth cells, a key defense component in the epitheleal lining of the intestine.
> 
> They hope their research can uncover how to make fecal transplants more effective for CD and UC treatment.


here is the full study. http://gut.bmj.com/content/early/2015/04/16/gutjnl-2015-309333.full.pdf+html

this is a great study, id prefer to address these issues in the fecal transplant thread, but i was waiting for a mouse model of IBD based on changes in the microbiome, and this is kind of a step in that direction. This is the first time I've heard of them transferring "IBD" into another mouse, they have done this with obesity in mice already.

what was really cool is that they could influence where the inflammation occured by giving the mice antibiotics. This supports my previous belief that one of the main differences in uc and crohn's is the type of pathogens that exist. But more importantly, it is strong evidence for the sole cause of IBD to originate from the microbiome and not genetics. This supports the idea of fixing the microbiome issues with a fecal transplant, which could then correct the disease itself.


----------



## wildbill_52280

More Studies planned for Fecal Transplants in Crohn's Disease in the US. I think that's a total of 18 studies either already completed or planned through 2016.

https://clinicaltrials.gov/ct2/show/NCT02417974?term=fecal+transplant+crohn's&rank=1

https://clinicaltrials.gov/ct2/show/NCT02335281?term=fecal+transplant+crohn's&rank=9

https://clinicaltrials.gov/ct2/show/NCT02391012?term=fecal+transplant+crohn's&rank=11


----------



## Crohn2357

wildbill_52280 said:


> More Studies planned for Fecal Transplants in Crohn's Disease in the US. I think that's a total of 18 studies either already completed or planned through 2016.


Impressive.


----------



## Crohn2357

Makes me really sad to think about our dysbiosis. Wish we had a way to restore our gut flora. Maybe after complete remission it would restore itself with the help of a good diet ha? 
Now I can't even tolerate lactic acid. Gives me migraines every time. This is why I can't even eat any fermented food.

The microbiome-gut-brain axis: from bowel to behavior
https://www.google.com.tr/url?sa=t&...pXzj9dI3lBK69dQ&bvm=bv.92291466,d.d2s&cad=rja


>


----------



## boax

Another Crohn's FMT study with only one treatment but quite positive results. Donor similarity seems to be key once again to a successful outcome once again. Still seems like FMT for ibd is more viable as a continuous treatment rather than a cure at this point. 

http://journals.lww.com/ibdjournal/...icrobial_Transplant_Effect_on_Clinical.7.aspx


----------



## rollinstone

boax said:


> Another Crohn's FMT study with only one treatment but quite positive results. Do Donor similarity seems to be key once to a successful outcome once again. Still seems like FMT for ibd is more viable as a continuous treatment rather than a cure at this point.
> 
> http://journals.lww.com/ibdjournal/...icrobial_Transplant_Effect_on_Clinical.7.aspx


Jansen and Jansen have pills on the way I'm pretty sure.


----------



## wildbill_52280

boax said:


> Another Crohn's FMT study with only one treatment but quite positive results. Donor similarity seems to be key once again to a successful outcome once again. Still seems like FMT for ibd is more viable as a continuous treatment rather than a cure at this point.
> 
> http://journals.lww.com/ibdjournal/...icrobial_Transplant_Effect_on_Clinical.7.aspx


Thanks but we already posted this awesome study, see post #339 on page 12.


----------



## boax

wildbill_52280 said:


> Thanks but we already posted this awesome study, see post #339 on page 12.


Thanks for pointing it out! Was latest news at an ibd news site, I'll check more thoroughly next time.


----------



## rollinstone

boax said:


> Thanks for pointing it out! Was latest news at an ibd news site, I'll check more thoroughly next time.


Reposts of news are always good incase people have missed older posts so don't worry too much if something's already been posted, if it raises more awareness it's a win.


----------



## xeridea

That separate studies draw different conclusions points to the nascent nature of FMT and suggests that so much more research is needed in this area. Or maybe that's just the nature of Crohn's. 

The above Suskind study concludes that the greater the difference in bacterial makeup of host and donor, the better the results. Conversely, I've seen other studies say the more similar the bacterial makeup the better the results. I don't have a reference to the similar makeup study to link to but will do so when I run across it again.


----------



## wildbill_52280

This is a google ad I saw today for a rebiotix fecal transplant pill study for c. difficile-

http://rebiotix.com/punchcd2/Clinic...gclid=CMWfj5KrqMUCFQcdaQodz30Atw#.VUeHd9JViko


----------



## wildbill_52280

Here is an article about microbiome diversity May 3rd 2015 BBC.
http://www.bbc.com/news/health-32543176


----------



## Spooky1

Shame I live in Bude, UK, and not Chicago.


----------



## xeridea

This is a cool study for folks who go the FMT route for C. Diff. Researches in a controlled randomized study show significant reduction of recurrent C. Diff when they orally administer harmless/non-toxigenic C. Diff spores during treatment.

http://jama.jamanetwork.com/article.aspx?articleid=2281703


----------



## wildbill_52280

Replenishing our defensive microbes
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4102301/




> The modern infatuation with cleanliness stems in part from the misguided midcentury thinking that most microbes cause disease, and that the absence of microbes is therefore a key component of health. Over the last twenty years, the use of culture-independent methods that allow us to identify the members of human-associated microbial communities that are difficult to grow in the laboratory, together with epidemiological studies and studies of germ-free mice, has started to change this thinking. There is now compelling evidence that the opposite is true: rather than reducing microbial exposure, we should balance our symbiotic microbial communities to protect us from pathogens and disease states.


----------



## Lady Organic

I wish I could get a transplant from those Malawi and Venezualian rural people they are talking about :ysmile:


----------



## wildbill_52280

Lady Organic said:


> I wish I could get a transplant from those Malawi and Venezualian rural people they are talking about :ysmile:


yea that would be awesome, assuming these bacteria are good, which they probably are. it inspire's me to find wild growing fruits and veggies to hopefully gain bacteria I've never been exposed to or even lost. May even try to ferment wild fruits like make some natural wine or something.

What was interesting is I was trying to find more information about these spirochaete Treponema berlinense, and found that a similar sounding organism is suspected to be the cause of alzheimers. I'm not sure these organism's have much similarity but it's interesting. something to learn more about. http://www.ncbi.nlm.nih.gov/pubmed/25932012

This almost reminds of the latest research on h.pylori, once believed to be the cause of stomach ulcers, but is now suspected to actually be a natural inhabitant as people with h pylori have a some protection from some diseases or something like that. Or of c. difficile infection, where a bacteria which is usually in the gi tract begins to dominate and now causes disease state because of the ABSENCE of other microbes, but is otherwise just a harmless bacteria. These are some complicated relationships were talking about here, it's all about ecosystems and how they work together as one.


----------



## wildbill_52280

Fecal microbiota transplant cures C. diff, blocks multi-drug resistant pathogens, study shows
http://www.sciencedaily.com/releases/2015/05/150506134855.htm


----------



## wildbill_52280

It's sort of related to fecal transplants, as FT will be how we correct microbiome problems. 

Microbiome and Autism. 
http://www.microbiome-autism.com/


----------



## Lady Organic

thx, towards the end of the video, they encourage eating fermeted veggies. Ive kept good discipline of that and I now eat a full big jar per week of raw saukrate. I use the juice to replace lemon or vinegar in salads. Its surprisingly good!


----------



## Spooky1

I've been making sauerkraut for 6 months now.  Gets rid of bloat too.  Normally I can't eat veg, but I've grated and sliced it thin through the food processor.


----------



## wildbill_52280

some FMT press from may 8th.

http://www.wcvb.com/bethisrael/fecal-transplant-for-Crohn's/32398976


----------



## wildbill_52280

May 11, 2015

The popularization of FMT in scientific medicine and its application for c. difficile, an interview with Colleen Kelly, MD from Brown Alpert Medical School. 
https://www.youtube.com/watch?v=F-EuCsHRWuw


----------



## wildbill_52280

Just a little excerpt from a paper studying fecal transplants in mice. Apparently pretreating the mice to lower the bacterial load(pathogens) before FMT didnt improve the ability for the FMT to restore missing bacteria, and seemed to reduce the success of FMT. Many people have asked this question pertaining to humans and it was always something i wondered myself. 





> Therefore, lowering the recipient bacterial load by antibiotic intake prior to transplantation did not increase establishment of the donor phylotypes, although some dominant lineages still transferred successfully. However, since antibiotic pretreatment counterintuitively interferes with the establishment of an exogenous community, such plasticity is likely conditioned more by the altered microbiome gut homeostasis caused by antibiotics than by the primary bacterial loss.


http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2945190/

At the moment I think the most important variables for FMT are the quantity and composition of the donors microbiota which is diet dependant, and the diet of the patient after fmt. If you get those correct, all other variables won't matter, the transplant will likely be successfull 100% of the time.


----------



## wildbill_52280

another craigslist ad searching for an FMT donor, it might be the same person who posted one a few weeks ago which was deleted. I did this once and got a few responses, although I did not trust the people I talked to. I got about 5 responses over an 8 week period. I put the ad in the volunteer section.

http://sfbay.craigslist.org/sfc/vol/5030142771.html


----------



## wildbill_52280

Awesome video

https://www.youtube.com/watch?v=aav9D3j6hvk


----------



## wildbill_52280

Ideal Donors for Fecal Transplant Rare
May 19, 2015
http://www.medscape.com/viewarticle/844905



> Because of limited resources, the researchers invited only 77 of the 251 potential donors to the onsite visit for further evaluation. After clinical assessment, 50 people were excluded, mainly because of sexual history (10%), travel history (10%), or psychiatric concerns (18%).
> 
> The remaining 27 potential donors underwent blood and stool assessment, which eliminated 15 people because of stool, not blood, screening considerations.
> 
> Six people were excluded because of rotavirus, which was asymptomatic. None of these donors had healthcare exposure or contact with young children or daycare, Burns pointed out.
> 
> "We ultimately enrolled 12 donors, which was an 8.5% donor enrolment rate," she said.


----------



## wildbill_52280

Microbiome Research: The New Horizon In Therapeutic Value Creation
May 19, 2015

http://www.clinicalleader.com/doc/m...ew-horizon-in-therapeutic-value-creation-0001


----------



## wildbill_52280

https://reflectionsipc.files.wordpr...rapsules-the-cure-for-cdiff-and-more_blog.pdf


----------



## wildbill_52280

RICHMAN OF UBIOME: SCIENTISTS CAN ACCELERATE FMT RESEARCH
Written on May 20 2015 at 7:09 PM 
By Kristina Campbell in Gut microbiota

http://www.gutmicrobiotaforhealth.com/richman-ubiome-scientists-can-accelerate-fmt-research-8152


----------



## Spooky1

Well, let's hope this does make many a research company get a wriggle on with this FMT trialling.  Here's hoping for better health very soon.
Thanks, Bill. Keep that info coming.


----------



## wildbill_52280

hilarious and cute.

https://www.youtube.com/watch?v=lOQmGWNMfHY


----------



## wildbill_52280

And she is right!! Take it from an evolutionary biologist,latest discoveries in microbiome science is a scientific revolution, germs CAUSE good health.

http://www.huffingtonpost.com/alanna-collen/microbiome-health_b_7305128.html


----------



## wildbill_52280

Seres health created one of the first versions of a fecal transplant pill, but for C. difficile. the company will be going public to be traded on the stock exchange, I would say it's probably a good investment, but since it's an area of rapid development competitors may come up with better products soon, throw some money at it but pull it out at the right time.

http://www.xconomy.com/boston/2015/...-files-for-first-ipo-of-human-microbiome-era/


----------



## wildbill_52280

Testimony of person who has had no symptoms of IBD for 2 years after doing a fecal Transplant.
http://www.healingwell.com/community/default.aspx?f=38&m=3420378


----------



## 7vNH

It has been 6 months since my 10-day FMT treatment ended and I am in good health, despite having significantly reduced my medication.  I was at a crossroads with my UC: to impede my immune system with expensive drugs that have serious side-effects, or battle what was causing my immune system to react.  I obviously chose the latter. So far, so good!

In this post I will outline the protocol I followed.  This is not to say that anyone should do exactly this, or even anything like it, only that this is what I did.  There's nothing to say that some of this, much of this, all of this was unnecessary and I'd be feeling this well if I had done less or none of this.  The purpose is to say what seems to have worked for me (so far), and so allowing correlations to be drawn from others who report what they did, and what their results were.  The formal studies are slow and often have poor design, so anecdotes may provide hints in the mean time.

Age 56, diagnosed with UC 14 years ago and have been on various 5-ASA's since.  No serious flare-ups until 18 months ago, when the 5-ASA became ineffective.  For 6 months I tried steroid formulations.  Budesonide (Uceris) reduced symptoms but flare returned when stopped.  Same with hydrocort enema.  Neither were long-term solutions, and during the 6 months of using those (on and off), I had flare symptoms of blood, mucus, diarrhea, urgency, many evacuations per day.  That's the worst I've felt in my life with the roller coaster of symptoms and steroid side-effects.  The 6 months following the use of the steroids I used the maximum dose of 5-ASA of 4.8g mesalamine (generic Lialda) in addition to about 1.3mg mesalamine in 20ml solution rectally.  This kept symptoms under better control, but still had occasional symptoms.  So going into the FMT, I was fairly healthy, but on the largest dose of 5-ASA and being careful about my diet.  The fecal calprotectin test showed low inflammation at this time.

Throughout the one month run-up to the FMT procedure, I kept my diet about the same as usual, but on the conservative side by eating fewer different things.  I tried to keeping things that worked for me and tried to reduce or eliminate things that did not work for me.  This is difficult for me, since rarely does a food cause an immediate reaction, but rather multiple instances over weeks of some foods might cause problems.  

28 days before the FMT was scheduled, I began taking osmotic laxative pills with a target of bristol#5.  This was continued up to the start of the FMT treatment.

11 days before the FMT treatment, I began a antibiotic regimen (under the supervision of a doctor who was on-board with the FMT idea) that lasted 9 days: Vancomycin Hcl 1g/day, Metronidazole 750mg/day, Doxycycline Mono 100mg/day, Amoxicillin 1.5g/day.

7 days before the FMT treatment, I had a colon irrigation (colonic lavage) http://www.crohnsforum.com/showpost.php?p=845588&postcount=322, and 4 days before the FMT treatment I did colonoscopy cleanse (http://www.crohnsforum.com/showpost.php?p=844368&postcount=312).  Between this cleanse and the FMT procedure, I ate normally, but on the light side (no large heavy meals).

Immediately before the first FMT infusion, I had another colonic lavage, then for 10 days I had human fecal probiotic from multiple healthy and screened donors introduced rectally (60ml centrifuged cells only, prepared in an anaerobic environment).  During this time I stopped, then eased back into a low dose of the osmotic laxative in order to maintain a bristol#4/5.  During the span of time of the FMT treatments, I ate slightly "worse" than my normal diet, since I didn't have a kitchen at the time.  By worse, I mean more refined carbohydrates and fewer veggies.  Also during the span of the FMT and every day up to today, I have been consuming a pre-biotic daily http://www.crohnsforum.com/wiki/Prebiotics.  During the span of the FMT, I maintained my dose of 5-ASA (4.8g mesalamine in addition to about 1.3mg mesalamine in 20ml solution rectally).  During, and immediately after the FMT, fecal calprotectin and CRP tests showed very low inflammation.

Five weeks post FMT, I cut the dose of mesalamine in half, down to 2.4g.  Nine weeks post FMT, I eliminated the rectal mesalamine.  These changes did not seem to change symptoms at all, which, generally were one evacuation per day at bristol#4.  None of the former notable UC symptoms were present.

My diet, post FMT has changed, somewhat.  1) I have reduced intake of foods containing gluten.  Going completely gluten-free was advised, but I have not had the drive to do so.  I have had the Cyrex 3 panel, which indicated I was certainly sensitive to 3 of the 24 things tested, so when convenient, I might go completely gluten-free for a couple of months, note how I feel, and then slam some gluten and see how I feel.  2) As I said before, I have added daily a pre-biotic (GOS).  3) I have started eating more organic raw and live foods.  Examples of a live foods are sauerkraut and kombucha, both of which I make myself (but you can get both at health food stores).  4) Before and after FMT, most of my carbohydrate calories came from veggies, so very few refined carbs (except in my weekly trip to the craft beer establishment).  So a large part of my diet has been and is fat and protein.  The change is that now I'm eating more raw veggies than before (less Atkins-like and more along the lines of paleo).


----------



## wildbill_52280

7vNH, glad to hear your health has improved after FMT procedure. It was unfortunate that your diet during the 10 day FMT process wasn't that great, as that was the most crucial time to get fiber to feed the new bacteria. High fat and meat diet is not good for the gut bacteria by the way, those foods don't have much fiber unless your source of fat is nuts which do have fiber. Keep us updated. Sources of resistant starch might be very important for a patient and donor that is doing an FMT, think pinto beans and potatoes, but many foods have varying degrees of resistant starch. Chitin may also be a very good fiber, it is found in mushrooms. The clostridial commensal bacteria are the main bacteria we seek to restore to treat IBD, although other types may be missing as well.

*Dietary modulation of clostridial cluster XIVa gut bacteria (Roseburia spp.) by
chitin–glucan fiber improves host metabolic alterations induced by high-fat diet
in mice.*
http://www.uclouvain.be/cps/ucl/doc/ir-ldri/images/Neyrinck_JNB_2012.pdf


----------



## Lady Organic

thank you for the testimony 7vNH. could you share the numbers of your fecal calprotecine before and after the FMT, thx! do you plan on getting another round of FMT?


----------



## 7vNH

I never got numbers on the fecal calprotectin.  I had one test in mid December, and another in mid January and my doctor said it was "low" both times.  I guess that by December my earlier flare had calmed down.  He said neither test indicated any level inflammation. As for another round of FMT, I hope not, because that would mean I've reverted to my former state of ill health.

The diet during the FMT was a bit unfortunate, but I was able to eat avocados, fresh fruit and nuts throughout as snacks.  It was difficult to prepare a full meal, but I was able to get some of these more healthy things at the grocery store instead of or in concert with eating out.  And even eating out, by the end, I was able to find a few places with a healthy menu, even with raw veggies and 'live' (fermented) veggies.


----------



## wildbill_52280

7vNH, Could you elaborate on how you were able to use a centrifuge and how this was done in an anaerobic environment? Thanks!


----------



## Rebel1992

P.s typing on a phone, excuse the errors
Wildbill, just wanted to let you know that 2 weeks agoI was emembarking on exactly what you were doing. While the results made a no show... I am refining my methods and will be doing a fmt oral this weekend again. .. same donor.

The first time I did the oral one... my plan was to break fecal matter apart and swallow it in several pieces with soft drink. Did exactly tht for 1 time. However note that I didnt take into account the anaerobic factpr when I was preparing the materials... left more than 20 mins from defecation from donor (teen, lived with me during transplant,) to swallowing material.so that might have killed most anaerobes ( but I still dont necessarily buy into that since there are many sections in stool where anaerobes may reside and escape an pxygenated enviroent) ...very similar to the theory of stomach acid will kill the fecal bacterawhiich is totally not true. Our stomach is alot less acidic than people think ( proven)  but thats for another day.
 Moreover my donor despite being healthy was not on a high fiber diet. I will be forcing my donor to consume more fruits since vegetables are a no no to him.and will be overlooking his diet this 2nd donation time around. 

Will continue this in the next post


----------



## Rebel1992

I also have concerns that since I consumed the material in broken up pieces...that lack of surface area did not necessarily spead enough bacteria around the intestinal walls where they may take hold.

So this time ,
The things I will be doing are...( 5day, 1 donation a day oral transplant)

1) donor will consume at least 2 whole pieces of fruit on day before 1st donation to ensure 1st donation has more helpful bacteria to take hold .. 

2) donors diet controlled when living with me.. includes meat, rice , spice....etc but no vegetables...thus to compensate for the lack of fiber... I have taken the liberty to prepare fruits to be yaken with every meal including times when consuming snacks. ( bananas looks to be the staple fruit)

3) when donation is excreted from anus... I will put in ziplock bag and try to release air before I lock to prevernt an oxygented environment.
Not sure of I will be mixing stool with saline or just water... 

4) whichever I mix stool with in ziplock bag, I willmanually mix the stool from the outside of the bag ...so not really blending but rather an imperfect mixing of stools that will still contain unbroken pices when I consume orally.

5) I kmkw all this sounds disgusting and what not  .. but desperation changes you. Theres alot more I have done with  fmt... 
Just to let everyone reading know.... the article about weight gain from obese fmts.... I ts true...cause I am living proof of that... put on 20 pounds in 6 months despite having continuous diarhea after fmt...did not cure my crohns infection though

So wildbill, I hope you can tell if this is a good enough plan or of theres any other improvement or mistakes I have made.

I am just as desperate as you are to see if this works...


----------



## wildbill_52280

Rebel1992, I cant really encourage you to do FMT but you are hopefully an adult and can make your own decisions.  If you decide to do it again, make sure your donor is healthy via blood tests. There are online blood test places where you can order them yourself (HIV, HEPATITIS, and Other STD's) I don't want you take any extreme risks to your health. Also I think your donor should be on a high fiber diet for at least one week and obtain fiber from many foods sources not just fruit, for example beans, whole grains, nuts, veggies etc. Make them take inulin and potato starch everyday as a fiber supplement. Refer to the first post of this thread under how to select a donor. You should also take more time to learn and think about this before doing anything at all.


----------



## Rebel1992

Wildbill, testing donor is not available to me since I dont live in the us... and only c diff is alllowed here for fmt. Alsp onlne test kits are a hasske I am willing to risk...plus my donor is healthy from all the questions I have imposed on him.
Moreover regarding the fiber issue, I dont really wanna step on my donors toes. He is totally against vegetables...so my only other fiber source are fruits.
He is also someone who is a huge spicy food person and I have requested him to leave spicy food during the week that he is staying with me just imcase it may affect stool quality.

Overall I think this weekends fmt, is an endevour I am hoping to get rwsults from. 
Onky other question I have is.... for saline solution how do you make them or do you get storebought ones.
Plus is there a reason why you use saline instead of distilled water for oral transplants...
I dont see osmolality affecting fmt ( care to explain a little)


----------



## wildbill_52280

Rebel1992 said:


> Wildbill, testing donor is not available to me since I dont live in the us... and only c diff is alllowed here for fmt. Alsp onlne test kits are a hasske I am willing to risk...plus my donor is healthy from all the questions I have imposed on him.
> Moreover regarding the fiber issue, I dont really wanna step on my donors toes. He is totally against vegetables...so my only other fiber source are fruits.
> He is also someone who is a huge spicy food person and I have requested him to leave spicy food during the week that he is staying with me just imcase it may affect stool quality.
> 
> Overall I think this weekends fmt, is an endevour I am hoping to get rwsults from.
> Onky other question I have is.... for saline solution how do you make them or do you get storebought ones.
> Plus is there a reason why you use saline instead of distilled water for oral transplants...
> I dont see osmolality affecting fmt ( care to explain a little)


Just make saline solution, you mix a certain amount of salt into water, preferably distilled i have instruction in the first post of this thread. If you are drinking it the salt will help mask the taste going down, also the saline should be chilled in the refrigerator or on ice the coldness will also mask the taste. keep your nose plugged during and for 20 minutes after so you do not smell it. DO all this and your stomach should hold it all down. I've done it 2x, so speaking from experiance of course.


----------



## Rebel1992

wildbill_52280 said:


> Just make saline solution, you mix a certain amount of salt into water, preferably distilled i have instruction in the first post of this thread. If you are drinking it the salt will help mask the taste going down, also the saline should be chilled in the refrigerator or on ice the coldness will also mask the taste. keep your nose plugged during and for 20 minutes after so you do not smell it. DO all this and your stomach should hold it all down. I've done it 2x, so speaking from experiance of course.


There are a few concerns regarding keeping it chilled ...wont coldness affect the bacteria s activity... anyway...to mask the taste ( despite having very little gag reflex) I have decided to get some sort of liquid flavouring. Possibly vanilla or smth.

Question is ....is there a reason why u used saline instead of water.? Was it purely because of taste or does issies like osmolality of the solution affect the availabity of bacteria?
Thx for yr help. 
Really need to clear any doubts, since if it doesnt work this time around for me.... the only other solution I can think of...is to get my Crohn's under very good control and then reattempting it 2 months later.


----------



## Spooky1

Rebel, great info, thanks.  It's always very interesting to read about how FMT is going as I think it might be the way forwards.  It's just getting the technique right.  I'm looking forward to hearing your results.

Would your donor drink something like Fibrogel for fibre beforehand.  Don't really know if it would help, but many people do take it to up their fibre intake.  It could be sprinkled into fruit juice. I don't know if it's called that in Singapore, but I'm sure there is some kind of equivalent.

Good luck.


----------



## Rebel1992

Spooky1 said:


> Rebel, great info, thanks.  It's always very interesting to read about how FMT is going as I think it might be the way forwards.  It's just getting the technique right.  I'm looking forward to hearing your results.
> 
> Would your donor drink something like Fibrogel for fibre beforehand.  Don't really know if it would help, but many people do take it to up their fibre intake.  It could be sprinkled into fruit juice. I don't know if it's called that in Singapore, but I'm sure there is some kind of equivalent.
> 
> Good luck.


Hey thx for the suggestions,  really mean it.. since sm1 might have a better method to proceed with fmt and make it work.

Anyway regarding fibrogel, its basically psylium husk, amd I wouldnt necessrily consider PH a prebiotic...more as for sm1 with constipation.

Regardless, I will probably getting my donor to eat fruits which I ll prepare 3 times after meals so that it fulfills the fiber requirements.

I think like what wildbill posted...the fiber is important because of the antimicrobial antiinflammatory substrates it produces when fermenting fiber.

The best idea I can think of regarding giving the bacteria from donor stool to feed on is...mixing say smthing like inulin powder in the oral stool solution that I ll be consuming. That way it hopefully gives the bactria a better chance to produce substates that can help them adhere to the intestinal lining.


----------



## wildbill_52280

Just a new video about the microbiome.
http://www.uctv.tv/shows/29535


----------



## wildbill_52280

Rebel 1992, The saline would be used for osmolarity issues, if the PH is not right this can stress the bacteria out and some may die. Most of my advice are based in science, so I'm not trying not to do too much guessing on this, by understanding as much science as you can this will increase your success, so it's not a, my method/opinion or your method/opinion type of issue, all of our opinions can be as firmly backed by science as possible, although you may also think of some new solutions by yourself which is great, and you also may have actual experience above and beyond the current science can offer. Its possible plain old water would be fine, but you should use the science we have to increase your chances of success and do not stray too much further from that, this will help you construct the best plan for success, because how many times do you really want to do this? or how long do you think your donor will cooperate? good luck.


----------



## too_cool

Is it available in india?


----------



## xeridea

This is an interesting thread, if for nothing else, reminds me of the two girls and a cup who may have been onto something.


----------



## Rebel1992

wildbill_52280 said:


> Rebel 1992, The saline would be used for osmolarity issues, if the PH is not right this can stress the bacteria out and some may die. Most of my advice are based in science, so I'm not trying not to do too much guessing on this, by understanding as much science as you can this will increase your success, so it's not a, my method/opinion or your method/opinion type of issue, all of our opinions can be as firmly backed by science as possible, although you may also think of some new solutions by yourself which is great, and you also may have actual experience above and beyond the current science can offer. Its possible plain old water would be fine, but you should use the science we have to increase your chances of success and do not stray too much further from that, this will help you construct the best plan for success, because how many times do you really want to do this? or how long do you think your donor will cooperate? good luck.


I guess I will probably be doing with saline solhtion instead of water then. And I completely agree with regarding putting as science on yr side to keep odds up. Fingers crossed.


----------



## UnXmas

wildbill - I just skimmed through this thread for the first time, and read many of the posts about your attempts at faecal transplants, and I have a couple of questions. (I'm sorry if I've missed the answers somewhere in the thread already.)

What is your relationship with your doners?

How can you be certain the changes you've noted were due to the transplant? You say your diet is consistent, but more things can affect symptoms than diet, including internal workings in our bodies which we are not aware of. In particular, how are you able to know your mood changes are results of the transplants? They could be placebo effects. No one's mood is consistent all the time, so it is difficult to determine they are the result of one factor, unless the mood changes are severe and have happened every time you do a transplant, which you haven't done enough times yet to know the mood change is always the result.

Your digestive symptoms don't sound all that bad at the moment, and I  wondered why you are so driven to achieve healing to go to the lengths you're going to with this? Also, what are you trying to achieve in terms of symptoms? If someone had terrible pain and bloody diarrhoea ten times a day, then it would be a huge change to become pain free with the odd loose bowel movement. But your bowel movements currently sound pretty normal. Is pain a symptom you experience? What would you view as a clear success regarding your digestive symptoms?

Do you have regular medical tests, whether blood tests, scopes or anything else? What sort of disease status is indicated by your recent results, and, again, what would you view as a clear improvement?

Thanks in advance for answering. I'm going to read some more of this thread now (again, sorry if I missed answers to my questions). It's not something I'd do myself, at least I would not try and do it myself; I have no objections to it if it were being carried out by doctors and was established as a safe and hopefully effective treatment, but it's interesting to read about.

Oh, and one very different question: what would happen if you did a faecal transplant with animals other than humans for doners?! I'm sure there are obvious reasons why this wouldn't work, but it seems far less disgusting to consume animal faeces.


----------



## wildbill_52280

UnXmas said:


> wildbill - I just skimmed through this thread for the first time, and read many of the posts about your attempts at faecal transplants, and I have a couple of questions. (I'm sorry if I've missed the answers somewhere in the thread already.)
> 
> What is your relationship with your doners?
> 
> 
> 
> I used 3 different donors for 4 attempts. Sister, cousin, and cousins son.
> 
> 
> 
> 
> How can you be certain the changes you've noted were due to the transplant? You say your diet is consistent, but more things can affect symptoms than diet, including internal workings in our bodies which we are not aware of. In particular, how are you able to know your mood changes are results of the transplants? They could be placebo effects. No one's mood is consistent all the time, so it is difficult to determine they are the result of one factor, unless the mood changes are severe and have happened every time you do a transplant, which you haven't done enough times yet to know the mood change is always the result.
> 
> Click to expand...
> 
> How am I certain my return to normal weight was a result of the fecal transplant? Because I've never weighed more then 134 lbs in the last six years of having crohn's and directly 8 weeks after the the FMT I gained around 9 pounds, 4 months later I gained about 15 pounds total. This was all without increasing my caloric intake, in all likelihood it was the fecal transplant. My bowel movements became healthier looking, and my mood improved all during this time. These changes are way beyond being a result of my own wishful thinking they are objective(other people can see it too/not in my head) and measureable/quantifiable. My mood in general has improved as well my anxiety is lower now, that isnt easily measureble by anyone but me though so you'll have to trust me on that one, but gi inflammation and the microbiome itself is implicated in anxiety, plenty of science to support my claims here.
> 
> 
> 
> 
> 
> Your digestive symptoms don't sound all that bad at the moment, and I  wondered why you are so driven to achieve healing to go to the lengths you're going to with this?
> 
> Click to expand...
> 
> my entire health declined not just my digestive symptoms, my mental health was affected alot too. I have chronic fatigue attention deficits and memory issues, THAT is why I'm driven. I have considered in teh past year the i may have also had c difficile on top of crohn's and that why i may have become so much worse after my colonoscopy but the doctor just ignored me when i said it got worse after the colonoscopy, during that time i had no idea what crohn's or c. difficle even was to question the doctors and have them test me for c. difficile. It is frequently contracted in medical facilities. Even though I control my diarhea with diet and some meds, I still want to restore my ability to digest food normally.
> 
> 
> 
> 
> What would you view as a clear success regarding your digestive symptoms?
> 
> Click to expand...
> 
> the ability to eat foods with sugar in it like fruits and not have any increased symptoms of diarhea. and I would also like my energy levels to go back to normal.my first symptom after taking the antibiotic augmentin/amoxicillin-clavulanic acid was horrible fatigue and anxiety. It took a few more months for digestive issues to develop.
> 
> 
> 
> 
> Do you have regular medical tests, whether blood tests, scopes or anything else? What sort of disease status is indicated by your recent results, and, again, what would you view as a clear improvement?
> 
> Click to expand...
> 
> before i did the FMT my doctor indicated all bloods tests came back normal that included inflammation indicators c-reactive protein and sedimentation rate. I refuse colonoscopy because of how it made my symptoms so much worse.
> 
> 
> 
> 
> 
> Oh, and one very different question: what would happen if you did a faecal transplant with animals other than humans for doners?! I'm sure there are obvious reasons why this wouldn't work, but it seems far less disgusting to consume animal faeces.
> 
> Click to expand...
> 
> It's unknown. Alot of the bacteria are similar though. Definitely not recommended.
Click to expand...


----------



## Crohn2357

Have you done fecal calprotectin tests before and after transplants? Which one do you have crohn's or colitis?


----------



## wildbill_52280

Crohn2357 said:


> Have you done fecal calprotectin tests before and after transplants? Which one do you have crohn's or colitis?


no and I have crohn's, small intestine and colon.


----------



## UnXmas

Thank you for answering, can I ask a few more things? The main changes you are aiming for are regarding your mental health, fatigue and memory, but is there much evidence faecal transplants help with these things? I've only really heard it talked about in relation to bowel conditions. I think I saw earlier in this thread you gave links to the odd account of faecal transplants helping other things, but there are treatments for your mental health problems which have far more chance of working. 

Also, since you are going about this very scientifically, would it be beneficial to have more medical tests so you have information about what is happening to you? Not necessarily a scope if they make you worse, but imaging studies, and frequent blood and stool tests, for example? Also, have you considered any scientific ways of measuring your mental improvements? E.g. neuropsychological tests? 

Have you had any ideas about how to reduce the hygiene risks?!

Thanks again for your answers.


----------



## wildbill_52280

UnXmas said:


> Thank you for answering, can I ask a few more things? The main changes you are aiming for are regarding your mental health, fatigue and memory, but is there much evidence faecal transplants help with these things? I've only really heard it talked about in relation to bowel conditions. I think I saw earlier in this thread you gave links to the odd account of faecal transplants helping other things, but there are treatments for your mental health problems which have far more chance of working.
> 
> Also, since you are going about this very scientifically, would it be beneficial to have more medical tests so you have information about what is happening to you? Not necessarily a scope if they make you worse, but imaging studies, and frequent blood and stool tests, for example? Also, have you considered any scientific ways of measuring your mental improvements? E.g. neuropsychological tests?
> 
> Have you had any ideas about how to reduce the hygiene risks?!
> 
> Thanks again for your answers.


I have thought about it and after FMT I may have my microbiome tested to see how i stack up against healthy microbiome. 
http://ubiome.com/

The energy issues are pretty clearly from the damage of antibiotics, i was pretty physically active and after the antibiotics i just couldn't keep up, and things have been a struggle ever since. Some studies show fatigue is common in IBD, dont really how common though like 30% or something like that, i think its common with many chronic diseases. http://www.crohnsandcolitis.org.uk/.../Publications/Info-Sheets/fatigue-and-ibd.pdf

Quote:


> Many people find that their fatigue
> improves as their IBD improves.
> However, for some, there can be a time
> lag of weeks or even months before they
> regain their normal energy levels.
> Sometimes the fatigue does not go away
> even when the IBD seems to be
> completely under control. Fatigue
> continues to affect over 2 out of 5 people
> whose IBD is in remission.


----------



## UnXmas

So you're not having any tests done? Have there been cases where faecal transplants have helped mental symptoms?


----------



## Rebel1992

Hey wildbill, I will doing my first oral fmt today... just looking up on the net... I was intending to add chia seeds after downing the oral fmt.
Do you think chia seeds may help? Since it forms almost like a mucilage sort of action on the intestines...or should I just stick to plain oold oats for the fiber?


----------



## Rebel1992

Rebel1992 said:


> Hey wildbill, I will doing my first oral fmt today... just looking up on the net... I was intending to add chia seeds after downing the oral fmt.
> Do you think chia seeds may help? Since it forms almost like a mucilage sort of action on the intestines...or should I just stick to plain oold oats for the fiber?


Note; I cant tolerate


----------



## rollinstone

UnXmas said:


> So you're not having any tests done? Have there been cases where faecal transplants have helped mental symptoms?


There is plenty of evidence that the microbiome is directly related to autism spectrum disorders, so fmt most certainly can have an effect on mental symptoms.


----------



## hugh

UnXmas said:


> Have there been cases where faecal transplants have helped mental symptoms?


It's all pretty "new frontier, may, might, gimme some funding and i'll do a study" or to quote one article
_"As the authors discuss, the impact of the microbiota on normal brain development remains unknown, but this has become an important emerging area of investigation."_

"proof" of anything is a while away

It seems widely (albeit recently) accepted that microbiome directly affects mental health so it is not unreasonable to assume that FMT may influence mental symptoms

_"Thus, the emerging concept of a microbiota–gut–brain axis suggests that modulation of the gut microbiota may be a tractable strategy for developing novel therapeutics for complex CNS disorders."_
http://www.nature.com/nrn/journal/v13/n10/abs/nrn3346.html

_"This review provides evidence for the gut microbiota as a key factor mediating the link between diet and depressive illness.
*Summary* Although in its early stages, the emerging field of research focused on the human microbiome suggests an important role for the gut microbiota in influencing brain development, behaviour and mood in humans. The recognition that the gut microbiota interacts bidirectionally with other environmental risk factors, such as diet and stress, suggests promise in the development of interventions targeting the gut microbiota for the prevention and treatment of common mental health disorders."_
http://www.medscape.com/viewarticle/836260

_"The concept that gut microbiota may modulate brain chemistry and behaviour is gaining traction and efforts are now turning to investigate the role of microbiota in animal models of psychopathology."_
http://onlinelibrary.wiley.com/doi/10.1111/nmo.12198/full

we live in interesting times


----------



## mf15

Here is an interesting paper on what goes on with FMT and Sepsis,case study.
Lots of good info on before and after gut bugs.
I might suspect much of the same happens with IBD and FMT.
Old Mike
http://www.omicsgroup.com/conferences/ACS/conference/pdfs/16568-Speaker-Pdf-T.pdf


----------



## wildbill_52280

> Given the demonstrated and potential value of microbiome research in such diverse applications, the White House Office of Science and Technology Policy (OSTP) is issuing a Request for Information to provide a broad community of stakeholders, including experts and members of the public an opportunity to comment on the current status and needs of microbiome research. The Request for Information can be found in the Federal Register here. OSTP encourages experts and interested individuals from across sectors and scientific disciplines to share your feedback on this critically important topic.


https://www.whitehouse.gov/blog/2015/05/21/whats-next-microbiome

https://www.federalregister.gov/articles/2015/05/20/2015-12191/microbiome-research


----------



## Rebel1992

UPDATE day 1

Collected donor feces mid afternoon.
Put in ziplock freezer bag immediately.
Stool was formed light brown and huge.
Once collected,  opened ziplock bag for second time to put 100ml of mineral water (bottled, did not have saline on hand)
Mixed stool and saline...manual manipulation from the outside of ziplock bag
Trasferred fecal slurry intocup.
Sm3eled like diarhea even though donor stool was nowhere near being diarhea.
Mentally prepared myself and swallow that **** down.
Sweared if I had a gag reflex, I would have puked all over myself.

After effects, suprisingly I felt hardly and discomfort when it was travelling through my imtestines. For eg, if I ate a banana, theres no doubt within 30 mins, I would have gurgling in my stomach.and have sharp pains for the next half hour. Dirhea would ensue the next day.

So fast forwrd 16 hours later. I needed to evacuate my bowels, diarhea feeling, and did have diarhea for the most part. But didnt feel like the food poisoning type. Just diarhea that gave me amild pain.

Improvements I intend to make in the next infusion tmrww...
1) saline instead of water ( hoping this will not induce diarhea though)
2) stomach acid suppressant ( I might be tempted to take this on 3rd fmt just to cancel out the stomach acid kills doubt)
3) must find an easier way to put the oral fecal liquid dkwn throat tha drinking it


----------



## Spooky1

I love this thread, and your so brave Rebel.  It will be interesting to know if things improve, but that could take months from what other people say.
Good luck.  perhaps you could find a naso-gastric tube to put down there to get the **** down you.


----------



## UnXmas

Rebel - are you aware of any risks involved in this? As I said earlier in this thread, in theory I have no objections to faecal transplants, if they're carried out by professionals and in a way that minimises the hygiene risks to an acceptable level. But doing them DIY in the way that you are does not sound a good idea to me, and the chance of it working seems to me to be far too small to justify it.

That said, I don't know much about the risks involved, and I would be interested in hearing what you've learned about this aspect of faecal transplants and why you (or anyone else) feels ok about it.

Thanks for your report, I hope you'll update soon. Take care.


----------



## Rebel1992

Spooky1 said:


> I love this thread, and your so brave Rebel.  It will be interesting to know if things improve, but that could take months from what other people say.
> Good luck.  perhaps you could find a naso-gastric tube to put down there to get the **** down you.


Any form of nasogatric tube or tubes I dont think is feasible after todays (day 2) infusion which I will update a post later on. And also I doubt it would take months, most effective fecal transplants have an almost immediate resolution of bowel problems. And its almost telepathic, in the way when IBDers know instantly when a food will cause them D once its in their stomach.... hope you get what I mean. Plus I made a typo in update 1, which I will edit later on...
I meant in that post that after the 1st infusion,  I did not feel in any form of pain like if I were to eat a banana.... so means no pain.


----------



## Rebel1992

UnXmas said:


> Rebel - are you aware of any risks involved in this?


----------



## UnXmas

I think you're right that it's unlikely to catch on.... unless you have fantastic results. Good luck! I hope for you it will be worth it.


----------



## mf15

I may have posted this before, but what does anyone make of this.
The controls were given their own poo for the transplant, and remission took place is some. A wild guess might be oral tolerance induction, or placebo effect.
Old Mike
Findings From a Randomized Controlled Trial of Fecal Transplantation for Patients With Ulcerative Colitis.

Rossen NG1, Fuentes S2, van der Spek MJ1, Tijssen J3, Hartman JH2, Duflou A1, Löwenberg M1, van den Brink GR1, Mathus-Vliegen EM1, de Vos WM4, Zoetendal EG2, D'Haens GR1, Ponsioen CY1.



Author information






Abstract

BACKGROUND & AIMS: 

Several case series have reported the effects of fecal microbiota transplantation (FMT) for ulcerative colitis (UC). We assessed the efficacy and safety of FMT for patients with UC in a double-blind randomized trial.

METHODS: 

Patients with mild to moderately active UC (n = 50) were assigned to groups that underwent FMT with feces from healthy donors or were given autologous fecal microbiota (control); each transplant was administered via nasoduodenal tube at the start of the study and 3 weeks later. The study was performed at the Academic Medical Center in Amsterdam from June 2011 through May 2014. The composite primary end point was clinical remission (simple clinical colitis activity index scores ≤2) combined with ≥1-point decrease in the Mayo endoscopic score at week 12. Secondary end points were safety and microbiota composition by phylogenetic microarray in fecal samples.

RESULTS: 

Thirty-seven patients completed the primary end point assessment. In the intention-to-treat analysis, 7 of 23 patients who received fecal transplants from healthy donors (30.4%) and 5 of 25 controls (20.0%) achieved the primary end point (P = .51). In the per-protocol analysis, 7 of 17 patients who received fecal transplants from healthy donors (41.2%) and 5 of 20 controls (25.0%) achieved the primary end point (P = .29). Serious adverse events occurred in 4 patients (2 in the FMT group), but these were not considered to be related to the FMT. At 12 weeks, the microbiota of responders in the FMT group was similar to that of their healthy donors; remission was associated with proportions of Clostridium clusters IV and XIVa.

CONCLUSIONS: 

In this phase 2 trial, there was no statistically significant difference in clinical and endoscopic remission between patients with UC who received fecal transplants from healthy donors and those who received their own fecal microbiota, which may be due to limited numbers. However, the microbiota of responders had distinct features from that of nonresponders, warranting further study. ClinicalTrials.gov Number: NCT01650038.


----------



## Rebel1992

mf15 said:


> I may have posted this before, but what does anyone make of this.
> The controls were given their own poo for the transplant, and remission took place is some. A wild guess might be oral tolerance induction, or placebo effect.
> Old Mike
> Findings From a Randomized Controlled Trial of Fecal Transplantation for Patients With Ulcerative Colitis.
> 
> Rossen NG1, Fuentes S2, van der Spek MJ1, Tijssen J3, Hartman JH2, Duflou A1, Löwenberg M1, van den Brink GR1, Mathus-Vliegen EM1, de Vos WM4, Zoetendal EG2, D'Haens GR1, Ponsioen CY1.
> 
> 
> 
> Author information
> 
> 
> 
> 
> 
> 
> Abstract
> 
> BACKGROUND & AIMS:
> 
> Several case series have reported the effects of fecal microbiota transplantation (FMT) for ulcerative colitis (UC). We assessed the efficacy and safety of FMT for patients with UC in a double-blind randomized trial.
> 
> METHODS:
> 
> Patients with mild to moderately active UC (n = 50) were assigned to groups that underwent FMT with feces from healthy donors or were given autologous fecal microbiota (control); each transplant was administered via nasoduodenal tube at the start of the study and 3 weeks later. The study was performed at the Academic Medical Center in Amsterdam from June 2011 through May 2014. The composite primary end point was clinical remission (simple clinical colitis activity index scores ≤2) combined with ≥1-point decrease in the Mayo endoscopic score at week 12. Secondary end points were safety and microbiota composition by phylogenetic microarray in fecal samples.
> 
> RESULTS:
> 
> Thirty-seven patients completed the primary end point assessment. In the intention-to-treat analysis, 7 of 23 patients who received fecal transplants from healthy donors (30.4%) and 5 of 25 controls (20.0%) achieved the primary end point (P = .51). In the per-protocol analysis, 7 of 17 patients who received fecal transplants from healthy donors (41.2%) and 5 of 20 controls (25.0%) achieved the primary end point (P = .29). Serious adverse events occurred in 4 patients (2 in the FMT group), but these were not considered to be related to the FMT. At 12 weeks, the microbiota of responders in the FMT group was similar to that of their healthy donors; remission was associated with proportions of Clostridium clusters IV and XIVa.
> 
> CONCLUSIONS:
> 
> In this phase 2 trial, there was no statistically significant difference in clinical and endoscopic remission between patients with UC who received fecal transplants from healthy donors and those who received their own fecal microbiota, which may be due to limited numbers. However, the microbiota of responders had distinct features from that of nonresponders, warranting further study. ClinicalTrials.gov Number: NCT01650038.


Hey, when I was combing through this thread a few days ago.  I came across this study you posted. 
Are you able to help clarify what oral tolerance means? ( cause I can make common sense outta it, but I wouldnt say I understand it) also how do you conclude oral tolerance if they all were administered by ng tube
Moreover, they also said the people who used their own stool who achieved remission were "in limited no.s" ....


----------



## ppk

mf15 said:


> However, the microbiota of responders had distinct features from that of nonresponders, warranting further study.


Exciting stuff!


----------



## mf15

Here is something on oral tolerance, which was a big theory for IBD years ago.
Since they used a nasoduodenal tube the stool is released into the first part of the small intestine so basically the whole small intestine is exposed to the bacteria and any antigens. The immune sampling for oral tolerance seems to be mostly done in the small intestine.  You could have a whole thread on oral tolerance, whether it is a valid IBD theory not sure.  Otherwise I am having a tuff time explaining remission in the above
trial by using your own stool as the control.
Since I cannot get the whole paper,dont know what else they did or meds the people were on. Another interesting thing  is that those with UC have dysbiotic colon bacteria, so how the hell can basically eating dysbiotic bacteria correct
the dysbiosis, unless the immune system is now tolerating the colon bacteria, which would down regulate the immune response, and ROS generation shifting
the facultative anaerobe populations back to the strict anaerobes in the
Clostridium cluster XIVa and IV.
Perhaps someone can get the paper.
I guess I will have to start researching oral tolerance again, did it years ago
but there is probably new info. 
Old Mike
http://www.nature.com/mi/journal/v5/n3/full/mi20124a.html

here is one on eating colitis proteins
http://www.ncbi.nlm.nih.gov/pubmed/20571813

ah what the heck here is my healingwell thread on this
http://www.healingwell.com/community/default.aspx?f=38&m=3374103


----------



## Rebel1992

Finally on a com and not on the phone

Update Day 2,

So with Day 1's experience done, day 2 started off with a watery bowel movement from day 1's infusion. No severe discomfort, actually I feel worse on days previous to FMT when I had to go no.2

when donor gave stool, inspecting the stool showed signs of a little undigested fruit, but irregardless they were well formed and of light brown colour. Due to the increase in fiber consumption, donor stool was very large long single piece.

Learning pts from day 1, 
use saline solution instead of water

On to the fmt, unfortunately today's transplant, was a complete failurein my eyes, 
collected stool,
in ziplock bag,
with saline,
made manual fecal slurry,
strained mixture into cup,
downed the liquid.

this time round, I made a mess in the washroom, if one was to sneak up on me, they would say I had watery diarhea squirting out from my ass while twerking.

unlike day 1, where I felt preety ok after fmt,
today was an unpleasant experience, the saline made it all the more worse, 
and I felt discomfort after. I am leaning towards diarhea tmrw once again because of today's mistakes.

things to improve on and plan for day 3,

since I am only collecting samples from donor for 5 days, time is running out and I have been sleeping on the best way to do a diy fmt.cause I need this shit to work.

so for the 3rd infusion, 

I am genuinely intending to take an antacid (ranitidine) to end all the doubts on whether stomach acid and enzymes will kill the fmt bacteria. 
moreover because my donor has been consuming a high fiber diet, mostly fruits with meals, there would be less pathogenic bacteria if any I hope... cause lowering stomach acid artificially is dangerous.

I also am not going to mix the fecal matter into a slurry anymore, as mentally its too draining, every time you choke on the fecal matter down yr throat, (and you will the moment the smell and taste hits), you have fecal liquid in yr entire mouth. disgusting just to think of it, daunting to experience it.

therefore, I will be manually breaking up stool to maximise surface contact area and then swallowing it, done it before, and way easier than fecl slurry method.

-Only other thing I am contempt plating is whether, I should consume food like oats (fiber foods) immediately after the infusion better propagate th bactria.

either way, update 3 should be 24 hours away.
and moreover I think his thread is catching spped, I mean 45k views, a lot of curious people considering fmt I guess.


----------



## Rebel1992

mf15 said:


> Here is something on oral tolerance, which was a big theory for IBD years ago.
> Since they used a nasoduodenal tube the stool is released into the first part of the small intestine so basically the whole small intestine is exposed to the bacteria and any antigens. The immune sampling for oral tolerance seems to be mostly done in the small intestine.  You could have a whole thread on oral tolerance, whether it is a valid IBD theory not sure.  Otherwise I am having a tuff time explaining remission in the above
> trial by using your own stool as the control.
> Since I cannot get the whole paper,dont know what else they did or meds the people were on. Another interesting thing  is that those with UC have dysbiotic colon bacteria, so how the hell can basically eating dysbiotic bacteria correct
> the dysbiosis, unless the immune system is now tolerating the colon bacteria, which would down regulate the immune response, and ROS generation shifting
> the facultative anaerobe populations back to the strict anaerobes in the
> Clostridium cluster XIVa and IV.
> Perhaps someone can get the paper.
> I guess I will have to start researching oral tolerance again, did it years ago
> but there is probably new info.
> Old Mike
> http://www.nature.com/mi/journal/v5/n3/full/mi20124a.html


old mke, thanks for sharing , this is def one topic to look up on.
I have just put out an update on my day 2 experience, do you think taking acid suppressants would be a good idea?

do you believe stomach acid and digestive enzymes etc will affect oral tolerance?
woud love to hear yr thoughts

P.s . would be interested to hear other peoples fact based opinions and wildbill's


----------



## mf15

Acid suppression not sure might be a bad idea, let the body sort out what it wants to kill.
As far as what you are doing limit the stools exposure to air as much as possible, it may kill the strict anaerobes, and saline may also kill, do to osmotic rupture of cells.
Mashing the stool may not also be a good idea,air exposure.
My worry about doing oral stools for one thing is aspiration into the lungs, sounds like
a good way to get a really bad infection.
Then also stool gets stuck in your teeth and other mouth parts.
Perhaps the triple gel cap method is the safer way, at least for lung aspiration.
SIBO is a possible eating poo.
If you fill the small cap with solid poo and use gloves for that step, then change gloves
and are carefull, the surface of the next cap should be clean and don't have to worry about
mouth on lungs unless you vomit. The last thing you want to do is vomit.
Using 3 caps probably the less chance that the outside is contaminated.

I am not as brave as you as of yet, thanks for doing this important self study.
Old Mike

here is a double gel cap method
http://thepowerofpoop.com/epatients...ctions/how-to-make-fecal-transplant-capsules/

here is the triple method, 
http://www.medpagetoday.com/MeetingCoverage/IDWeek/42044


----------



## wildbill_52280

mf15 said:


> and saline may also kill, do to osmotic rupture of cells.


Saline will NOT kill the bacteria. mixing stool with saline is how its done.


----------



## mf15

I know that is how they do it but is it the best way.
There is going to be oxygen in the saline, unless air is removed.
50% die in 4-5 minutes, so depending on how long people mess with this 
you can have variable amounts of live bacteria.
Which brings up the question, do you even need a whole bunch of live bacteria.
Old Mike
http://link.springer.com/article/10.1007/BF01568901#page-1


----------



## wildbill_52280

mf15 said:


> I know that is how they do it but is it the best way.
> There is going to be oxygen in the saline, unless air is removed.
> 50% die in 4-5 minutes, so depending on how long people mess with this
> you can have variable amounts of live bacteria.
> Which brings up the question, do you even need a whole bunch of live bacteria.
> Old Mike
> http://link.springer.com/article/10.1007/BF01568901#page-1


yes, you do need live bacteria. How else will they repopulate your intestinal wall if they are dead?

please provide a link that says oxygen is in saline, saline solution is water and sodium(salt).(EDIT- ohhhh you mean oxygen is in water because the molecule is H2O and that means 2 atoms of hydrogen and one of oxygen, then yes oxygen is in water, scientists still have been successfully using saline for FMT regardless its not a big issues bacteria will survive long enough to perform FMT.)

I already know that anaerobic bacteria which live in the intestine are sensitive to oxygen and will die quickly and i have seen the link you provided at least 2 years ago.


----------



## UnXmas

> Since I cannot get the whole paper,dont know what else they did or meds the people were on.


This was the first question I thought of - what other treatments were involved? Though I assume somewhere in the full paper they take them into account. It would also be interesting to know what the results would be for a group getting no faecal treatment at all.


----------



## mf15

If you use tap water to make saline it will contain oxygen.
Cant find specific link.
But even boiled water left sitting around will absorb oxygen from the air.
If you mix the poo in a blender like many do, then lots of oxygen.
If you mix in a baggie then best to squeeze out the air.
If part of the mechanism is oral tolerance then live bacteria perhaps not necessary,
If oral tolerance reduces the immune response and ROS generation, then your own
anaerobes may grow, or if immune tolerance is re established.
The appendix is now thought to be a protected storage area to repopulate your gut bacteria, so might be possible that once tolerance is re established the appendix can repopulate the gut with our own bacteria.
I might also add that appendix removal is associated with protection from UC risk,
and that once you have UC appendix removal not associated with remission.
Where that leads, don't know.
But I do agree that live bacteria are probably necessary for better colonization, just that many other things are going on with the immune system, even with dead bacteria.

And as you can see here you don't need live bacteria to modulate immune response
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1905615/

or even this type of mechanism
http://ini.sagepub.com/content/3/6/481.abstract

here is another on killed bacteria providing an immune response
http://www.karger.com/Article/Pdf/265537

here is more on heat killed probiotics
http://www.ncbi.nlm.nih.gov/pubmed/25116382

Just trying to show that the immune system can be modulated by 
both live and dead bacteria.


OM


----------



## mf15

Believe I posted this before.
These 3 people got up to 30 rounds of FMT, but all relapsed eventually.
What went wrong, perhaps oral is a better way to do it. 

Old Mike

Serial Fecal Microbiota Transplantation Alters Mucosal Gene Expression in Pediatric Ulcerative Colitis

Not even a dam abstract.



here is the supplement link just click on the doc

http://www.nature.com/ajg/journal/v110/n4/suppinfo/ajg201519s1.html


----------



## Rebel1992

Update day 3-


----------



## wildbill_52280

@Rebel1992,

It's going to take at least 4 weeks for your microbiome to approach normal could be 6-12 months to fully normalize. I wouldn't suggest taking in too many untolerated foods just yet, but you do need fiber from many sources asap. but expect noticable changes after one week. 

For comparison it takes 6 months to 1 year for an infant to establish its microbiome. Your expectations seem unrealistic and this is why i think you should have read more about this before doing it, but oh well you are here doing it as we speak, haha. Hope things work out for you!! i have had this thread up for two years and only 2-3 people besides me have decided to do this, your willingness to explore FMT is something we need more of around here.


----------



## Rebel1992

wildbill_52280 said:


> @Rebel1992,


----------



## wildbill_52280

Rebel1992 said:


> Hey wildbill, my expectatins of fmt are actually very similar to yrs.you see I dont necessarily have the equipment to ever statistically ensure that my microbiota is similar to that of  my donor. Not to mention we do not yet have evidence of what an ideal donor microbiota should be like. Note: this is actually my 4th time doing fmt, the amount of fecal matter I have ingested on this 4th try is more than what I can say for the other 3. Donor's diet and all...  my expectations from fmt are mainly the ability to start digesting normal fruits like apples without discomfort, and of yesterdays post, I am writing to inform that even though I felt like I was about to have diarhea today, I had one normal stool. That means the apple didnt give me diarhea this time around.
> However I did feel a little discomfort with apples.
> Not to mention I consumed several handful of grapes yesterday ...so if I get D later maybe it might not have worked ...who knows.
> 
> However I do agree with you on that the microbiome will take several days if not weeks for it to get established. Any maybe I might have started consuming forbidden foods too soon.
> Well, I ll try apples in another few days time.
> And lastly, regarding the issue of taking it months to work, I dont necessarily agree with that...like for c diff treatmemt, if it works...its almost within a few days. And even for ibd, most who have had success works within a few days. If not immediate.


just take the time to read the studies that have already been done on the first page of this thread and on c. diff, and good luck.


----------



## Rebel1992

Update 4 -


----------



## wildbill_52280

Here is why you dont want to use acid blockers when doing an oral FMT.
http://www.empr.com/news/acid-reducing-medications-c-diff-children/article/421273/


----------



## mf15

Here is a new FMT study out of China, its small but goes into adverse effects.
Enjoy.
Old Mike
http://www.ncbi.nlm.nih.gov/pubmed/26080819


----------



## Rebel1992

wildbill_52280 said:


> Here is why you dont want to use acid blockers when doing an oral FMT.
> http://www.empr.com/news/acid-reducing-medications-c-diff-children/article/421273/


I completely agree with this.. but I was having a dilemma at moment of fmt. Didnt do it though.
Because fact is, we are quite unsure of whether certain bacteria in donors stool will survive stomach acid. And because I am unable to plan donors evacuation, unsure of when to eat food. Also going hungry actually tends to stimulate more gastric juices and could otentially harm the bacteria.

But the fact is, if we take ppi, theres a very legitamate chance that colonisation and take place in the stomach in a way similar to how h pylori buries itself beyond the mucus layer of the stomach.


----------



## Rebel1992

...


----------



## wildbill_52280

Rebel1992 said:


> And guys, I would like a response to the following regardless if another erson has answered it. Caused I dont neccessarily think anyone has the  definite answer.
> 
> Now when I look up medical websites etc, they always say that a normal healthy stool colour is one that is ranges from green to dark briwn. But when I was a kid,  my stools in each bm were about 3 stools. And were dark brown. I mean dark brown.
> P.s I am uploading a stool chart into my profile's  photo album regarding colour of stool.
> 
> I am asking this because the donor I did the fmt with had a light coloured stool regarless of what he ate and only had 1 stool in each bm regardless of how much he ate the day before.


Normal healthy color will range from light brown to medium brown, always brown though. Green is not good, black is not good, red(blood) is not good, and pale/white, absence of brown pigment is also not good.

Also if it floats, that's not good.


----------



## Rebel1992

wildbill_52280 said:


> Normal healthy color will range from light brown to medium brown, always brown though. Green is not good, black is not good, red(blood) is not good, and pale/white, absence of brown pigment is also not good.
> 
> Also if it floats, that's not good.


oh


----------



## Rebel1992

mf15 said:


> Acid suppression not sure might be a bad idea, let the body sort out what it wants to kill.
> As far as what you are doing limit the stools exposure to air as much as possible, it may kill the strict anaerobes, and saline may also kill, do to osmotic rupture of cells.
> Mashing the stool may not also be a good idea,air exposure.
> My worry about doing oral stools for one thing is aspiration into the lungs, sounds like
> a good way to get a really bad infection.
> Then also stool gets stuck in your teeth and other mouth parts.
> Perhaps the triple gel cap method is the safer way, at least for lung aspiration.
> SIBO is a possible eating poo.
> If you fill the small cap with solid poo and use gloves for that step, then change gloves
> and are carefull, the surface of the next cap should be clean and don't have to worry about
> mouth on lungs unless you vomit. The last thing you want to do is vomit.
> Using 3 caps probably the less chance that the outside is contaminated.
> 
> I am not as brave as you as of yet, thanks for doing this important self study.
> Old Mike
> 
> here is a double gel cap method
> http://thepowerofpoop.com/epatients...ctions/how-to-make-fecal-transplant-capsules/
> 
> here is the triple method,
> http://www.medpagetoday.com/MeetingCoverage/IDWeek/42044


hey mf15 and others who have had dilemmas on acid suppression for fmt, 
do read up this entire study on this... 
http://iai.asm.org/content/76/2/639.full

it talks about how even acid resistant bacteria have very low tolerability under stomach acid. 

even baking soda effectively lowers stomach acid.

just read up, pretty interesting I might add..


----------



## wildbill_52280

Rebel1992 said:


> hey mf15 and others who have had dilemmas on acid suppression for fmt,
> do read up this entire study on this...
> http://iai.asm.org/content/76/2/639.full
> 
> it talks about how even acid resistant bacteria have very low tolerability under stomach acid.
> 
> even baking soda effectively lowers stomach acid.
> 
> just read up, pretty interesting I might add..



Your stomach produces no acid unless food is present. Liquids empty into the small intestine almost immediatly within 20 minutes or less i have read creating very little stomach acid. solid foods 1-2 hours in the stomach and this creates the most stomach acid. 

The first FMT study that used pills to treat c. difficile didn't use any acid blockers/proton pump inhibitors. They took the pill on an empty stomach and it seemed to be effective without acid supression. sorry no links I've researched these issues long long ago, search for science links yourself, they exist, that's all im saying. i think it was dr louie university of calgary?

So again im saying acid blockers for oral FMT, in all likelihood, is not that important at all.


----------



## wildbill_52280

More press on fecal transplants for c. difficile infection though.
http://phenomena.nationalgeographic.com/2015/06/22/fmt-film/


----------



## wildbill_52280

https://newyork.craigslist.org/mnh/dmg/5093263595.html


----------



## wildbill_52280

welcome to the future of bacteria treating and curing disease.

http://www.firstwordpharma.com/node/1294803#axzz3eDzwTcbL


----------



## xeridea

Exciting times! Aside from Seres, some other players in this area include Second Genome, Rebiotox, Vithera, among others. And my personal favorite Vedanta, which has the most research that I've seen supporting their platform.


----------



## UnXmas

wildbill_52280 said:


> https://newyork.craigslist.org/mnh/dmg/5093263595.html


This advert seems to imply only one bowel movement is required ("one time service"?), I thought it took many?


----------



## Lady Organic

wildbill_52280 said:


> https://newyork.craigslist.org/mnh/dmg/5093263595.html



offering cash to unknown donors put this person at risk of attracting people with psychopathic personality disorder, people who have zero remorse or care and willing to do anything for cash or simply for the pleasure of harming. They are experts at lying and manipulating to make you hear what you want to hear. I'd never do that.


----------



## wildbill_52280

howstuffworks has a fecal transplant article.

http://health.howstuffworks.com/medicine/modern-treatments/fecal-transplant.htm


----------



## 7vNH

wildbill_52280 said:


> 7vNH, Could you elaborate on how you were able to use a centrifuge and how this was done in an anaerobic environment? Thanks!


I know this is a "home FMT" thread, but in my case, I didn't do this at home. But I thought there was value in describing the steps I did do at home.


----------



## mf15

They finally released the whole paper on this FMT trial.
I find it most interesting that they used autologous FMT as a control.
Placebo effect a possible, shift in bacteria population in wrong direction yet still some remissions, what's really going on.
Old Mike
http://www.gastrojournal.org/article/S0016-5085(15)00448-5/fulltext


----------



## baistuff

Had my one year FMT anniversary yesterday. No complaints. Granted, I was never too bad off to begin with, but 1 year later I feel pretty well, no meds except for VSL3. Still gurgle a lot, still have to be careful with the diet, but I rarely if ever have pain, no diarrhea, less gas, and though careful with diet, it is more inclusive than it used to be.  I still every now and then if I go overboard may get some increased gas and a bit of urgency, but nothing too bad.  My GI thinks those minor symptoms are more IBS related than anything else. My gut will always be hypersensitive to a point. 

I was part of a study, and they were crystal clear they think FMT is useful for some IBDers, but that a NON family member should be used in order to introduce a whole new ecosystem and environment.  Last fecal cal 7 mos ago was 37, last scope several months ago was normal. 

I do NOT consider myself cured by any means. I like to think of myself as healed, at least for now. I always feel like I'm one step away from being back Crohns land.  If/when it does- I would do FMT again.


----------



## wildbill_52280

baistuff, did you do enemas and how many? or nasogastric tube? 

I only did one DIY FMT drinking a solution and I gained 15 pounds so I'm a normal weight and other symptoms are about 15% reduced. I believe some bacteria have been restored but a better performed FMT will restore more missing bacteria. The bacteria we need to restore are about 15% of a donors stool sample maximum, so if they don't follow a strict high fiber diet, Patient dosage will be very small and may not be enough.


----------



## greypup

Baistuff, that's amazing that you are off of meds and have good reports! What doctor are you using? Where is he/she located?


----------



## baistuff

I did the FMT as part of a clinical trial. It was done via colonoscopy. The prep, the scope was really no different than any other. No antibiotics, no diet change beforehand. At the time I was on Uceris and doing pretty well. In fact, though biopsies were not done during that scope, grossly the scope at the time of FMT didn't look all that bad. I was given immodium right afterwards. Held on to the transplant for a couple of hours. 

I was actually then constipated for 3 days, but with great appetite and passing gas, so had no real worries. Had a couple days of a few odd looking stools, but then slowly over time felt like I was "normalizing."  I still can't do dairy other than aged cheeses, and I still don't overdue the carbs- especially guten, but my tolerance of them has really improved. I had a scope 3 months later as part of the trial, and it was normal. Labs 6 months later all normal, including a fecal cal. Only on VSL3.

I cannot say where it was done b/c the trial is still ongoing. I still have my own GI who had no issue with me trying it. 

I want folks to keep in mind that I never had terrible disease like many on this board.  Mucosal, inflammatory, right sided colitis. No small bowel involvement. No strictures/fistulas.  my IBD started after a course of antibiotics and my symptoms clearly had a dysbiosis connection. 

My GI thought if ever there was a candidate for FMT I would probably be a good one. 

Again, I am NOT cured. Simply healed- for now. I am afraid of dairy, avoid cereals, pasta, breads. I can do corn again which is great, and small amounts of gluten, but too much and I get reminders I'm not home free. 

To me FMT is like any other treatment. Some respond amazingly well, others meh, others not at all. Just learned a colleage has had crohns for 25 years. She has been on 5ASA and never anything more. Responded great and has never looked back-eats everything.  Others as we know are quite the opposite. 

We have to find what works for us. I believe in FMT, but will not call it a miracle cure by any means.


----------



## wildbill_52280

baistuff said:


> We have to find what works for us. I believe in FMT, but will not call it a miracle cure by any means.


Thanks baistuff, I understand this is your opinion, but you should review all the evidence on FMT on the initial post of this thread and you'll see there is much more to this. Oral routes of administration have been pretty dramatic compared to enemas or colonoscopic routes. It's only unreliable because we have so little control over the dosage of bacteria patients receive, and doing FMT is a laborious task to co-ordinate. When we get a fecal transplant pill, that's when you will see better and consistent results I believe.


----------



## baistuff

wildbill_52280 said:


> Thanks baistuff, I understand this is your opinion, but you should review all the evidence on FMT on the initial post of this thread and you'll see there is much more to this. Oral routes of administration have been pretty dramatic compared to enemas or colonoscopic routes. It's only unreliable because we have so little control over the dosage of bacteria patients receive, and doing FMT is a laborious task to co-ordinate. When we get a fecal transplant pill, that's when you will see better and consistent results I believe.




You may be right. Like I said, I believe in it and consider mine a success,  but there are a lot of moving parts to take into account. Agree about route of administration- could be a key to success. Look forward to more data on it


----------



## wildbill_52280

wildbill_52280 said:


> It's only unreliable because we have so little control over the dosage of bacteria patients receive, and doing FMT is a laborious task to co-ordinate. When we get a fecal transplant pill, that's when you will see better and consistent results I believe.


I'm quoting myself because its fun!!
I just read an article released that supports my views.



> "In addition to screening for infections and disease, donors that harbour an abundance of the beneficial bacterial groups identified in our study could be selected to increase the chances of success of transplantation," said Verdu.



McMaster researchers test fecal transplantation to treat ulcerative colitis.
This study used 75 patients and found greater changes IN Fecal Transplant group over placebo group.
http://www.eurekalert.org/pub_releases/2015-07/mu-mrt070215.php


----------



## jayann

Wild Bill,

GREAT information!  You've really covered the topic.

About 2 years ago when fecal transplants were approved by the FDA for C. Diff, I asked my GI if she would do one for me but she refused.  She would do it for C. Diff which I didn't have at the time.   I have had but then it was treated with Vancomycin, and it happened to work.  Since C. Diff has a tendency to recur, I hoped she would do it for Crohn's since I've had C.Diff, but no deal.

Since then I have learned about much of the research being done on the Microbiome.  Wow!!! is that interesting.

You might be interested in an online course through the University of Colorado and the Knight Lab that was there researching the Microbiome.  Very informative about the critters that live with us.  BTW the Knight Lab has moved in  2015 Univ of Calif (UCSD) to work with other researchers in the area.

Coursera--Microbiome: Exploring your Gut.  I don't recall if that is the exact title, but I think if you google it, you'll find it.  It's free.  You can monitor it or take it for a certificate.  The course is available on demand now so can be started at any time. One of the interesting things that was mentioned is that Crhon's patients are missing certain microbes.  

With additional research I learned that IBD patients have more of some harmful microbes and less of the helpful ones.   There are microbes that digest fiber and make short chain fatty acids (SCFA).  One SCFA is butyrate.  It is important for the colonic cells lining the gut.  Our good microbes also make Vitamin K and some B vitamins and provide some calories.

Since I couldn't restore my gut with a fecal transplant I've been working to delvelop a healthy set of microbes in my gut by diet and probiotics.

I have been on VSL#3 DS(2 sachets daily) and two capsules of S. boulardi
Since Sept.  It is July (10 months later) and I have not had symptom 1. 

I'm working to nourish my good microbes by cutting out unhealthy processed food that nourishes the bad guys and eating more fibrous foods like fruits and vegetables and healthy oils and proteins.  So far, so good!

Books I recommend are:

1- Inside Tract and  2- The Gut Balance Revolution  both by Gerard Mullin from Johns Hopkins, --

Follow Your Gut: The Enormous Impact of Tiny Microbes  by Rob Knight

Missing Microbes by Martin Blaser

Honor thy Symbionts and Eat Bugs. Not Too Much. Mainly With Plants both by Jeff Leach.

Then, of course, google, google, google.  There's so much out there!!

Again, Thanks Wild Bill for great info on transplants and best of luck to everyone out there with any IBD problem.  Keep searching for your solution.


----------



## wildbill_52280

Here's more reasons why the donor diet must be good for the successful transfer of butyrate producing bacteria. And why FMT efficacy has not been more consistent.



> Another study[14] explored what would happen if a group of African Americans in Atlanta swapped diets with a group of rural black South Africans. The investigators were curious to see whether dietary differences could help explain the drastically differing rates of colon cancer between the two populations (65:100,000 in African Americans vs < 5:100,000 in rural South Africans). The South African diet was high in fiber and prebiotics, while the American diet was much higher in junk food, refined carbohydrates, and animal fats. Within 14 days of switching to the South African diet, healthy butyrate-producing microbial species increased by 258% in the American population. Butyrate is a byproduct of bacterial fermentation in the colon and is thought to protect against colon cancer.
> 
> Dr Deans then mentioned the recent media coverage of a geneticist who put his son on a 10-day all-McDonald's diet and measured his microbiome before and after. It was found that the son reduced the diversity of his microbial species by 40%, as assessed by three different labs. (In all fairness, he was restricted to burgers and fries and not the healthier options that McDonald's offers.)


http://www.medscape.com/viewarticle/847304_8


----------



## wildbill_52280

https://www.youtube.com/watch?v=1LtXIiy3TF0


----------



## Lady Organic

Use of a Novel Diet (UC DIET) Targeting the Microbiota for Treatment of Mild to Moderate Active Pediatric Ulcerative Colitis: An Open Label Pilot Study

https://clinicaltrials.gov/ct2/show/NCT02345733?term=butyrate+IBD&rank=5

and
https://clinicaltrials.gov/ct2/show/NCT02217722?term=butyrate+IBD&rank=4

''we have postulated that a diet that we developed that reduces exposure to dietary ingredients that allow sulfide reducing bacteria to thrive, or that impair the mucous layer, coupled with dietary products that enhance butyrate production, could induce remission in UC without involving additional immune suppression.''


----------



## Lady Organic

Seems like this Dr Arie Levine from Israel is quite interested in diet, the microbiome and FMT. Here'S a full list of the trials he is involved in, one includes FMT for UC and UC-like Crohn's : Yeah thats me!!! (in partnership with several countries, including, Toronto, Canada.):

https://clinicaltrials.gov/ct2/results?term=arie+levine&Search=Search

and his research papers on diet: 

http://www.ncbi.nlm.nih.gov/pubmed/?term=arie+levine+diet


----------



## InstantCoffee

Scratch what I originally posted. The more I research this the more sources conflict on what bacteria we are actually having problems with.

While some have deficient bacteroidetes or firmicutes, others are higher. 

http://taymount.com/all/study-ulcerative-colitis-crohns-fmt 

Now I see this. 

While  bacteria seem to play a role it's interesting that it fluctuates so much in the highs and lows between patients with the same conditions.

Maybe their symptoms are different though? I've seen studies suggesting firmicutes dominant crohns is constipated and bacteroidetes dominant is diarrhea.


----------



## wildbill_52280

InstantCoffee said:


> Scratch what I originally posted. The more I research this the more sources conflict on what bacteria we are actually having problems with.
> 
> While some have deficient bacteroidetes or firmicutes, others are higher.
> 
> http://taymount.com/all/study-ulcerative-colitis-crohns-fmt
> 
> Now I see this.
> 
> While  bacteria seem to play a role it's interesting that it fluctuates so much in the highs and lows between patients with the same conditions.
> 
> Maybe their symptoms are different though? I've seen studies suggesting firmicutes dominant crohns is constipated and bacteroidetes dominant is diarrhea.


We have pretty good information so far supporting the idea that clostridial species that regulate inflammatory process are the crucial issue in IBD. But since there are like 1000 different species or more and many seem to have similar properties and dominate different section of the GI tract, its pretty complex and we have to abandon reductionist frameworks because the small parts seem to add up to a greater whole. To effectively supress inflammation we need the cooperation of multiple bacteria. But then it gets even more complex when you consider the types of pathogens that have taken over the gut so that can get pretty diverse as well. In crohn's AIEC and MAP seem to play a large role of the pathogens the promote and sometimes thrive off of byproducts of inflammation. There needs to be a pre existing inflammatory process for some of these bacteria to thrive, its not coincidence the produce molecules that upregulate the inflammatory response as well to promote their own survival. It's like the circle of life you know we eat food and our excrements also encourage more plants to grow we can eat more for and so on and so forth.


----------



## wildbill_52280

Hey, it's this guy again!!!

http://sfbay.craigslist.org/sfc/vol/5124735266.html


----------



## InstantCoffee

I think it seems increasingly likely that something is causing a targeted death of the bacteria we need, as we know there's a codependency among bacteria cross-feeding etc. and most of them rely on the same resources (resistant starches). 

I think the theories involving protease and/or oxidation support this kind of targeted death. 

The role of AIEC and MAP is still interesting to me because we don't know if it's the chicken or the egg still. While treating with antibiotics may be able to put someone in remission, the question remains if these bacteria caused the imbalance, then caused the symptoms, or if the imbalanced caused the bacteria that caused the symptoms preventing the gut from naturally rebalancing itself.


----------



## jayann

Lady Organic said:


> Seems like this Dr Arie Levine from Israel is quite interested in diet, the microbiome and FMT. Here'S a full list of the trials he is involved in, one includes FMT for UC and UC-like Crohn's : Yeah thats me!!! (in partnership with several countries, including, Toronto, Canada.):
> 
> https://clinicaltrials.gov/ct2/results?term=arie+levine&Search=Search
> 
> and his research papers on diet:
> 
> http://www.ncbi.nlm.nih.gov/pubmed/?term=arie+levine+diet


Hi Organic Girl,

Impressive list of studies.  I thought one of use of Modulen IBD-  Turns out it is by Nestle.  Did a little investigating.  Found this. http://www.scdrecipe.com/blog/archive/2001/07/15/nestle-modulen-ibd

If this is really the ingredient list, I'm wondering how it can work.

jayann


----------



## jayann

Lady Organic said:


> Seems like this Dr Arie Levine from Israel is quite interested in diet, the microbiome and FMT. Here'S a full list of the trials he is involved in, one includes FMT for UC and UC-like Crohn's : Yeah thats me!!! (in partnership with several countries, including, Toronto, Canada.):
> 
> https://clinicaltrials.gov/ct2/results?term=arie+levine&Search=Search
> 
> and his research papers on diet:
> 
> http://www.ncbi.nlm.nih.gov/pubmed/?term=arie+levine+diet


Hi Organic Girl,

Impressive list of studies.  I thought one of use of Modulen IBD-  Turns out it is by Nestle.  Did a little investigating.  Found this. http://www.scdrecipe.com/blog/archive/2001/07/15/nestle-modulen-ibd

If this is really the ingredient list, I'm wondering how it can work.

jayann


----------



## jayann

Lady Organic said:


> Use of a Novel Diet (UC DIET) Targeting the Microbiota for Treatment of Mild to Moderate Active Pediatric Ulcerative Colitis: An Open Label Pilot Study
> 
> https://clinicaltrials.gov/ct2/show/NCT02345733?term=butyrate+IBD&rank=5
> 
> and
> https://clinicaltrials.gov/ct2/show/NCT02217722?term=butyrate+IBD&rank=4
> 
> ''we have postulated that a diet that we developed that reduces exposure to dietary ingredients that allow sulfide reducing bacteria to thrive, or that impair the mucous layer, coupled with dietary products that enhance butyrate production, could induce remission in UC without involving additional immune suppression.''


This is info from Nestle about Modulen IBD.  I'd be curious if any patients have been successful with it.  There are a lot of vitamins and so forth, but is it really good nutrition?
https://www.nestlehealthscience.co....roducts/data-sheets/data card modulen ibd.pdf


----------



## Lady Organic

I know the list of ingredients is pretty repulsive, but it works in a great proportion of CD patients... before I tried Modulen IBD (only tried 2 days) I called Nestlé and complained about the poor choice of ingredients. The corn and maltodextrine is even from GMO! In the diet section of the forum, lots of threads discuss this topic and a lot of patients go into remission with these enteral diets. check it out. studies are abundant regarding this treatment, which is mostly offered to pediatric CD and very rarely in adults in America.


----------



## wildbill_52280

Lady Organic said:


> I know the list of ingredients is pretty repulsive, but it works in a great proportion of CD patients... before I tried Modulen IBD (only tried 2 days) I called Nestlé and complained about the poor choice of ingredients. The corn and maltodextrine is even from GMO! In the diet section of the forum, lots of threads discuss this topic and a lot of patients go into remission with these enteral diets. check it out. studies are abundant regarding this treatment, which is mostly offered to pediatric CD and very rarely in adults in America.


It's because there is no fiber and so little other complex polysachriddes and this starves all the bad bacteria.


----------



## wildbill_52280

Another craigslist ad for FMT, this time in philadelphia

http://philadelphia.craigslist.org/wan/5126838673.html


----------



## jayann

Lady Organic said:


> I know the list of ingredients is pretty repulsive, but it works in a great proportion of CD patients... before I tried Modulen IBD (only tried 2 days) I called Nestlé and complained about the poor choice of ingredients. The corn and maltodextrine is even from GMO! In the diet section of the forum, lots of threads discuss this topic and a lot of patients go into remission with these enteral diets. check it out. studies are abundant regarding this treatment, which is mostly offered to pediatric CD and very rarely in adults in America.


Organic Girl,

Can't knock it if it works. Did it put you in remission?  How long were you on it?  I might not like the HFCS  but at least you don't have side effects like a depressed immune system that you get with biologics.  That was a problem for me with Cimzia.

Once someone is in remission, they can work on building a healthy gut and microbiome.

I've always been able to go into remission with Prednisone.  My doc doesn't like it and doesn't want me to be Prednisone dependent.  I know it's not the best for you in the long run.  I hope my probiotics continue to keep me in remission.  

Thanks for sharing so much info.  I still have to "digest" it all.

jayann


----------



## jayann

wildbill_52280 said:


> It's because there is no fiber and so little other complex polysachriddes and this starves all the bad bacteria.


Good point, Wild Bill.


----------



## InstantCoffee

jayann said:


> Organic Girl,
> 
> Can't knock it if it works. Did it put you in remission?  How long were you on it?  I might not like the HFCS  but at least you don't have side effects like a depressed immune system that you get with biologics.  That was a problem for me with Cimzia.
> 
> Once someone is in remission, they can work on building a healthy gut and microbiome.
> 
> I've always been able to go into remission with Prednisone.  My doc doesn't like it and doesn't want me to be Prednisone dependent.  I know it's not the best for you in the long run.  I hope my probiotics continue to keep me in remission.
> 
> Thanks for sharing so much info.  I still have to "digest" it all.
> 
> jayann


Where do you see HFCS?

If there's HFCS in EN it's strictly off limits for me. It's not just unhealthy for me, I get very bad reactions to small amounts of it. 

I'd rather just make my own shakes. I've been using an unflavored protein with milk and mixed vegetable oils and using honey as a sweetener.


----------



## jayann

Hi Instant Coffee,

Couldn't get the last link to work that I sent to Organic Girl, so found another.  Lists Corn Syrup as 1st ingredient.  (most likely HFCS)  wouldn't you think?  Or are they going to put Caro in there??  If you're allergic to corn or can't tolerate it for some reason.  I don't think it is terribly nutritious, so wouldn't jump to take it.  However, if I was having a flare, I might try it as it would only be temporary until flare ended.  Then I'd go super nutritious.  With this darn disease, you've got to do what you've got to do.  

I noticed that on one sight it listed 17 countries where available, but US wasn't on the list.  Why do you suppose that is?  Can it be purchased by mail order from other countries?

http://www.nestle.co.za/brands/health_sciences/modulen-ibd

Here's info from their website.
MODULEN® IBD
Modulen® IBD is a nutritionally complete formula suitable for oral and tube feeding, especially designed for the dietary management of Crohn’s Disease in paediatric (>5years) and adult patients. 
INDICATIONS

In Crohn’s disease: As an alternative to steroid therapy during the active phase/As a supplement during the remission phase/As an adjunct to medical steroid therapy.

SPECIAL FEATURES:
 Contains Transforming Growth Factor –ß2 (TGF-ß2) from patented manufacturing process. TGF-ß2 has natural anti-inflammatory properties to reduce inflammation associated with inflammatory bowel disease
Contains 25% of fat as MCT
 Lactose and Gluten free
Fibre free 
Meets the RDI for adult patients in 2000ml per day; for children the RDI is met per volume appropriate for age 
 Suitable as sole source of nutrition

DOSAGE RECOMMENDATIONS:

As directed by a health care professional 
 200g powder (24 scoops) + 850 ml water = 1000ml 
 50g powder (6 scoops) + 210 ml water = 250ml

INGREDIENTS

Corn syrup, casein, sucrose, milk fat, medium chain triglycerides, corn oil, emulsifier (soya lecithin), potassium citrate, calcium phosphate, sodium citrate, calcium carbonate, magnesium chloride, acidity regulator potassium hydroxide (e525), potassium chloride, vitamins: vitamin C, vitamin E, niacin (vit. PP), pantothenic acid (vit. B5), vitamin B6, thiamine, (vit. B1), vitamin A, riboflavin (B2), vitamin D, folic acid, vitamin K, biotin, vitamin B12, choline bitartrate, ferrous sulphate, zinc sulphate, magnesium oxide, manganese sulphate, copper sulphate, sodium molybdate, potassium iodide, chromium chloride, sodium selenate.

Modulen (400g powder) 

Nurtitional Analysis UOM per 500ml per 1000ml 
Energy kj 2070 4200 
Protein g 18 36 
Carbohydrate g 54 110 
of which       
Sugar g 15 30 
Fat g 23 47 
of which       
-MCT g 6 12 
Total fibre g 0 0 
Vit A μgRE 420 840 
Vit D μg 4,9 10 
Vit E mgTE 6,5 13 
Vit K μg 27 55 
Vit C mg 47 97 
Folic Acid μg 120 240 
Vit B1 (Thiamine) mg 0,59 1,2 
Vit B2 (Riboflavin) mg 0,64 1,3 
Vit B6 mg 0,83 1,7 
Vit B12 μg 1,6 3,2 
Niacin mgNE 5,8 12 
Pantothenic Acid mg 2,4 5 
Sodium mg 170 350 
Potassium mg 600 1200 
Chloride mg 370 750 
Calcium mg 450 910 
Phosphorus mg 300 610 
Magnesium mg 100 200 
Copper μg 0,49 1 
Zinc mg 4,7 9,6 
Iron mg 5,4 11 
Selenium μg 17 35 
Chromium μg 25 51 
Molybdenum μg 37 75 
Manganese μg 0,98 2 
Iodine μg 49 100 
Biotin μg 16 32 
Choline mg 35 72 


 USE UNDER MEDICAL SUPERVISION. Not for children under 5 years of age. Not for parenteral use. Gluten Free YES, Soy ingredients YES, Milk ingredients YES.


----------



## wildbill_52280

Please my friends lets keep this thread focused on Fecal transplants and the microbiome, THANKS!!


----------



## UnXmas

wildbill_52280 said:


> Another craigslist ad for FMT, this time in philadelphia
> 
> http://philadelphia.craigslist.org/wan/5126838673.html


How come this asks for one donation when others are saying you need several?


----------



## wildbill_52280

UnXmas said:


> How come this asks for one donation when others are saying you need several?


It's unknown how many you will need. Review the first post of this thread there is one experiment of a man who did an oral fecal transplant with nasogastric tube and achieved remission quickly without drugs afterwards. It seems an oral FMT has quicker results compared to enemas though.

One woman who is believed to be completely cured for 12 years did a large volume oral with nasogastric tube using 3 donors.

so from this information we can see that is within reality that one oral FMT is all you would need, but not gauranteed. but this has been my goal all along to develop a protocol to guaranty one FMT will provide a cure.


----------



## wildbill_52280

Wish i had access to this.
One of the very few studies of this kind, more to come I'm sure.
http://www.sciencedirect.com/science/article/pii/S0960982215006144


----------



## Ihurt

A disruption in the human microbiome I believe is connected to a lot of different chronic illnesses. Our immune systems reside in the gut. If that perfect ecosystem is disrupted, it can cause a cascade of health issues and ailments. I think Fecal transplants are going to be a way of the future. Some people are actually doing them on their own in order to heal their guts and bodies of different illnesses. 

I have been having horrible intestinal issues as well as other health issues. I really would like to do a FT but there are literally no Dr's in or around Chicago who will do them. They will do them at like only a couple hospitals and only for refractory C-diff that will not respond to antibiotics. I think FT should be a first line of treatment for C-diff, not antibiotics. Antibiotics only further damage the gut Microbiome. 

I also have heard of people who had UC and IBS who got cured from doing FT's. I really think this is the way of the future. I think mainstream thinking is going to change when it comes to treating infections. Instead of treating with antimicrobials, they will probably start fighting bacteria with bacteria. It makes sense..


----------



## wildbill_52280

Ihurt said:


> A disruption in the human microbiome I believe is connected to a lot of different chronic illnesses. Our immune systems reside in the gut. If that perfect ecosystem is disrupted, it can cause a cascade of health issues and ailments. I think Fecal transplants are going to be a way of the future. Some people are actually doing them on their own in order to heal their guts and bodies of different illnesses.
> 
> I have been having horrible intestinal issues as well as other health issues. I really would like to do a FT but there are literally no Dr's in or around Chicago who will do them. They will do them at like only a couple hospitals and only for refractory C-diff that will not respond to antibiotics. I think FT should be a first line of treatment for C-diff, not antibiotics. Antibiotics only further damage the gut Microbiome.
> 
> I also have heard of people who had UC and IBS who got cured from doing FT's. I really think this is the way of the future. I think mainstream thinking is going to change when it comes to treating infections. Instead of treating with antimicrobials, they will probably start fighting bacteria with bacteria. It makes sense..


yes i did 4 of them so far. The third was a partial success i gained my weight back after being underweight for 6-7- years since diagnoses, i feel better too, many symptoms of crohn's remain doing it again soon.

Dr Borody reported recovery from multiple sclerosis in a patient and another report from duke university reports a man with severe ALS got up out of his wheelchair after an FMT. Autism studys planned in the future with FMT as well. I'll post links in a sec. 

I realized the power of Fecal transplants maybe 4 years ago when I learned more about the bacteria in the gut and how many things we come in contact with that can destroy it. I'm dedicated to this idea's value and find value in promoting it.

*EDIT*- Other factors which led me to embrace the idea of the microbiome as an important general cause of disease were a book called prolongation of life optimistic written by nobel prize winning scientist elie metchnikoff which theorized the bacteria in the colon was highly involved in the aging process and disease in a process called autointoxication today this concept may be similar to something we call leaky gut/intestinal permeability and dysbiosis. his belief in the idea of probiotics to maintain health was an additional factor. https://books.google.com/books?id=U...olongation of life optimistic studies&f=false

another book was written by john harvey kellogg
https://en.wikipedia.org/wiki/John_Harvey_Kellogg
he was a doctor who also believed and experimented with altering the microbiome with yogurt enemas, in his case it was for psychological illness. This is the same guy who believed in a high fiber diet and started kellog cereal company. 

And then there is denis burkitt a researcher that studied illness in africa during to 50 and 60's he theorized many modern diseases not found in africa were somehow related to the fiber in peoples diets and the quality and size of there stools. We know now that bacteria ferment fiber in the colon, so I believe burkitt's work compliments and reinforces the work or john harvey kellogg and elie methnikoff.  http://nutritionfacts.org/video/dr-...dium=rss&utm_campaign=dr-burkitts-f-word-diet

And finally there is my own experiances, i have been exposed to lots of antibiotics since 20 years old for acne, then after one course in 2008 for bronchitis 3 weeks later i had no energy and it felt like my brain was on fire i was stressed out and couldnt think straight, my hair started falling out and months later I developed colonic/ileal inflammation had an anxiety attack a colonoscopy and diagnosed with crohn's. After some studies i found linked antibiotics to crohn's it was becoming more clear, the idea that i was missing bacteria essential for health is a very likely theory this is what one major variable to how i developed this disease. 

Now I sit back and watch study after study confirm this theory, and I already know the truth.


----------



## Lady Organic

''Increased Proportions of Bifidobacterium and the Lactobacillus Group and Loss of Butyrate-Producing Bacteria in Inflammatory Bowel Disease''

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3911339/

so I am getting confused. I thought lactobacillus were good probiotics for us? I had heard being cautious with Bifido, but lactobacillus too? could someone comment this research? thank you!


----------



## jayann

Hi Organic Girl,

Yes it is confusing.  I'm going to stick with VSL#3 until it isn't helping.

I took the Gut Check: Exploring your Microbiome.  It was a Coursera Class through the University of Colorado put on by Rob Knight's Lab.  It covered everything from how we acquire our microbes, to how they identify them by sequencing, to fecal transplants. One thing I learned is that Crohn's patients are missing or have very low Faecalibacterium prausnitzii.  What I'd like to know is how do we get them.  They are butyrate producing bacteria.  I'd like to also know what are other Butyrate producing bacteria and how do we cquire them?   If you were going to do a FMT then you'd certainly want the donor to have them.

I found this on Reference #16 of the link you just sent.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2575488/

BTW I got a notice about private conversation from you.  It said "hi"  I couldn't figure out how to respond.


----------



## wildbill_52280

Lady Organic said:


> ''Increased Proportions of Bifidobacterium and the Lactobacillus Group and Loss of Butyrate-Producing Bacteria in Inflammatory Bowel Disease''
> 
> http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3911339/
> 
> so I am getting confused. I thought lactobacillus were good probiotics for us? I had heard being cautious with Bifido, but lactobacillus too? could someone comment this research? thank you!


Lacto and bifido are still good for us, they are probably just unbalanced in ibd guts. It's possible they could take on a pro-inflammatory role as well because of intestinal permeability issues as no bacteria good or bad are supposed to be coming through the intestinal barrier. Butyrate producing bacteria such as clostridium clusters which dominate the intestinal lining maintain this barrier function. One study I read showed a loss of b. adolescentis. Lets just say the butyrate producing bacteria are the most important in IBD and other bacteria are also messed up and play a minor role.


----------



## jayann

wildbill_52280 said:


> Lacto and bifido are still good for us, they are probably just unbalanced in ibd guts. It's possible they could take on a pro-inflammatory role as well because of intestinal permeability issues as no bacteria good or bad are supposed to be coming through the intestinal barrier. Butyrate producing bacteria such as clostridium clusters which dominate the intestinal lining maintain this barrier function. One study I read showed a loss of b. adolescentis. Lets just say the butyrate producing bacteria are the most important in IBD and other bacteria are also messed up and play a minor role.


Wild Bill,

Do you have a list, or can you name a few of the butyrate producing bacteria.  My understanding is that butyrate feed the colonic tissue and has a healing effect.  Some people have had success with butyrate enemas. 

 I've heard of one person from a my doc. She said he gives it to his wife. She takes it orally and says it helps.  I'm under the impression that it doesn't make it through the stomach acid, so not much gets to the colon.  Can you confirm or deny this.


----------



## wildbill_52280

jayann said:


> Wild Bill,
> 
> Do you have a list, or can you name a few of the butyrate producing bacteria.  My understanding is that butyrate feed the colonic tissue and has a healing effect.  Some people have had success with butyrate enemas.
> 
> I've heard of one person from a my doc. She said he gives it to his wife. She takes it orally and says it helps.  I'm under the impression that it doesn't make it through the stomach acid, so not much gets to the colon.  Can you confirm or deny this.


In mice they have fed them butyric acid in their drinking water and it seemed to positively affect the immune system just by oral administration. I don't recall if the mice specifically had colitis or not, they may have. A study was conducted with butyric acid supplements with enteric coating and had a dramatic effect on IBD for some patients at least. This med was not developed any further though. It was disappointing that a natural based therapy would just be scrapped. 

Niacin can stimulate the same receptor for butyrate, adding to your regimen would likely have some benefit but some negative reports of high doses exist in animal studies, it inhibits sirtuins which is essential for autophagy function. I would recommend 50mg of niacin in the form of nicotinic acid, then try messing with niacinamide they are similar but may affect your disease differently. I can say in my own experience the 100mg nicotinic acid form i take supresses some of my symptoms. I have not messed around with niacinamide yet but its in my multivitamin i think I'm getting enough.

On ebay you can order a probiotic clostridium butyricum, it's popular in japan to protect against antibiotic associated diarhea. That's probably going to provide more benefits then any other probiotic on the market in the us, but I have not tested this yet.


----------



## Lady Organic

''Oral butyrate for mildly to moderately active Crohn's disease.''
http://www.ncbi.nlm.nih.gov/pubmed/16225487

http://ibdcrohns.about.com/od/alternativeremediesforuc/p/butyrate-ulcerative-colitis.htm

''Dietary Gut Microbial Metabolites, Short-chain Fatty Acids, and Host Metabolic'' Regulation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4425176/

im supplementing with Inulin prebiotics in hope to increase my butyrate production. I could consider taking supplements.

@jayann: click on private messages on top right corner of the page., you shall be able to open my message there. It was a response to your questions about my experience with enteral diet.


----------



## wildbill_52280

Lady Organic said:


> ''Oral butyrate for mildly to moderately active Crohn's disease.''
> http://www.ncbi.nlm.nih.gov/pubmed/16225487
> 
> http://ibdcrohns.about.com/od/alternativeremediesforuc/p/butyrate-ulcerative-colitis.htm
> 
> ''Dietary Gut Microbial Metabolites, Short-chain Fatty Acids, and Host Metabolic'' Regulation
> http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4425176/



yep!! that's the one for butyrate. 7 out of 9 crohn's patients achieved remission with enteric coated butyrate. Safe, natural therapy that was ditched 10 years ago.


----------



## ppk

wildbill_52280 said:


> yep!! that's the one for butyrate. 7 out of 9 crohn's patients achieved remission with enteric coated butyrate. Safe, natural therapy that was ditched 10 years ago.


That is a shame - is anyone here on the board currently using enteric coated butyrate as a supplement?


----------



## jayann

wildbill_52280 said:


> In mice they have fed them butyric acid in their drinking water and it seemed to positively affect the immune system just by oral administration. I don't recall if the mice specifically had colitis or not, they may have. A study was conducted with butyric acid supplements with enteric coating and had a dramatic effect on IBD for some patients at least. This med was not developed any further though. It was disappointing that a natural based therapy would just be scrapped.
> 
> Niacin can stimulate the same receptor for butyrate, adding to your regimen would likely have some benefit but some negative reports of high doses exist in animal studies, it inhibits sirtuins which is essential for autophagy function. I would recommend 250mg of niacin in the form of nicotinic acid, then try messing with niacinamide they are similar but may affect your disease differently. I can say in my own experience the 250 nicotinic acid form i take supresses some of my symptoms. I have not messed around with niacinamide yet but its in my multivitamin i think I'm getting enough.
> 
> On ebay you can order a probiotic clostridium butyricum, it's popular in japan to protect against antibiotic associated diarhea. That's probably going to provide more benefits then any other probiotic on the market in the us, but I have not tested this yet.


Thanks,

Some great suggestions.  It is disappointing that a natural remedy would be scrapped.  Guess no one can make billions off of it.

I'll look into the probiotic you suggested.  Sounds promising.  I've got some sodium butyrate, but only took a few, as didn't think it was getting to the colon.  Will try again.  Wish someone made an enteric coated.  I understand they have enteric coated for cattle industry of some such.  Just not for humans.


----------



## ppk

wilbill - I just bought some Myarisan, thanks for the tip! I bet it will help reduce my intestinal permeability.


----------



## jayann

wildbill_52280 said:


> yep!! that's the one for butyrate. 7 out of 9 crohn's patients achieved remission with enteric coated butyrate. Safe, natural therapy that was ditched 10 years ago.


Where does one get enteric coated butyrate?  Thanks, jayann


----------



## wildbill_52280

jayann said:


> Where does one get enteric coated butyrate?  Thanks, jayann


one does not!!


----------



## ppk

There is a product called ButyrEn which is enteric coated butyrate. You can get it from a lot of different websites, but here is one link (I don't get any referral money from this):

http://www.amazon.com/Allergy-Research-Group-ButyrEn-tabs/dp/B000LVDI5M

Keep in mind that intestinal cells in the small bowel mostly use glutamine, and butyrate probably mostly helps intestinal cells in the large bowel. Someone please correct me if this is wrong.


----------



## wildbill_52280

ppk said:


> There is a product called ButyrEn which is enteric coated butyrate. You can get it from a lot of different websites, but here is one link (I don't get any referral money from this):
> 
> http://www.amazon.com/Allergy-Research-Group-ButyrEn-tabs/dp/B000LVDI5M
> 
> Keep in mind that intestinal cells in the small bowel mostly use glutamine, and butyrate probably mostly helps intestinal cells in the large bowel. Someone please correct me if this is wrong.


Then I stand corrected. Enteric coated just means it resists stomach acid, there isn't any guaranty its slowly released in the colon or stays intact in the small intestine, as far as im aware.


----------



## ppk

wildbill_52280 said:


> Then I stand corrected. Enteric coated just means it resists stomach acid, there isn't any guaranty its slowly released in the colon or stays intact in the small intestine, as far as im aware.


Yeah, I think that understanding is correct. For me, I'm not sure how much ButyrEn would help me as all of my disease activity is focused around my terminal ileum.


----------



## wildbill_52280

Some general news on microbiome research.

http://www.streetinsider.com/Press+...tern+Canadian+Microbiome+Centre/10766684.html


----------



## wildbill_52280

wildbill_52280 said:


> Some general news on microbiome research.
> 
> http://www.ucalgary.ca/utoday/issue...arch-centre-launched-99-million-federal-grant


----------



## wildbill_52280

consumer reports magazine mentions fecal transplants in an article.

http://www.consumerreports.org/cro/...good-bacteria-to-fight-bad-bacteria/index.htm


----------



## wildbill_52280

A new paper(july 6 2015) by Thomas Borody on Fecal Transplants.
http://www.mdpi.com/2079-6382/4/3/254/htm


----------



## wildbill_52280

Just a blurb about someones conversations with professer borody.

http://www.ibsgroup.org/forums/topic/247994-important-news-about-curing-ibs/


----------



## wildbill_52280

Womens claims to give fecal transplant to autistic son and he is now able to speak.

http://www.dailymail.co.uk/news/art...sm-post-shared-celebrity-chef-Pete-Evans.html


----------



## christiffa25

Hi peeps, just a question regarding FMT I wonder if anyone has an idea on a possible answer. (I know there's NO definite answers to anything regarding this yet) 

I've read plenty about how it can possibly help our diseases. I've seen loads of people's clad to be much much better after doing this treatment.  

I've had 2 surgeries already for my Crohns. First one was a right heloclectomy (spelt wrong I know) the second was a small resection at the site of the join (scar tissue) from the first op. I now have a stricture again in the same place at the join. Have had 2 dilations to open it up, but it doesn't last long. A 3rd Surgery is being organized to do a small resection again.... 

Anyway....once in this posistion, is it at all possible that FMT can help with recuring strictures (most likely due to scar tissue) that need surgery or are these strictures not likely to be helped by FMT.??? 

Any insight would be great. I just have no idea!!


----------



## wildbill_52280

christiffa25 said:


> Hi peeps, just a question regarding FMT I wonder if anyone has an idea on a possible answer. (I know there's NO definite answers to anything regarding this yet)
> 
> I've read plenty about how it can possibly help our diseases. I've seen loads of people's clad to be much much better after doing this treatment.
> 
> I've had 2 surgeries already for my Crohns. First one was a right heloclectomy (spelt wrong I know) the second was a small resection at the site of the join (scar tissue) from the first op. I now have a stricture again in the same place at the join. Have had 2 dilations to open it up, but it doesn't last long. A 3rd Surgery is being organized to do a small resection again....
> 
> Anyway....once in this posistion, is it at all possible that FMT can help with recuring strictures (most likely due to scar tissue) that need surgery or are these strictures not likely to be helped by FMT.???
> 
> Any insight would be great. I just have no idea!!



there was just a study that tried to answer a question about FMT use in people who had surgery, I dont have a link it may be somewhere in this FMT thread, but you can try googling the terms to find the study. I do recall there was still some benefit.


----------



## christiffa25

Thanks wildbil I'll try find some info.


----------



## christiffa25

Can't really find anything.....

If anyone does find anything and could link to it that would be great!


----------



## wildbill_52280

christiffa25 said:


> Hi peeps, just a question regarding FMT I wonder if anyone has an idea on a possible answer. (I know there's NO definite answers to anything regarding this yet)
> 
> I've read plenty about how it can possibly help our diseases. I've seen loads of people's clad to be much much better after doing this treatment.
> 
> I've had 2 surgeries already for my Crohns. First one was a right heloclectomy (spelt wrong I know) the second was a small resection at the site of the join (scar tissue) from the first op. I now have a stricture again in the same place at the join. Have had 2 dilations to open it up, but it doesn't last long. A 3rd Surgery is being organized to do a small resection again....
> 
> Anyway....once in this posistion, is it at all possible that FMT can help with recuring strictures (most likely due to scar tissue) that need surgery or are these strictures not likely to be helped by FMT.???
> 
> Any insight would be great. I just have no idea!!



christiffa25
study isn't completed yet, but it is believed FMT would be a benefit for someone with a resection.
https://clinicaltrials.gov/ct2/show/NCT02417974?term=fecal+transplant+crohn's&rank=1


----------



## wildbill_52280

Les Dethlefsen, Ph.D., is a staff scientist at the Relman labs at Stanford. Since joining the lab in 2004, his work has been focused on the temporal dynamics of the gut microbiota. Les has an undergraduate double major in physics and molecular biology. He earned his Ph.D. in both Microbiology and Ecology/Evolutionary Biology from Michigan State.

Hear what he has to say about fecal Transplants @53:00
https://www.youtube.com/watch?v=HnyyB_aKjAs


----------



## jayann

Lady Organic said:


> ''Oral butyrate for mildly to moderately active Crohn's disease.''
> http://www.ncbi.nlm.nih.gov/pubmed/16225487
> 
> http://ibdcrohns.about.com/od/alternativeremediesforuc/p/butyrate-ulcerative-colitis.htm
> 
> ''Dietary Gut Microbial Metabolites, Short-chain Fatty Acids, and Host Metabolic'' Regulation
> http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4425176/
> 
> im supplementing with Inulin prebiotics in hope to increase my butyrate production. I could consider taking supplements.
> 
> @jayann: click on private messages on top right corner of the page., you shall be able to open my message there. It was a response to your questions about my experience with enteral diet.


I'm not sure this is accessing your private message.  I'm still a little green at this blog.


----------



## jayann

jayann said:


> I'm not sure this is accessing your private message.  I'm still a little green at this blog.


I thought I had the "bull by the horn" with my VSL#3 DS and S. boulardi.
I ate quite a few servings of raw nuts over several days.  I think it may have irritated my colon and caused inflammation.  My doc doesn't think it's the nuts.
Anyway, I'm flaring.  CRP was 79!!!!!!

So, I've been investigating SCD and started it this morning.  It is counter to what I've been doing and very confusing.  The idea is to STARVE bacteria who digest fiber that we can't digest.  I've been trying to encourage them so they will make butyrate.  However, the science and reasoning for SCD sounds good.
So am giving it a shot.

Presently on 60mg Pred (will start taper tomorrow) and Alinia.  Feeling some improvement.  Am going to do diet along with it.

I know a gentlemen in an organization I volunteer for whose wife was scheduled to start Humira and elected to do SCD instead.  It took her about 2 months to see a difference.  I got an email from him this morning.  She  has been on it since Nov. 2013 and is doing very well!!!!  So I am optimistic,

Jay Ann


----------



## jayann

ppk said:


> That is a shame - is anyone here on the board currently using enteric coated butyrate as a supplement?


I think you have to be a cow.  I recall reading somewhere that they have an enteric coated through veterinarians for the cattle industry.  Wish I remembered the source.


----------



## wildbill_52280

jayann said:


> I thought I had the "bull by the horn" with my VSL#3 DS and S. boulardi.
> I ate quite a few servings of raw nuts over several days.  I think it may have irritated my colon and caused inflammation.  My doc doesn't think it's the nuts.
> Anyway, I'm flaring.  CRP was 79!!!!!!
> 
> So, I've been investigating SCD and started it this morning.  It is counter to what I've been doing and very confusing.  The idea is to STARVE bacteria who digest fiber that we can't digest.  I've been trying to encourage them so they will make butyrate.  However, the science and reasoning for SCD sounds good.
> So am giving it a shot.
> 
> Presently on 60mg Pred (will start taper tomorrow) and Alinia.  Feeling some improvement.  Am going to do diet along with it.
> 
> I know a gentlemen in an organization I volunteer for whose wife was scheduled to start Humira and elected to do SCD instead.  It took her about 2 months to see a difference.  I got an email from him this morning.  She  has been on it since Nov. 2013 and is doing very well!!!!  So I am optimistic,
> 
> Jay Ann


SCD diet which is in the book breaking the vicious cycle does attempt to starve pathogenic bacteria, this theory does help to some degree. It has just recently been investigated in a formal study and shown benefit to patients, which is good in terms of the academic world but patients who have tried the diet already know there is a benefit. Results will vary though. I have benefited from avoiding lactose and sucrose as the book book and the diet suggests. Also avoiding corn and rice has helped a bit, but beans actually provide great benefit for me and many studies show benefits to bowel health. Ive always had a hard time making the yogurt i never have been able to get all the lactose out even when fermenting beyond 24 hours, either way information in this book i have used and it has helped greatly. Your better off combining medications with the diet though, this will provide greatest supression of the disease. on another note, good bacteria need fiber to create short chain fatty acids and lower intestinal ph to help eliminate pathogens, the problem with IBD is that the bacteria that ferment fiber to create beneficial SCFA's are damaged many times, which allows more pathogens to access these nutrients and create toxins, so depending on how bad your bacteria are damaged and how many different pathogens you harbor will determine how you react to fiber. 

I have started to create a scientific model of IBD to aid its management, it is the balance of variables that feed pathogen bacteria and and variables that kill bacteria, addressing these can allow fermentation to normalize and symptoms to improve. Inflammation feeds bad bacteria by creating nitrite and nitrate byproducts, suppressing inflammation can reduce pathogens and in a sense, starve them. This process is responsible for perhaps 70% of the issues of IBD, and is currently the state of treatment of modern medicine and its many times successful, but not 100%. Other ways of starving bacteria is the principles in the SCD diet and reducing intake of lactose sucrose and some complex polysacharides. Vitamin D boosts antimicrobial enzymes in the intestine and I believe keeping your blood levels as high as possible can boost these and help to address the other problems in our gut and other ways pathogens persist to cause symptoms. coconut oil is also one tool that can help kill bacteria in the gut, as are probiotics and fermented foods like cheese and yogurt. I believe after these issues are addressed and pathogens are as low as possible a person could increase their intake of fiber as supplements and then their gut will likley ferment them properly, now at this point it will create more scfa's and ph will be lowered and as you encounter pathogens in the environment they will never take hold in your gut to create symptoms, and you could possibly maintain a good remission indefinitly for life. But it has to happen in this order and is theoretical, but those are some of my opinions about IBD management at this point.


----------



## wildbill_52280

Bacteria still considered to play larger role then viruses in IBD.

*Metagenomic Analysis of Crohn's Disease Patients Identifies Changes in the Virome and Microbiome Related to Disease Status and Therapy, and Detects Potential Interactions and Biomarkers.*
http://journals.lww.com/ibdjournal/...alysis_of_Crohn_s_Disease_Patients.99055.aspx


----------



## jayann

wildbill_52280 said:


> Bacteria still considered to play larger role then viruses in IBD.
> 
> *Metagenomic Analysis of Crohn's Disease Patients Identifies Changes in the Virome and Microbiome Related to Disease Status and Therapy, and Detects Potential Interactions and Biomarkers.*
> http://journals.lww.com/ibdjournal/...alysis_of_Crohn_s_Disease_Patients.99055.aspx


Wild Bill,

Thank you for all of your valuable information.  Have you taken the Coursera Course through the University of Colorado, Rob Knight lab(moved this summer)?

Anway, it's very interesting, free, and can either be monitored or taken for a certificate which does have a charge.  Some great presenters and information. I think you probably know most of the information it covers, but you might enjoy it anyway.

When I feel better and my brain is functioning better I'll do a better job of replying to your posts.

jayann


----------



## wildbill_52280

jayann said:


> Wild Bill,
> 
> Thank you for all of your valuable information.  Have you taken the Coursera Course through the University of Colorado, Rob Knight lab(moved this summer)?
> 
> Anway, it's very interesting, free, and can either be monitored or taken for a certificate which does have a charge.  Some great presenters and information. I think you probably know most of the information it covers, but you might enjoy it anyway.
> 
> When I feel better and my brain is functioning better I'll do a better job of replying to your posts.
> 
> jayann


No but I would like to. Won't be able to anytime soon.


----------



## Lady Organic

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4532993/

''Variable alterations of the microbiota, without metabolic or immunological change, following faecal microbiota transplantation in patients with chronic pouchitis''

not very encouraging results, but maybe due to suboptimal FMT protocol...


----------



## Rebel1992

wildbill_52280 said:


> SCD diet which is in the book breaking the vicious cycle does attempt to starve pathogenic bacteria, this theory does help to some degree. It has just recently been investigated in a formal study and shown benefit to patients, which is good in terms of the academic world but patients who have tried the diet already know there is a benefit. Results will vary though. I have benefited from avoiding lactose and sucrose as the book book and the diet suggests. Also avoiding corn and rice has helped a bit, but beans actually provide great benefit for me and many studies show benefits to bowel health. Ive always had a hard time making the yogurt i never have been able to get all the lactose out even when fermenting beyond 24 hours, either way information in this book i have used and it has helped greatly. Your better off combining medications with the diet though, this will provide greatest supression of the disease. on another note, good bacteria need fiber to create short chain fatty acids and lower intestinal ph to help eliminate pathogens, the problem with IBD is that the bacteria that ferment fiber to create beneficial SCFA's are damaged many times, which allows more pathogens to access these nutrients and create toxins, so depending on how bad your bacteria are damaged and how many different pathogens you harbor will determine how you react to fiber.
> 
> I have started to create a scientific model of IBD to aid its management, it is the balance of variables that feed pathogen bacteria and and variables that kill bacteria, addressing these can allow fermentation to normalize and symptoms to improve. Inflammation feeds bad bacteria by creating nitrite and nitrate byproducts, suppressing inflammation can reduce pathogens and in a sense, starve them. This process is responsible for perhaps 70% of the issues of IBD, and is currently the state of treatment of modern medicine and its many times successful, but not 100%. Other ways of starving bacteria is the principles in the SCD diet and reducing intake of lactose sucrose and some complex polysacharides. Vitamin D boosts antimicrobial enzymes in the intestine and I believe keeping your blood levels as high as possible can boost these and help to address the other problems in our gut and other ways pathogens persist to cause symptoms. coconut oil is also one tool that can help kill bacteria in the gut, as are probiotics and fermented foods like cheese and yogurt. I believe after these issues are addressed and pathogens are as low as possible a person could increase their intake of fiber as supplements and then their gut will likley ferment them properly, now at this point it will create more scfa's and ph will be lowered and as you encounter pathogens in the environment they will never take hold in your gut to create symptoms, and you could possibly maintain a good remission indefinitly for life. But it has to happen in this order and is theoretical, but those are some of my opinions about IBD management at this point.


Wildbill,
This is an interesting post.
I do hope you remember me from the fmt.
Anyways what i havent posted in this forum regarding fmt, is that i recently tried 2 attempts again with a different donor. And this donor is the most ideal from the consistent stool shape texture colour and past antibiotic use none.
Anyways, i would like to give you a detailed history regarding my fmt attempts, since only my first donors stool (parent) worked and she has ibs systems but not really bothered by it.
It didnt work per se, but rather i gained her obesity trait 25pounds gain in 3 months while having D. Never been obese in my life. Always hovered around below 130 @ 5'9
...now @155 despite calorie intake of less than 1500.
So i definitelt got that effect passed. But the other 2 donors, effects of normal stool are shrort lived.

Anyways..my question was... do you think being in a flare affects the succes of fmt.
Do you think a long fast which will bring down flaring in most patients and then fmt after work better?

Simce my mother has ibs symtoms and i did fmt during that period allowed her flora to take hold better due to inflammation etc?

Would love to get yr thoughts on this.


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## wildbill_52280

An interview with a scientist working in the microbiome field.
http://scopeblog.stanford.edu/2015/...ginning-and-there-is-so-much-more-to-explore/


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## jayann

wildbill_52280 said:


> An interview with a scientist working in the microbiome field.
> http://scopeblog.stanford.edu/2015/...ginning-and-there-is-so-much-more-to-explore/


Thanks, very interesting.

We haven't begun to even see the tip of the iceberg.  The microbiome will be the next great shift in medicine, after such events as Harvey and the Circulatory system and the advent of antibiotics.  I think it I tremendously exciting!!


----------



## 7vNH

I have a question about a specific risk of FMT, if it has been researched, and what the conclusions were, if any.   I think the answer is "we still don't know", but this would be the thread to find out. 

First, let me say that I think that even with the "shotgun" approach that FMT is, the "reward" wins if one has active, serious disease.  By this I mean that we're not targeting specific gut microbes to eliminate and adding specific gut microbes, but rather adding a range of microbes and hoping that, after the resulting 'battle', more "good" ones remain than before.

*The question: how likely is it that one may acquire an autoimmune disease from FMT?*

Here's an example to illustrate the risk I'm talking about.  Say you have a donor that's never taken an antibiotic, has eaten like her great grandmother her whole life, passed all of the current disease screens, etc, etc.  At age 30, she's the picture of health.  What we don't know is that at age 50, she will come-down with rheumatoid arthritis (accepted as an autoimmune disease).  Since FMT can change the microbiome in such a way to improve autoimmune diseases (if you're reading this forum, this is probably something you have accepted already), then could not the FMT from this "perfect" donor put you at risk?

What I am proposing here is that the "perfect" donor has microbe profile that will result in an autoimmune disease in the future.  By accepting that donor microbiome, the recipient might be adding risk of acquiring a disease to which they were not formerly predisposed.  Science currently doesn't know enough about how to identify microbiome profiles to tell us why we have gut disease, much less how to identify microbiome profiles that will cause some future autoimmune disease.

My justification for this risk is, first, the possible immediate removal of the need for surgery and/or immune suppressing drugs.  That is a huge reward that can take a miserable life into one of normalcy.  And second, the reasonable likelihood that, through genomics of the microbiome,  more will be learned and specific microbial treatments will come about to address any problems introduced through today's rather unscientific approach to altering gut microbiome in patients with serious gut issues.


----------



## wildbill_52280

7vNH said:


> I have a question about a specific risk of FMT, if it has been researched, and what the conclusions were, if any.   I think the answer is "we still don't know", but this would be the thread to find out.
> 
> First, let me say that I think that even with the "shotgun" approach that FMT is, the "reward" wins if one has active, serious disease.  By this I mean that we're not targeting specific gut microbes to eliminate and adding specific gut microbes, but rather adding a range of microbes and hoping that, after the resulting 'battle', more "good" ones remain than before.
> 
> *The question: how likely is it that one may acquire an autoimmune disease from FMT?*
> 
> Here's an example to illustrate the risk I'm talking about.  Say you have a donor that's never taken an antibiotic, has eaten like her great grandmother her whole life, passed all of the current disease screens, etc, etc.  At age 30, she's the picture of health.  What we don't know is that at age 50, she will come-down with rheumatoid arthritis (accepted as an autoimmune disease).  Since FMT can change the microbiome in such a way to improve autoimmune diseases (if you're reading this forum, this is probably something you have accepted already), then could not the FMT from this "perfect" donor put you at risk?
> 
> What I am proposing here is that the "perfect" donor has microbe profile that will result in an autoimmune disease in the future.  By accepting that donor microbiome, the recipient might be adding risk of acquiring a disease to which they were not formerly predisposed.  Science currently doesn't know enough about how to identify microbiome profiles to tell us why we have gut disease, much less how to identify microbiome profiles that will cause some future autoimmune disease.
> 
> My justification for this risk is, first, the possible immediate removal of the need for surgery and/or immune suppressing drugs.  That is a huge reward that can take a miserable life into one of normalcy.  And second, the reasonable likelihood that, through genomics of the microbiome,  more will be learned and specific microbial treatments will come about to address any problems introduced through today's rather unscientific approach to altering gut microbiome in patients with serious gut issues.


So far in 1000 patients treated with FMT mostly for C. difficile, very few negative events have been reported. That's all we have to go on so far but things are looking good in terms of safety. The donor of course must be free of disease to reduce risk. Some people have developed new autoimmune diseases after FMT, so it has happened, it's absolutely not risk free. The rewards are pretty great though if one can do it successfully.


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## Lady Organic

very valid and... scary question 7vNH. They predict, what or maybe even actual stats... about 1 person out of 2 will have cancer in their live... How many will have chronic inflammatory conditions, 1/2 or prolly more...? I feel its quite rare in north america to find people who live long, disease free and meds free... so with such reasoning, basically very few people could be an interesting donor.

I personally dont feel that ''genes'' are passed through stools.
I belive that an impaired microbiome can trigger all kinds of cancers and chronic inflammatory conditions, but only if the genes are present in the person. It only depends what our bad genes are. so if you dont have the specific genes to develop for instance rheumatoid arthritis or pancreas cancer, then you would not develop them. 
 Impaired microbiomes must share some similaries before the development of  all kinds of conditions and i tend to think for instance that people with CD, psoriasis, RA or cancer will share similar microbiomes when disease is active.  So IDEALLY stool samples should be screened before transplant, making sure they are of optimal level of benefiacial bacterias, what is already being done and accepted in many places I believe. 
It becomes quite obvious then that the optimal donnor will be young, does a lot of physical activity and eat very well, a Life style that is less likely to trigger disease and has been said a ''protective factor''. ''eating well'' as yet to be defined...

the people who have developped other auto-immnune disease after a FMT, (for which i'd like to have more info) were prolly predisposed or ''intended'' to develop them prior to the FMT. I doubt the disease came from their donor... well just my thoughts...


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## hugh

7vNH said:


> At age 30, she's the picture of health.  What we don't know is that at age 50, she will come-down with rheumatoid arthritis (accepted as an autoimmune disease).  Since FMT can change the microbiome in such a way to improve autoimmune diseases (if you're reading this forum, this is probably something you have accepted already), then could not the FMT from this "perfect" donor put you at risk?


The short answer is we don't know. 
the long answer is that there is far more evidence to *suggest* that some foods cause changes in microbiota that lead to auto-immune disease (particularly thyroid and celiac (at this stage))

Introduced bacteria (and those already present) will only thrive if they are fed and have a conducive environment.

Incidentally (and anecdotally) my arthritis has disappeared after dietary changes



Lady Organic said:


> very valid and... scary question 7vNH. They predict, what or maybe even actual stats... about 1 person out of 2 will have cancer in their live... .......I personally dont feel that ''genes'' are passed through stools.
> I belive that an impaired microbiome can trigger all kinds of cancers and chronic inflammatory conditions, but only if the genes are present in the person


20 day diet swap between african americans and rural south africans.
Huge change in cancer risk markers.

_“We were astounded by the gravity and the magnitude of the changes. In Africans, the diet changes produced microbiota that were cancerous."_
http://thinkprogress.org/health/2015/05/15/3658983/going-back-to-the-motherland/

_"In comparison with their usual diets, the food changes resulted in remarkable reciprocal changes in mucosal biomarkers of cancer risk and in aspects of the microbiota and metabolome known to affect cancer risk,"_
http://www.nature.com/ncomms/2015/150428/ncomms7342/full/ncomms7342.html


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## xeridea

hugh said:


> The short answer is we don't know.
> the long answer is that there is far more evidence to *suggest* that some foods cause changes in microbiota that lead to auto-immune disease (particularly thyroid and celiac (at this stage)) ...


"We don't know..." hits the nail on the head. There are so many variables. For example, there is the field of epigenomics that tries to look at how various factors influence gene transcription. For instance this paper.


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## wildbill_52280

Fecal Transplants in the press.

http://www.cnn.com/2015/08/26/health/fecal-transplant-poop-medicine/index.html
http://wqad.com/2015/08/27/thousands-sign-up-to-donate-to-life-saving-fecal-transplant-program/


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## wildbill_52280

An article about the loss of biodiversity among microbiome associated with "westernization" implying antibiotics playing a large role.
http://www.independent.ie/life/heal...h-antibiotics-slowly-killing-us-31468371.html


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## Spooky1

very interesting article. Thanks.


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## Lady Organic

''The adoptive transfer of behavioral phenotype via the intestinal microbiota: experimental evidence and clinical implications.'' :

http://www.ncbi.nlm.nih.gov/pubmed/23845749

http://www.nature.com/scitable/blog/accumulating-glitches/behavioral_transplants

I watched the lead investigator Dr Stephen Collins on a tv documentary talked about his reasearch on mouse microbiota and FMT.

So now what I understand that even personality traits could be passed on FMT... 

so my personal thoughts are that we have to investigate personality of donor as well, this is getting complicated and worrisome... We have seen also that obesity pattern could be passed on... Im starting to question more and more the possibility of transfering other diseases the donor may have in store in his future...


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## Spooky1

Omg, that is somewhat scary!  

So if I digest dairy, do I become a docile cow?:ylol:


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## wildbill_52280

Lady Organic said:


> ''The adoptive transfer of behavioral phenotype via the intestinal microbiota: experimental evidence and clinical implications.'' :
> 
> http://www.ncbi.nlm.nih.gov/pubmed/23845749
> 
> http://www.nature.com/scitable/blog/accumulating-glitches/behavioral_transplants
> 
> I watched the lead investigator Dr Stephen Collins on a tv documentary talked about his reasearch on mouse microbiota and FMT.
> 
> So now what I understand that even personality traits could be passed on FMT...
> 
> so my personal thoughts are that we have to investigate personality of donor as well, this is getting complicated and worrisome... We have seen also that obesity pattern could be passed on... Im starting to question more and more the possibility of transfering other diseases the donor may have in store in his future...


Personality is due to many factors, I think a better way of thinking about it is to be concerned about the psychological health to the donor. Severe anxiety disorders, depression or delusions should eliminate them as a donor for FMT.


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## Lady Organic

from what I understood it goes beyond mental health disorders. Personality trait /style is what the dr Collins is observing being passed on in his lab. I for one do not suffer from psychiatric disorder, but I clearly have a anxious type of personality compared to many people. I am very often smooth and easy and this is what most people see and think of me. But people who know me really well will know my inner core/instinct is anxious. In the documentary, Dr Collins mentionned he notices many of his IBS patients in his GI practice for instance have this personality profile. (he didnt talk about IBD). 
So, personally, I would not want my donor to have this style or aggressive style (and we know how many people can be aggressive which is another form of anxiety I believe.) Having people to admit they have a tendency for aggressivity or anxiety is difficult to get. I met quite a lot of people in my life who are all glitters and smiles but when getting to know them more intimately, they turn out to be really problematic (aggressive) people (screaming, always wanting to fight, etc). Taking stool sample from random donors in medical settings for instance becomes somewhat of a gamble in my opinion. So i would really want to look for someone who is known to to be truly smooth and easy. maybe I am overly concerned, but it is definately worth thinking about it in light of the the research by Dr. Collins.


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## Spooky1

I couldn't agree more, Lady.  From looking forward to this procedure becoming standard practice to help gut issues, I now feel as though I wouldn't trust the medical world to investigate the characteristics of a donors personality.  It is scary at this point.  Wonder if it's anything like those people who receive transplants of organs and suddenly have a love of poetry when actually they were perhaps more aggressive sports minded, such as rugby or American football.  They can't understand why the change until they research the donors character and discover they loved poetry.


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## Lady Organic

I must say I must reconsider my choice if you tell me I could play rugby or football in the future... that would be a MIRACLE :biggrin::biggrin::biggrin:


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## wildbill_52280

An excerpt from a recent Paper by Professor Thomas J. Borody.



> Clostridium difficile can be eradicated in patients with IBD even though the IBD is rarely cured. Whilst occasionally curable, IBD can respond to FMT, especially if the procedure is administered repeatedly, and can result in a “remission”. In 1988, we administered FMT to a patient at CDD for colitis in the absence of CDI — the first of such patients to receive FMT at our facility. Her indeterminate colitis completely disappeared over several weeks and has not recurred over the past 26 years of follow-up [35,36]. We term such profound IBD remission as a “Sporadic remission” after FMT. Figure 1 documents a more recent example of a CDD patient who had 14 days of FMT, after which her colitis reversed completely to normality for 3 years even though she did not have CDI. Based upon our extended experience over 24 years of using FMT in colitis patients [37], we believe that FMT researchers, as a group, can modify treatment paradigms to achieve better cure results and not just short term remissions.


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## wildbill_52280

New article today from the New York Times on the Microbiome and Fecal Transplants.

Excerpt:


> North York General Hospital in Toronto recently completed a pilot study banking incoming patients’ own stool. Should any of these patients develop infections after antibiotics, their own microbes were on hand for reconstitution.





> Memorial Sloan Kettering Cancer Center in New York has also started a proactive stool-banking study. Most of the subjects are patients with leukemia. Before stem cell transplants, patients receive antibiotics and chemotherapy, often wiping out their microbiota.
> Dr. Eric Pamer, a physician and scientist at Memorial Sloan Kettering, has discovered that the diversity of the microbiota just after the stem cell transplant predicts well-being and survival. Those with the least diverse microbiomes after surgery were five times less likely to remain alive three years later, when compared with those with the most diverse.


http://www.nytimes.com/2015/10/11/opinion/sunday/should-we-bank-our-own-stool.html?_r=0


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## greypup

That is an amazing idea!


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## wildbill_52280

A microbiome transplant of oral bacteria for treating periodontitis.
http://www.huffingtonpost.ca/jason-tetro/oral-microbial-transplantation_b_8319670.html


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## wildbill_52280

A short article from CBS news on Fecal Transplants.
http://www.cbsnews.com/news/fecal-transplants-need-better-regulation-experts-say/


Another article about FMT.
https://upvoted.com/2015/10/22/a-fecal-transplant-saved-my-life/


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## Spooky1

Still sounds promising to me.  Just biding my time.


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## wildbill_52280

Fecal Transplant could help Multiple sclerosis.
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0137429

Dr borody treated a man with MS for constipation with a fecal transplant and afterwards his MS  improved, which suggested the FMT help or cured it. So borody may have done it again!! I hope more studies will be done to prove it. 
http://freakonomics.com/2011/03/04/freakonomics-radio-the-power-of-poop/


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## wildbill_52280

wildbill_52280 said:


> Fecal Transplant could help Multiple sclerosis.
> http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0137429
> 
> Dr borody treated a man with MS for constipation with a fecal transplant and afterwards his MS  improved, which suggested the FMT help or cured it. So borody may have done it again!! I hope more studies will be done to prove it.
> http://freakonomics.com/2011/03/04/freakonomics-radio-the-power-of-poop/


Just one more interesting thing about this study on MS microbiome:



> These taxa comprised primarily of clostridial species belonging to Clostridia clusters XIVa and IV and Bacteroidetes. The phylogenetic tree analysis revealed that none of the clostridial species that were significantly reduced in the gut microbiota of patients with MS overlapped with other spore-forming clostridial species capable of inducing colonic regulatory T cells (Treg), which prevent autoimmunity and allergies; this suggests that many of the clostridial species associated with MS might be distinct from those broadly associated with autoimmune conditions


Clostridial bacteria also are found lacking diversity in IBD microbiome and at first I was afraid this information would contradict the theory that the bacteria missing in IBD is the first and prime cause of the disease, but it seems the theory still stands and restoring the bacteria with an FMT is likely to cure BOTH conditions as the bacteria missing either in IBD or MS are distinct but have similar sounding names.


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## Spooky1

I'm right to remain hopeful then.  Sometime in the near future they will cure us.  I just regret the 40 years I've suffered it.  Roll on FMT tests.


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## Rebel1992

wildbill_52280 said:


> Fecal Transplant could help Multiple sclerosis.
> http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0137429
> 
> Dr borody treated a man with MS for constipation with a fecal transplant and afterwards his MS  improved, which suggested the FMT help or cured it. So borody may have done it again!! I hope more studies will be done to prove it.
> http://freakonomics.com/2011/03/04/freakonomics-radio-the-power-of-poop/


Just my 2 cents,
You do have to understand, its not only bacteria that you can replace,
Its also the curent enviroment in the gut that plays a massive part.
I have done the fmt with perfect donors orally, and failed on multiple occasions.

And i always corelate back to the various studies,
2 variables always play apart in the other fmt studies that are succesful...
1)antibiotics - though i disagree with this method as, eradicating the current gut flora, doesnt automatically switch off innflammation...its takes time for inflammation to go down for sure.

2) in the studies, the docs never take them of steroids... they might taper them off slowly... but even at the end of the fmt weeks... they still use minute amounts of steroids ..

In my opinion, i really think the environment plays the biggest factor in allowing the donors flora to take part..

People who often have the constipation side of bowel problems... do not have uncontrollable levels of gut inflammation!
Easier to help them with fmt.. higher success rate.

Lastly, i would like to say, i have seen studies showing, when inflammation is quelled thiugh steroids or any other drugs people may use... if inflammtion goes down, the gut flora reverses very quickly to closely resemble those of control patients.


----------



## wildbill_52280

Rebel1992 said:


> Just my 2 cents,
> You do have to understand, its not only bacteria that you can replace,
> Its also the curent enviroment in the gut that plays a massive part.
> I have done the fmt with perfect donors orally, and failed on multiple occasions.
> 
> And i always corelate back to the various studies,
> 2 variables always play apart in the other fmt studies that are succesful...
> 1)antibiotics - though i disagree with this method as, eradicating the current gut flora, doesnt automatically switch off innflammation...its takes time for inflammation to go down for sure.
> 
> 2) in the studies, the docs never take them of steroids... they might taper them off slowly... but even at the end of the fmt weeks... they still use minute amounts of steroids ..
> 
> In my opinion, i really think the environment plays the biggest factor in allowing the donors flora to take part..
> 
> People who often have the constipation side of bowel problems... do not have uncontrollable levels of gut inflammation!
> Easier to help them with fmt.. higher success rate.
> 
> Lastly, i would like to say, i have seen studies showing, when inflammation is quelled thiugh steroids or any other drugs people may use... if inflammtion goes down, the gut flora reverses very quickly to closely resemble those of control patients.


You bring up a good point and this is something I'm aware of. without a pill giving the precise amount of bacteria needed, factors like the disease state of the patient will begin to outweigh a DIY protocol and you will not achieve success. Achieving success with an at home DIY Fecal transplant is difficult, can it ever be done successfully? I'm not sure yet but I'm convinced it's difficult at this point.


----------



## wildbill_52280

Another company created a Fecal Transplant pill. I assume this is based on the whole flora which his probably freeze dried. It's patent pending so I'm wondering if they will get a patent for it, its doubtful Professor borody own's a similar patent and i recall university of minnesota created a similar full spectrum flora FMT pill, which seemed to be completely terminated there no more evidence anywhere on the net that this is still in the works, I also assume from patent issues, but i don't really know.

http://www.openbiome.org/press-rele...tion-begins-following-successful-dosing-study


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## xeridea

One thing that plays a critical role is the host immune system. It can act like an herbicide and kill off a good portion of the gut flora, or negatively impact the mucus membrane which provides much of the nutrients to the bacteria. It's the chicken or the egg causality dilemma. We don't know which came first, an imbalance in the bacteria triggering an immune response, or an off-kilter immune system disrupting normal flora.


----------



## wildbill_52280

xeridea said:


> One thing that plays a critical role is the host immune system. It can act like an herbicide and kill off a good portion of the gut flora, or negatively impact the mucus membrane which provides much of the nutrients to the bacteria. It's the chicken or the egg causality dilemma. We don't know which came first, an imbalance in the bacteria triggering an immune response, or an off-kilter immune system disrupting normal flora.


I do not believe is just a coincidence that the bacteria missing in IBD play a large role in regulating inflammatory response. This strongly suggests, the microbiota was damaged and immune system went out of whack, and restoring these bacteia with a Fecal Microbiota Transplant, can reverse/cure IBD. If it were the case that these bacteria that were missing had a complelet unrelated function, then i would consider an alternative theory, and see these missing bacteria as insignificant in explaining IBD.

Another observation to consider is that when people are in remission and inflammation is suppressed with drugs, the reduced diversity in good bacteria doesn't correct itself, which suggests the immune system malfunction isn't the cause of missing bacteria. In other words the immune system hasn't killed them off or pushed them out or whatever.


----------



## xeridea

The model doesn't explain pediatric IBD, say when no prior ABX use is involved.


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## wildbill_52280

Nice video on Microbiome Science.
http://nutritionfacts.org/video/mic...=rss&utm_campaign=microbiome-the-inside-story


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## Lady Organic

''Donor species richness determines fecal microbiota transplantation success in inflammatory bowel disease'':

http://ecco-jcc.oxfordjournals.org/content/early/2015/10/28/ecco-jcc.jjv203

anyone has full article?


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## wildbill_52280

Pretty lengthy article on FMT.

http://www.24news.ca/the-news/canad...aling-to-patients-convinced-its-a-wonder-cure


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## Spooky1

Thanks, Bill.  

That's also a highly readable one too.  Not too 'official' or blinding with 'science'.


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## wildbill_52280

Reduced Diversity in Microbiome bacteria in Lupus, which suggest Fecal Transplant could help.

http://www.hcplive.com/conference-c...obiome-seems-to-have-role-in-triggering-lupus


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## wildbill_52280

Something I've been talking about for a few years now. There is no abstract though.

*Methodology, Not Concept of Fecal Microbiota Transplantation, Affects Clinical Findings*

Medical Center for Digestive Diseases, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
Available online 23 November 2015

http://www.sciencedirect.com/science/article/pii/S0016508515015814


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## irishgal

Hi Wildbill - a couple of quick questions that may have been answered already, but I haven't had time to search the whole thread. Does FMT work better in UC or Crohn's where the colon is involved? If disease is limited to the small intestine, would the route of FMT need to be oral vs. via enema? In Crohn's patients that have tested positive for a pathogenic mycobacteria through Aitken's lab, do you think a course of AMAT followed by (or run concurrent with) FMT would be beneficial? Kind of a double whammie - killing the bad bug plus restoring the beneficial bacteria which seems to be impaired in CD. 

I seem to recall Dr. Rubin's video from Chicago discussing the gut flora in CD patients being permanently impaired vs. controls and unable to recover from a course of antibiotics. Although I'm on AMAT and have done remarkably well, I think there may be something more needed to rehab the immune system and microbiome. I added LDN which seems to be working since I'm not sick. I know Dr. Chamberlin and Dr. Borody are both in favor of FMT but they use AMAT as well. Have you ever heard either reconcile the two?

I think the biggest issue with both of these is that they're both difficult for the average patient to obtain. GI's won't generally touch AMAT, and FMT has to be done correctly with supervision of a knowledgeable doc and correct donor matter. Did I hear Dr. Borody was working on a pill? So both could be beneficial if done right I believe. Also, do you think in the interim FMT could be done on people with colon disease using fivelac or other probiotic enema instead of fecal matter? Another member here had huge success with that in CD.

All very interesting and exciting. Thanks for the thread! I hope you are well.


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## wildbill_52280

Irishgal, I will try to answer your questions. I don't consider myself an absolute expert in all these areas but ill try to help.



> Does FMT work better in UC or Crohn's where the colon is involved? If disease is limited to the small intestine, would the route of FMT need to be oral vs. via enema? In Crohn's patients that have tested positive for a pathogenic mycobacteria through Aitken's lab, do you think a course of AMAT followed by (or run concurrent with) FMT would be beneficial? Kind of a double whammie - killing the bad bug plus restoring the beneficial bacteria which seems to be impaired in CD.


Studies so far suggest FMT as an enema and in any form is more effective in UC when compared to crohn's. Oral route's seem better for crohn's affecting small intestine, most studys are in the first post of this thread. Borodys experiment with FMt in 5 uc patients usining enemas used antibiotics prior to lower pathogenic bacteria and to encourage new bacteria to take hold better, this study wasn't enough to demonstrate it was more effective then without using antibiotics so really it is unknown whether this would improve FMT efficacy. In my opinion the antibiotic would have to be very precise to target pathogens and leave the good bacteria unharmed to have any benefit, other wise it's probably better not to use them at all so you can possibly preserve some of your own microbes that have been passed down through your family, antibiotics could also cause further damage since we know how important bacteria are for our health now. AMAT has shown efficacy, maybe it would help to use this prior to FMT, But FMT just need's to be available in pill form and most of these questions will be unimportant as we gain more control over how much bacteria and in what ratios a patient will recieve.






> I think the biggest issue with both of these is that they're both difficult for the average patient to obtain. GI's won't generally touch AMAT, and FMT has to be done correctly with supervision of a knowledgeable doc and correct donor matter. Did I hear Dr. Borody was working on a pill? So both could be beneficial if done right I believe. Also, do you think in the interim FMT could be done on people with colon disease using fivelac or other probiotic enema instead of fecal matter? Another member here had huge success with that in CD.


I dont think using a store bought probiotic as an enema will have more benefit over consuming it orally, these bacteria need fiber from food anyways to grow and make beneficial compounds so eating it with a meal will have much more impact. Store bought probiotics will definitely not be comparable to a real FMT as the bacteria we need is not available which you probably know already, its only in healthy people's poop at the moment. 



> All very interesting and exciting. Thanks for the thread! I hope you are well.


 Your welcome!


----------



## wildbill_52280

This is interesting.

http://www.ncbi.nlm.nih.gov/pubmed/26616138

And this.
http://www.ncbi.nlm.nih.gov/pubmed/26525055


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## wildbill_52280

I remember this. It's just crazy to think there was a time in the very recent past the FDA didn't care if anyone decided to do a fecal transplant until it was proven to be a valuable medicine curing C. difficile infection in a placebo controlled study, now it's strictly regulated. Those were the days!



> The vast majority of FMTs were performed without any oversight or regulation until early 2013, when the Food and Drug Administration (FDA) ruled that stool fell within the definition of a biological product and drug.


http://journals.lww.com/jcge/Fullte...robiota_Transplant__Respice,_Adspice,.16.aspx


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## wildbill_52280

Potential risks of FMT.

http://www.ncbi.nlm.nih.gov/pubmed/26302500

EDIT: one more note about this, i recall a few months back a women developing obesity after a Fecal transplant which done under professional supervision, they these professionals knowingly chose a donor with obesity, something i personally would never have done even in a DIY FMT. So even some professionals may not   want to read all the papers that exist on FMT and take the necessary precautions, the same could be with this reported case too. It's not necessarily FMT that is more dangerous just a lack of education and taking the time to screen donors.


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## irishgal

Thanks for the articles wildbill. Wish I could read the pouchitis one! Looks like it's published ahead of print, so hopefully they will at least have an abstract when it's released.


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## wildbill_52280

AbstractSend to:
World J Gastroenterol. 2015 Oct 14;21(38):10907-14. doi: 10.3748/wjg.v21.i38.10907.

*Gastroenterologist perceptions of faecal microbiota transplantation.*

Abstract

AIM:
To explore gastroenterologist perceptions towards and experience with faecal microbiota transplantation (FMT).

METHODS:
A questionnaire survey consisting of 17 questions was created to assess gastroenterologists' attitude towards and experience with FMT. This was anonymously distributed in hard copy format amongst attendees at gastroenterology meetings in Australia between October 2013 and April 2014. Basic descriptive statistical analyses were performed.

RESULTS:
Fifty-two clinicians participated. Twenty one percent had previously referred patients for FMT, 8% more than once. Ninety percent would refer patients with Clostridium difficile infection (CDI) for FMT if easily available, 37% for ulcerative colitis, 13% for Crohn's disease and 6% for irritable bowel syndrome. Six percent would not refer any indication, including recurrent CDI. Eighty-six percent would enroll patients in FMT clinical trials. Thirty-seven percent considered the optimal mode of FMT administration transcolonoscopic, 17% nasoduodenal, 13% enema and 8% oral capsule. The greatest concerns regarding FMT were: 42% lack of evidence, 12% infection risk, 10% non infectious adverse effects/lack of safety data, 10% aesthetic, 10% lack of efficacy, 4% disease exacerbation, and 2% inappropriate use; 6% had no concerns. Seventy seven percent believed there is a lack of accessibility while 52% had an interest in learning how to provide FMT. Only 6% offered FMT at their institution.

CONCLUSION:
Despite general enthusiasm, most gastroenterologists have limited experience with, or access to, FMT. The greatest concerns were lack of supportive evidence and safety issues. However a significant proportion would refer indications other than CDI for FMT despite insufficient evidence. These data provide guidance on where education and training are required.


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## wildbill_52280

A new Article on webMD titled: The Rise of the Do-It-Yourself Fecal Transplant.

http://www.webmd.com/digestive-disorders/news/20151209/diy-fecal-transplant?src=RSS_PUBLIC


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## wildbill_52280

A synthetic "fecal transplant pill" being tested soon for ulcerative colitis by the company Seres Health. 

http://www.bizjournals.com/boston/b...es-seres-targets-ulcerative-colitis-with.html


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## Lady Organic

wow a synthetic pill that would be awesome. It is news such as these that keep me enthousiastic, thrilled, hopeful and confident there is going to be a friendly solution to our problems in the near future. I so wish to give a kick in the gut to these %#@#$%% meds I have to take!!!


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## wildbill_52280

Lady Organic said:


> wow a synthetic pill that would be awesome. It is news such as these that keep me enthousiastic, thrilled, hopeful and confident there is going to be a friendly solution to our problems in the near future. I so wish to give a kick in the gut to these %#@#$%% meds I have to take!!!


A selection of bacteria or in other words, synthetic, would be the safest option. But we still don't know exactly which bacteria we need, most likely clostridia. Open biome is making Fecal transplant pill's on a large scale that contain the full spectrum of human bacteria. I'm hoping someone uses these to treat IBD, i think there is study underway for crohn's using FMT pills but dont have the link handy though, ill look for it. 
http://www.openbiome.org/press-rele...tion-begins-following-successful-dosing-study


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## baistuff

Just had a follow up scope this week. I am 1.5 years removed from an FMT done as part of a clinical trial.  Couple of disclaimers- 1) I've had a mild course throughout my crohns journey 2) at the time of the FMT I was not doing too badly. 

Scope grossly was normal- per the GI- "if this were your first time here I'd never know you have IBD."  Biopsies are still pending. 

Still have to avoid gluten/dairy. Both are in essense immunogenic and, in some ways promote IBS type sxs in those with any gut issues (some more than others.) They still cause a ton of gas, urgency, loud bowel sounds, and stool changes- certainly related to amount ingested.

 I don't think I'll ever be able to know whether it was the FMT, havnig a mild course to begin with, having the FMT during relative quiescense, or who knows what.  But a normal scope 1.5 years later only on VSL and watching diet- I'll take it. 

Do not ask me to claim FMT is a cure. It isn't. I'm not cured. For NOW, I'm healed. I don't doubt this disease will show its ugl face again.  I think of FMT as an OPTION. For those with mild colonic disease, dysbiosis symptoms- maybe give it a whirl. 

Good luck to all. Hope everyone heals and feels well soon.


----------



## wildbill_52280

baistuff said:


> Just had a follow up scope this week. I am 1.5 years removed from an FMT done as part of a clinical trial.  Couple of disclaimers- 1) I've had a mild course throughout my crohns journey 2) at the time of the FMT I was not doing too badly.
> 
> Scope grossly was normal- per the GI- "if this were your first time here I'd never know you have IBD."  Biopsies are still pending.
> 
> Still have to avoid gluten/dairy. Both are in essense immunogenic and, in some ways promote IBS type sxs in those with any gut issues (some more than others.) They still cause a ton of gas, urgency, loud bowel sounds, and stool changes- certainly related to amount ingested.
> 
> I don't think I'll ever be able to know whether it was the FMT, havnig a mild course to begin with, having the FMT during relative quiescense, or who knows what.  But a normal scope 1.5 years later only on VSL and watching diet- I'll take it.
> 
> Do not ask me to claim FMT is a cure. It isn't. I'm not cured. For NOW, I'm healed. I don't doubt this disease will show its ugl face again.  I think of FMT as an OPTION. For those with mild colonic disease, dysbiosis symptoms- maybe give it a whirl.
> 
> Good luck to all. Hope everyone heals and feels well soon.


Awesome, thanks for sharing.

It is an experimental treatment, so it is too soon to conclude whether it is a cure or not. It's not a simple issue because there are official reports of people being cured already. At this time the treatment must be improved, there are variables to FMT success such as how it is administered, the health of the donor, the diet of the donor, the severity of the patient, the diet of the patient, the amount of stool(bacteria) used, whether it was performed as an enema, nasogastric tube, how many treatments did the patient receive, did they use FMT pills. There are so many question's to be answered still which  more research should be able to answer. The main goal here is to restore the good bacteria that is missing by obtaining it from a healthy donor, it's something so new, it's hard to do at the moment but we will get there soon.


How was the Fecal Microbiota Transplant you had administered? 

Also have you ever considered that it is not the gluten that increases your symptoms but glyphosate(Roundup) residues on the wheat? or even the yeast used to leaven the bread? anti Saccharomyces cerevisiae antibodies are found in crohn's disease patients which means your immune systems see it as an invader and wants to kill it. I eat alot of homemade wheat products that cause no issues whatsoever, but some  brands of wheat do cause issues, gold medal brand whole wheat causes no issues for me.


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## baistuff

wildbill_52280 said:


> Awesome, thanks for sharing.
> 
> It is an experimental treatment, so it is too soon to conclude whether it is a cure or not. It's not a simple issue because there are official reports of people being cured already. At this time the treatment must be improved, there are variables to FMT success such as how it is administered, the health of the donor, the diet of the donor, the severity of the patient, the diet of the patient, the amount of stool(bacteria) used, whether it was performed as an enema, nasogastric tube, how many treatments did the patient receive, did they use FMT pills. There are so many question's to be answered still which  more research should be able to answer. The main goal here is to restore the good bacteria that is missing by obtaining it from a healthy donor, it's something so new, it's hard to do at the moment but we will get there soon.
> 
> 
> How was the Fecal Microbiota Transplant you had administered?
> 
> Also have you ever considered that it is not the gluten that increases your symptoms but glyphosate(Roundup) residues on the wheat? or even the yeast used to leaven the bread? anti Saccharomyces cerevisiae antibodies are found in crohn's disease patients which means your immune systems see it as an invader and wants to kill it. I eat alot of homemade wheat products that cause no issues whatsoever, but some  brands of wheat do cause issues, gold medal brand whole wheat causes no issues for me.




FMT was done via colonoscopy. Sprayed from TI through the transverse colon. 

Good question about the wheat. It's entirely possible. It's interesting. I'll try to pay closer attention.  My autoantibodies have been normal (ASCA/ANCA.) 

The FMT was so simple in terms of the trial. Usual colo prep, got the scope. Held it for a few hours. Went home, was at work the next day.  It's a low risk option. I don't see it as a "cure" b/c it cannot correct the host defect. 

Cure is also a term I'm not a fan of. For me, I care about healing and decreasing risk of complication.  I look at big ticket items, not the day to day variability in symptomatolgy.  Diet, stress etc… can effect the GI system on a day to day basis even in the "normal" population. We can go crazy over thinking very fart or every bathroom trip. I try not to get caught up in that. I'd lose my sanity.


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## wildbill_52280

I found the article that mentioned a trial of FMT pills for crohn's. New York Times Nov 15, 2015.
http://www.nytimes.com/2015/11/10/health/fecal-transplants-made-somewhat-more-palatable.html?_r=0



> Dr. Jessica R. Allegretti, a physician at Brigham and Women’s Hospital in Boston, is putting together trials of the capsules against Crohn’s disease, obesity and primary C. difficile.


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## wildbill_52280

I haven't updated my progress in a while from my DIY Fecal Microbiota Transplant 15 months ago, so I'm letting you all know I ended up gaining 25 lbs total over the course of that time, after being under weight for like 8 years despite having my IBD symptoms largely under control( 1 healthy BM per day, good blood work, no complications). The first 10 lbs were rapidly gained in the first 2 months, then over the next thirteen months I slowly gained 15 more pounds. I'm Still eating about 1700 calories a day so the only way to explain all this weight gain is that I restored some healthy bacteria and I'm now able to extract more calories from the same amount of food. 

    My other symptoms of IBD have only improved around 10%, so The FMT did not restore the most important bacteria that regulate inflammation, and another course of FMT is needed for that. So I think that is the final extent of my DIY Fecal Transplant results and benefits. At some point I will try another attempt and find a suitable donor, probably a healthy college student with glowing smooth skin, perfect hair, muscular physique, positive ambitious personality,high energy, who is working out at the gym or playing tackle football, basketball or tennis somewhere!! Or finally they will put this bacteria in a pill and I know so deep in my heart and mind, when they perfect this treatment it will be the final cure for IBD. And the damage the many courses of antibiotics(and low fiber diet, vit d deficiency) did to me will finally be reversed.

If I had the education and the means to do it myself, trust me we would have it by now.


----------



## wantok

(Forgive me if I am repeating, but I have not followed this whole thread)...have you tried VSL#3 or  the double strength VSL#3?  I take it before bed, one or two.  It is expensive.


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## Spooky1

Great to hear, Wildbill.
I also agree that it is the answer.  I've had two lots of antibiotics lately for dental abscesses.  Now having lots of probiotics.  It's interesting to hear that you gained a lot of weight, but I understand, and laughed, at the required sort of donor needed.

I tried VSL#3 and my god I was on and off the loo about 50 x pd.  Amazing, immuprobio is costly too but is gastro resistant.  However if I take about 8 I can cut the loo visits down by half the next day.  Only works whilst in the system, and I can't really afford 8 per day.  I do make sauerkraut and have some of that each day.  It is a benefit as I have very little bloat the next day.  So something good about its probiotic properties are helping.


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## wantok

Homemade kefir is not expensive, although you have to hunt down the grains to start.  Tons of probiotics in it.  My experience is that taking the probiotic stuff before bed is essential, and not all of the probiotics work the same for me.  My doc said VSL#3 doesn't work for everyone.  But if you have a good response to probiotics then it may help.  I ran into lots of varieties when I was looking at amazon to buy the VSL#3 that I was not aware of.


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## Spooky1

I have tried milk kefir with dire results as dairy is an issue.  I used to do water kefir too, but it wasn't as helpful as the sauerkraut and immuprobio.  I usually take some immuprobio along with other 50 billion cheaper probiotics and just hope for the best.  But one day we will all be given fmt for our ills and then hopefully they won't be our ills and we'll all be blessed with good health.  I certainly deserve it after 40 years of Crohns.

I take it VSL#3 works for you?  I bought some on ebay fairly cheaply.  Must have had bad gut flora for it to have such a clear out effect.  Might try them again sometime.  I checked with my gp recently about having it on the NHS here in the UK, but it was blacked out, meaning too expensive to prescribe and it's only a supplement.  So not pharma enough for them to pay for I think.


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## wantok

Yes, VSL#3 works, but other cheaper ones do too.  But taking before bed is the key.  Kefir works sometimes.  I'm very lucky I have a mild case.


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## Lady Organic

Thanks for the update Wildbill. have you monitored with fecal calprotectine?


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## jayann

If I had the education and the means to do it myself, trust me we would have it by now.[/QUOTE]

Hi Wild Bill,

I've not responded to your posts often, but wanted to let you know how much I appreciate your sharing of such valuable information. Glad you are doing so well.   I think FMT with the right donor could very well be the answer to IBD.  Thanks again.

jayann


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## Lady Organic

Speaking of the perfect donor (makes me laugh too Spooky1!) in Ontario, a team of doctors are conducting a second trial of FMT with UC patients. They will use the specific donor who had the most success in the first trial and they will also give antibiotics for 14 days prior to the procedure. :''The investigators will also use stool from donor B exclusively for frozen/thawed FMT as this donor was associated with the most success in the previous trial''

https://clinicaltrials.gov/ct2/show/NCT02606032?term=fecal+transplant+ulcerative+colitis&rank=3


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## wildbill_52280

Latest news on companies developing microbiome based therapies for IBD. Microbiome is a term that refers to all the microorganisms(bacteria,virus fungi,ETC) that live on or in the body,of which the most important communities live in the GI tract. This is all related to fecal microbiota transplants which also attempt to treat the microbiome to influence or cure disease states.



> Seres granted Nestlé Health Science commercial rights in global markets outside of the United States and Canada to SER-109 and SER-262 for CDI, and SER-287 and SER-301 for IBD. The U.S. Food and Drug Administration (FDA) has granted SER-109 Orphan Drug, as well as Breakthrough Therapy, designations. In exchange for commercial rights, Nestlé Health Science agreed to provide Seres with an upfront payment of $120 million in cash and a series of contingent payments for development and sales milestones and tiered royalties on sales ranging from the high single digits percentages up to the high teens for all products.
> 
> Nestlé Health Science agreed to contribute to certain development efforts, including 33 percent of expenses for potential global Phase 3 studies for SER-287, SER-301 and SER-262.


http://www.cbs8.com/story/30932362/...-clostridium-difficile-and-inflammatory-bowel

https://www.nestlehealthscience.com/newsroom/press-releases/Strategic-collaboration


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## Christi

wildbill_52280 sorry for me asking this maybe even a dumb question but how do you do the fmt? Im just curious to know as this is interesting


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## wildbill_52280

Christi said:


> wildbill_52280 sorry for me asking this maybe even a dumb question but how do you do the fmt? Im just curious to know as this is interesting


You can read the first post in this thread for more information, but in general the procedure requires a stool sample from a healthy person. this is mixed in saline and given to the patient via enema or nasogastric tube or colonoscopy. Still waiting on pill form. The idea is the restore bacteria that have become extinct in the patient intestines, by obtaining it from healthy people.


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## wildbill_52280

related article to microbial diversity and fecal transplants.
http://www.thenakedscientists.com/HTML/interviews/interview/1001647/


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## wildbill_52280

Article related to gut microbiota and arthritis.

http://www.theatlantic.com/health/archive/2015/01/joint-pain-from-the-gut/383772/


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## Spooky1

I just wish they'd get a wriggle on with this stuff.  I've been waiting as long as the rest of us here and am willing to go for any trials necessary or volunteer.  I swear this is the answer to many auto-immunes.  Thanks for the info Bill.  It still raises my hopes greatly it's just I'm not getting any younger.  I can see 30 years down the line as soon as someone presents with an auto-immune they will just cure it with FMT.  Unfortunately, I will probably have popped my clogs by then.


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## ppk

Not to temper your enthusiasms too much - but I have Sjogren's, Raynaud's, celiac, and possibly SLE, and after 4 FMTs I definitely still have all the conditions.

However, I cured my ankylosing spondylitis with a low starch diet and doxycyline. Dr. Alan Ebringer's research on ankylosing spondylitis, diet, and Klebsiella pneumoniae all seemed to be very accurate and invaluable to me.

edit: I also drank cabbage juice, which is purported to be of assistance in healing intestinal lesions

edit 2: Also, after the FMTs, I was able to eat certain FODMAPs like onions and garlic, which I couldn't tolerate at all before.


----------



## Spooky1

I also have Sjogrens symptoms and my good friend a retired GP also stated she thought I hade it.  I'm also a Raynaud's sufferer with Crohn's, iritis and arthritis.  But, as ever, I'm always hopeful.  I have home made sauerkraut which is cabbage and carrot raw with sea salt and fermented.  This gets rid of bloating.  I also take a few 50 billion probiotics at night.  This is helpful only whilst it is in the system.

Thanks, PPK,


----------



## Eridon2002

Also said:
			
		

> I would go through FMT just to be able to eat onions and garlic again.  I miss them!


----------



## ppk

Eridon2002 said:


> I would go through FMT just to be able to eat onions and garlic again.  I miss them!


I must say - it is very nice to be able to eat lots of healthy/delicious veggies again!


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## Spooky1

I always loved fruit and veg and miss them badly.  Actually I would give anything to eat anything and everything.


----------



## ppk

Spooky1 said:


> I always loved fruit and veg and miss them badly.  Actually I would give anything to eat anything and everything.


I wholeheartedly believe much of the suffering in those with IBD/IBS/celiac/etc. is caused by nutrient deficiencies, because our diets are so restricted and they suffer from malabsorption. My quality of life has definitely improved follow my four FMTs, and therefore I recommend FMTs to those suffering from any GI/autoimmune-related conditions. Just make sure you find a healthy donor. If you're rich, you can run tests on both the donor's and your microbiome, and determine which species are in greatest abundance in both of your stools. Then, post-FMT, you can test donor engraftment by running another test on your stool and seeing how many of the donor species took root in your GI tract.

For what it's worth, I found that I tolerated FMTs much better than any probiotics I've taken since I got sick.


----------



## wildbill_52280

@9:00 Thanks Rob Knight, but the whole video is great.
https://www.youtube.com/watch?v=M5KlhCKMmK8


----------



## wildbill_52280

> Our data reveal that mice recovering from antibiotic treatment or C. difficile infection retain lingering signatures of inflammation, despite compositional normalization of the microbiota, and host responses could be rapidly and durably relieved through fecal transplant.


http://www.cell.com/cell-reports/abstract/S2211-1247(16)00029-2


----------



## jayann

wildbill_52280 said:


> @9:00 Thanks Rob Knight, but the whole video is great.
> https://www.youtube.com/watch?v=M5KlhCKMmK8


Thanks, Wild Bill,

Rob Knight is my hero.  Have you taken the Coursera course online?  It was put out by the Rob Knight Lab while it was at University of Colorado.  It is still available on demand. It's called something like- Exploring your Gut- the Microbiome. I'm sure a Google search will locate it.  Fabulous course, can be audited, all, or in part and certificate can be earned.  

jayann


----------



## Spooky1

I looked at that course as I love Coursera.  Unfortunately when I changed broadband I got limited usage and doing more than one course at a time ate away at my usage.  I'm changing to a better supplier on the 11th and will be back doing coursera courses by the dozen.
thanks.


----------



## wildbill_52280

jayann said:


> Thanks, Wild Bill,
> 
> Rob Knight is my hero.  Have you taken the Coursera course online?  It was put out by the Rob Knight Lab while it was at University of Colorado.  It is still available on demand. It's called something like- Exploring your Gut- the Microbiome. I'm sure a Google search will locate it.  Fabulous course, can be audited, all, or in part and certificate can be earned.
> 
> jayann


I have not taken Rob Knight's coursera course, interested though.


----------



## wildbill_52280

Study of Fecal Microbiota Transplant(FMT) Pill in C. difficile patients achieves 96.7% cure rate. The pill SER-109 is a mixture of spores of approximately 50 species of beneficial bacteria made by Seres Therapeutics, that is meant to replace to procedure of getting fecal transplant. Using bacterial spores would guaranty almost 100% safety and reliability compared to using stool from a live donor.

Excerpt:


> "This oral microbial preparation that contains a small fraction of the total microbiome works as well as, if not better than, FMT," says Elizabeth Hohmann, MD, of the Massachusetts General Hospital (MGH) Infectious Diseases Division, senior author of the study. "These few key species seem to work in restoring a healthy microbiome, and other, beneficial species not in the capsules return, while harmful bacteria are removed. The product is also designed to be safer than FMT, by eliminating the potential for transmission of pathogens that might be present in donor fecal material."


----------



## wildbill_52280

FMT pill used to treat C.difficile is very successful, similar pills are currently being studied to be used for Crohn's and U.C. pills will be safer and easier then a fecal transplant, and may even be more effective at repairing a damaged microbiome.



> "This oral microbial preparation that contains a small fraction of the total microbiome works as well as, if not better than, FMT," says Elizabeth Hohmann, MD, of the Massachusetts General Hospital (MGH) Infectious Diseases Division, senior author of the study. "These few key species seem to work in restoring a healthy microbiome, and other, beneficial species not in the capsules return, while harmful bacteria are removed. The product is also designed to be safer than FMT, by eliminating the potential for transmission of pathogens that might be present in donor fecal material."


http://medicalxpress.com/news/2016-02-oral-capsule-bacterial-spores-effective.html
http://www.serestherapeutics.com/pipeline/ser-109


----------



## wildbill_52280

sorry about the double post above, my computer was acting up.


----------



## JaimeM

I just wanted to comment on here, I had a FMT in october for recurrent cdiff... I felt great after a few days. Like a completely new person.. Unfortunately, I had to stay off my crohns medicine for a few months afterwards and ended up flaring again.. But the cdiff has stayed away. I felt the best i had in a very long time afterwards


----------



## xeridea

wildbill_52280 said:


> FMT pill used to treat C.difficile is very successful, similar pills are currently being studied to be used for Crohn's and U.C. pills will be safer and easier then a fecal transplant, and may even be more effective at repairing a damaged microbiome.
> 
> http://medicalxpress.com/news/2016-02-oral-capsule-bacterial-spores-effective.html
> http://www.serestherapeutics.com/pipeline/ser-109


I read a report (I can't find the link ATM) that says it's expected that the microbiome treatment/diagnostic field will grow by about 75% a year over the next decade or so. Over the past couple years there's been about $1 billion venture capital flowing into the field. And that's expected to grow as well. There's a lot more players in the field now than there was a couple years ago. There might be some exciting developments coming along in the next couple of years. Research into treating recurrent CDI seems to be the short term objective, but CD and UC seem to be on the horizon.


----------



## wildbill_52280

xeridea said:


> I read a report (I can't find the link ATM) that says it's expected that the microbiome treatment/diagnostic field will grow by about 75% a year over the next decade or so. Over the past couple years there's been about $1 billion venture capital flowing into the field. And that's expected to grow as well. There's a lot more players in the field now than there was a couple years ago. There might be some exciting developments coming along in the next couple of years. Research into treating recurrent CDI seems to be the short term objective, but CD and UC seem to be on the horizon.


C.diff may have been a priority because people more frequently die from it. Much of the knowledge about c. diff will further support the concept of Bacteriotherapy for Crohn's. Its hard to understand which companies products will survive, they seem to be all treating the same diseases though, kind of a wild west of sorts, with different strategies. Some products aren't even using bacteria but metabolites of bacteria and I'm absolutely not interested in any of that knowing what I know about the disease and the probabability of curing it by restoring the microbiome permanately. I almost feel like investing in these companies myself!!


----------



## wildbill_52280

Just reading some more info about Seres Therapuetics, the company who devloped SER-109 to restore a healthy microbiome in C. difficile patients, interesting stuff.

http://www.serestherapeutics.com/our-science/microbiome-therapeutics-platform

SER-301 could be for Crohn's disease, there is a chart in this link which shows how far along the drug is in development, its going to be at least a few years it seems for crohn's disease, but there are other companies which may be further along for IBD.
http://www.serestherapeutics.com/pipeline/products


----------



## Spooky1

We just need to wait until big pharma can make enough from this.  then we will all be fine, so long as we keep taking their weakened down form in the pill.  The magical cure one wouldn't bring them enough me thinks.  But i'm still hopeful and just biding my time.


----------



## wildbill_52280

Spooky1 said:


> We just need to wait until big pharma can make enough from this.  then we will all be fine, so long as we keep taking their weakened down form in the pill.  The magical cure one wouldn't bring them enough me thinks.  But i'm still hopeful and just biding my time.


Since know one has tried this method before(treating disease with live/dormant probiotic bacteria), know one knows for sure whether restoring the microbiome with bacteria will cure IBD, the current research strongly suggests this is what could happen but these companies will have to consider it an unexpected side effect of the medication. I'm sure the people who are making these pills are generally aware of this possibility, but to say something is a cure needs to have very good evidence to support that claim and we just aren't there yet.  We have maybe 7 cases of IBD that seems to be cured, that's very small number but some good evidence to suggest it could happen.


----------



## wildbill_52280

FMT pills to be used in a study to treat obesity in australia.

http://www.sbs.com.au/topics/scienc...freeze-dried-faecal-pills-could-treat-obesity


----------



## wildbill_52280

Seres health stock valuation is down, but we know better, now is the time to buy it while it's cheap.


> Seres Therapeutics Inc (NASDAQ:MCRB) has declined 36.70% since July 10, 2015 and is downtrending. It has underperformed by 26.50% the S&P500.


 http://www.fdanewsalert.com/seres-t...creased-by-7-23-after-short-covering/8513489/


----------



## Spooky1

they've got a nerve treating fat people before us Crohnies.  I don't mean to be rude but they ate too much of the wrong stuff.  I'd like more food than just liquid E028extra.  A hot meal for instance.


----------



## 7vNH

7vNH said:


> It has been 6 months since my 10-day FMT treatment ended and I am in good health, despite having significantly reduced my medication.  I was at a crossroads with my UC: to impede my immune system with expensive drugs that have serious side-effects, or battle what was causing my immune system to react.  I obviously chose the latter. So far, so good!
> .......
> .......
> .......


It has been 13 months since my 10-day FMT treatment ended.  I have been putting-off this 12 month report since it's not good news.  Unfortunately, I'm back to symptoms similar to before my FMT. The quoted post will give you the background on the protocol I followed just over a year ago, and here I will report what has happened since.  Right now I am under control, but I'm taking the maximum dose (4.2g) mesalamine, and also using the mesalamine suspension nightly.

I had maintained hope that the FMT would have caused my gut microbiome to settle in a place where UC symptoms would be gone, but I decided in November that if the microbiome had shifted, that was not going to help me to live with UC, long-term.  In September, I began seeing small red streaks, but just once or twice a month.  Otherwise, I felt fine.  But in November, I knew that the old inflammation had returned.  That flare was of short duration, but I finally had to admit that the FMT was only a temporary fix for me.

This is paragraph isn't about FMT, but instead about my experiment with gluten.  Gluten testing (Cyrex) indicated I had sensitivity to 3 of the 24 things tested (regular doc's test had 3 things, not sensitive to those).  Anyway, in December I decided to hit gluten hard (daily bread, lol!), as opposed to my almost gluten-free diet.  "Almost" means I would drink beer and not worry about traces of gluten or even sauces thickened with flour, but no bread, crackers, etc.  So after eating bread or crackers every day for a few weeks, I had inflammation again, to the point of introducing a low residue diet.  It was then that I decided to go strict gluten-free.  No sign of blood since November.  As I said earlier, I'm stable now with the top and bottom mesalamine.  I'm going to hit the gluten again (when I get the courage), and see if it, again, is aligned with inflammation symptoms.  But that's a story for another day.

So looking over my diary for the last 18 months, it starts with 4 months with frequent blood and mucus, then a relatively calm spot before the FMT, then 10 months of calm after the FMT.  It wasn't perfect digestive health during that time, but it was a pretty long span with nothing to report.  That span could have been at least partially due to my being more careful with my diet (very little processed carbohydrate and more raw plant material).  The last few months I've had a few minor short flares.  That's enough to convince me that if the 10-day FMT changed my gut microbiome, then that's not enough.  Or maybe my original gut microbiome re-asserted itself.  I had sent a pre-FMT sample to the American Gut Project, but they apparently lost it, or something.  I'd really like to do a compare between now and then to see if it changed, or is the same as pre-FMT.  But I don't think I'm going to get anywhere with that.  So if symptoms persist even through maximum doses of mesalamine, I might have to be done with the FMT route, give-in, and go with anti-inflammatory biologics.


----------



## wildbill_52280

7vNH, what can I say, it's an experimental procedure that is not perfected yet and one you should not expect reliable results with. Also, a low residue diet is low in fiber, I thought you were aware this old advice is no longer good and the high fiber foods improve IBD. This knowledge is crucial to even performing a successful FMT. If it is true you had 10 months of calm after fmt then it sounds like it was partially successful, and that's a good thing. After an FMt you really should adopt a high fiber, low meat dairy egg diet for life since we know how the gut bacteria rely on this for nutrition. By all means though, control your disease with drugs but in no way does this experiment you did conclusively tell us about the potential of restoring the microbiome in IBD, but we are glad to hear about your experiences. Maybe in the future you can try it again but of course, try to improve the procedure to get better results, I think you got some decent results and you should feel good about that, at least you got something out of the experiment.


----------



## 7vNH

Thanks WB, I might try FMT again. Didn't mean to imply that FMT didn't have potential, just that in my case, the benefits didn't last all that long.  Glad to have seen some benefits, though.  And I think I did the post-FMT diet correctly...I was eating very little processed carbohydrate and more raw plant material.  The only time I went low residue was for a few days to give myself a rest during and after a flare.  If I do get the FMT treatments again, I'll have uBiome tests before and after.


----------



## wildbill_52280

Just a new article on Fecal Microbiota Transplants.
https://www.thrillist.com/health/nation/poop-transplants-do-they-work-and-what-theyre-good-for


----------



## Spooky1

Love that humour in that article, Wildbill.


----------



## xeridea

This paywalled FMT study in children may shed some evidence on whether dysbiosis is a cause or result of IBD.

"FMT gives sustained C. difficile eradication in children with and without IBD. FMT-restored diversity is sustained in children without IBD. In those with IBD, bacterial diversity returns to pre-FMT baseline by 6 months, suggesting IBD host-related mechanisms modify faecal microbiome diversity."


----------



## wildbill_52280

> In those with IBD, bacterial diversity returns to pre-FMT baseline by 6 months, suggesting IBD host-related mechanisms modify faecal microbiome diversity."



These study results could mean alot of things,  "IBD host-related mechanisms modify faecal microbiome diversity" is just one possible meaning. We have known for sometime IBD requires multiple FMT's to have an effect and c. difficile patients often are cured with only 1 FMT, it would be nice to know more about how they measured diversity in this study and we also know that different donors have varying quality of stool health. My question is to what degree of diversity was momentarily restored in these patients? Maybe this means there is an Intracellular pathogen that take's much more time to eliminate then c. difficile, maybe this is something that could be considered an "IBD host related mechanism". Don't forget we have official reports of FMT curing IBD as well so there is lots of evidence which "suggests" many possibilities.


----------



## jayann

Hi Wild Bill,
"IBD requires multiple FMT's to have an effect"  Do you have a reference for how many FMT's are most effective?  Do they need to be done on consecutive days or could they be done say once a week for a given number?

jayann


----------



## wildbill_52280

jayann said:


> Hi Wild Bill,
> "IBD requires multiple FMT's to have an effect"  Do you have a reference for how many FMT's are most effective?  Do they need to be done on consecutive days or could they be done say once a week for a given number?
> 
> jayann


Read the first post of this thread, some early experiments it took 30-60 FMT enemas in crohn's patients to get remission, also some cases using single FMT via nasogastric tube achieved long remissions without drugs which some consider to be a cured since they have been confirmed to be free of crohn's from follow up colonoscopy 13 years later.


----------



## Spooky1

Maybe daily fmt pill form is better for us.


----------



## wildbill_52280

Spooky1 said:


> Maybe daily fmt pill form is better for us.


Valid question, but read through the entire thread to understand the issues, otherwise I'm Just going to have to keep repeating the same thing over and over again, I don't want a 100 page thread with no real content.


----------



## wildbill_52280

A new study examining the different responses to FMT in normal and IBD patients when treated for C. Diff.
http://www.cghjournal.org/article/S1542-3565(16)00166-X/abstract?cc=y=


----------



## Lady Organic

from the previous article in the conclusion: '' More than 25% of patients with IBD have a disease flare following FMT.''
Scary and unfortunate...


----------



## wildbill_52280

Lady Organic said:


> from the previous article in the conclusion: '' More than 25% of patients with IBD have a disease flare following FMT.''
> Scary and unfortunate...


Again it all depends on the health of the donor, 25% is still pretty low for any adverse event. This is why a FMT pill with only the good bacteria will be superior, using whole stool can potentially contain pathogenic bacteria as well as the good bacteria we need to restore the microbiome, while a pill could contain only the good.


----------



## wildbill_52280

New study on FMT for IBD being done in turkey.

https://clinicaltrials.gov/ct2/show...lant&rcv_s=09/01/2015&rcv_e=12/24/2015&rank=2


----------



## wildbill_52280

Lady Organic said:


> from the previous article in the conclusion: '' More than 25% of patients with IBD have a disease flare following FMT.''
> Scary and unfortunate...


but how soon we forget the great things we already know!! 76% of patients achieved remission within one month following single oral FMT for refractory crohn's disease, these may be the most dramatic turnarounds ever observed in science. The study you commented on was for colonoscopic FMT, please note again I have been promoting the idea of oral FMT as more promising for quite a few years now.
http://www.ncbi.nlm.nih.gov/pubmed/25168749


----------



## wildbill_52280

News segment on women from Houston Texas who was cured of C.Diff with FMT pills.
http://www.fox26houston.com/health/healthworks/103292797-story


----------



## wildbill_52280

Another company plans on developing a Fecal Transplant Pill and they are located in my state!!They are making one for C diff. 
http://www.jsonline.com/business/fl...-for-the-squeamish-b99680488z1-371880281.html


----------



## wildbill_52280

News from the University of Connecticut whom are also trying to create a Fecal transplant pill.



> “You have in your gut this tremendous fermenter,” says microbiologist George Weinstock, Evnin family chair and director of microbial genetics at the Jackson Laboratory. “Full of species as diverse as a tropical rainforest.” And, much like a tropical rainforest, many of these organisms are obscure, unknown to science because their native habitat is hard to explore and the organisms hard to breed in a lab. Weinstock and fellow microbiome researcher Julia Oh have developed bioreactors at the Jackson Laboratory in Farmington that can grow these fragile organisms and reproduce entire artificial microbiotic communities.
> 
> They’ve been happy to partner with UConn Health gastroenterologist Dr. Tom Devers and nurse Lynn Baccaro. Devers and Baccaro have been treating patients with life-threatening gut infections since 2012 using fecal transplants. They take the bacteria-rich intestinal contents (otherwise known as poop) from a healthy person and put it in the colon of someone who’s sick with C. difficile, a terrible bacteria that ravages the gut. And 95 percent of the time, the person is cured within days.
> 
> Devers and Baccaro also want to know why their patients get healthy. What is it about the microbiome population of a healthy person that so quickly rescues the gut of someone suffering from C. difficile? And could they possibly make an extract of pure bacterial strains that a patient could swallow, instead of enduring a fecal transplant?
> 
> Weinstock and Oh think the answer to that last question is yes. They’ve developed a collection of four bacteria types that, when swallowed by a mouse with C. difficile, cure the mouse. Will it work in humans? Baccaro and Devers would like to do a study to find out."


http://today.uconn.edu/2016/03/uconn-jax-partnership-begins-to-bear-fruit/


----------



## Spooky1

If they don't want to make a Crohn's FMT pill we are gonna have to surreptitiously find a way to get all of us on this forum to get infected with C-Diff.


----------



## wildbill_52280

Spooky1 said:


> If they don't want to make a Crohn's FMT pill we are gonna have to surreptitiously find a way to get all of us on this forum to get infected with C-Diff.


HAHA! my thoughts exactly. IBD patients are next in line though, I assure you. Surprisingly this may be kind of a new benefit of getting c. diffcile when you also have IBD and suddenly one of the most deadly diseases... is in high demand! Remember though, the dosage that clears c diff, may not correct IBD, it could take a week treatment rather then a day, we just have to have the experimental data and we are waiting on that.


----------



## wildbill_52280

Results of a new study On U.C. using Fecal Microbiota transplants. 
http://www.medscape.com/viewarticle/860690

My thoughts:
I'm just really waiting for FMT pills to be used in IBD, but this study helps give the idea of FMT more merit because it was a placebo controlled study and demonstrated much greater efficacy compared to placebo. Supposedly these are  some of the best ways to demonstrate the effectiveness of any therapy, but even in some single case studies FMT has shown such a dramatic effect, it's hard to ignore, but this study will always help further the cause.


----------



## 7vNH

This is the first trial that I've seen that "does it right", with respect to number of infusions.  





> Forty-one adults were treated with an initial fecal microbiota transplantation, delivered by colonoscopy, followed by five active enemas per week for 8 weeks.


They all started out with an empty colon and they did plenty of infusions using multiple donors.  It was an "open label" study, though.  It doesn't say what the placebo group did...maybe they gave them sterilized (killed) FMTs?  I can't imagine why someone would knowingly go through 40 worthless enemas.  It does say that 37 (of the 40) in the placebo group switched to live FMTs after 8 weeks.  Maybe the option to switch is why they did 40 worthless ones.

The study says that 37% got a response and 17% got remission of their UC.  Of those that switched at week 8, 27% got a response (compared to the 37%).

To me, this is essential information if someone with UC is considering the FMT route since it gives them an idea of how likely it is that they will get benefit (in the 30% range).  It's still a roll of the dice, but it's better than the sketchy information I had a few years ago.

Improvements for the next study might include being double blind, large, and possibly using Borody's antibiotic cocktail the week before.


----------



## wildbill_52280

7vNH said:


> This is the first trial that I've seen that "does it right", with respect to number of infusions.  They all started out with an empty colon and they did plenty of infusions using multiple donors.  It was an "open label" study, though.  It doesn't say what the placebo group did...maybe they gave them sterilized (killed) FMTs?  I can't imagine why someone would knowingly go through 40 worthless enemas.  It does say that 37 (of the 40) in the placebo group switched to live FMTs after 8 weeks.  Maybe the option to switch is why they did 40 worthless ones.
> 
> The study says that 37% got a response and 17% got remission of their UC.  Of those that switched at week 8, 27% got a response (compared to the 37%).
> 
> To me, this is essential information if someone with UC is considering the FMT route since it gives them an idea of how likely it is that they will get benefit (in the 30% range).  It's still a roll of the dice, but it's better than the sketchy information I had a few years ago.
> 
> Improvements for the next study might include being double blind, large, and possibly using Borody's antibiotic cocktail the week before.


I agree, maybe they were glad to have the opportunity to get the real treatment after the placebo enemas, the fact that they began to respond to real stool helped emphasize the effect of FMT. For the record, right now FMT is still an experimental treatment option for IBD that's being explored and not ready for everyone to do, except for some well informed adventurous folks like myself.


----------



## wildbill_52280

Analysis of japanese microbiomes.
https://www.waseda.jp/top/en-news/39264


----------



## wildbill_52280

Martin Blaser, a leading expert on the human microbiome, will present two free, public seminars at the University at Buffalo in April. 
http://www.buffalo.edu/news/releases/2016/03/064.html


----------



## Spooky1

I wonder if they will put it on youtube for all too see.


----------



## mf15

What else you getting with FMT,just a FYI.
Old Mike

http://www.ncbi.nlm.nih.gov/pubmed/27025251


----------



## wildbill_52280

A new company making bacterial based microbiome therapies to prevent Chronic illnesses.
http://www.businesswire.com/news/ho...Microbiome-Platform-Targeting-Early-Childhood


----------



## wildbill_52280

kind of related to the microbiome.
http://www.npr.org/sections/health-...n-body-s-complicated-relationship-with-fungus


----------



## wildbill_52280

The Microbiome Center at UChicago, MBL, and Argonne National Laboratory.
https://www.youtube.com/watch?v=HlMwfYVZuv8


----------



## wildbill_52280

mf15 said:


> What else you getting with FMT,just a FYI.
> Old Mike
> 
> http://www.ncbi.nlm.nih.gov/pubmed/27025251


fungus have even been shown to have an influence on IBD, bacteria most likely play the biggest role, as ~99% of the organisms that exist are bacteria, as far as I understand at the moment.


----------



## wildbill_52280

dietary habits that influence the diversity of your microbiome.
http://medicalxpress.com/news/2016-04-lifestyle-strong-impact-intestinal-bacteria.html


----------



## wildbill_52280

wow I missed this study from 2014, it further makes connections between the gut bacteria and the regulation of the immune system specifically in IBD patients. More evidence to encourage the restoration of the microbiome through Fecal transplants.

PLoS Biol. 2014 Apr 8;12(4):e1001833. doi: 10.1371/journal.pbio.1001833. eCollection 2014.
*CD4CD8αα lymphocytes, a novel human regulatory T cell subset induced by colonic bacteria and deficient in patients with inflammatory bowel disease.*

http://www.ncbi.nlm.nih.gov/pubmed/24714093


----------



## wildbill_52280

A new story of a guy who did a DIY fecal transplant. not just any guy though he is also scientist.


> That’s not to say Zayner is dubious of science — in fact, he’s a scientist himself. In 2013, he earned a PhD in Biophysics from the University of Chicago and subsequently served as a postdoc researcher at NASA’s Ames Research Center for two years.


http://www.theverge.com/2016/5/4/11...ransplant-josiah-zayner-microbiome-ibs-c-diff


----------



## wildbill_52280

Seres therapeutics takes further steps to develop FMT pill for U.C.
Anybody living in this area should keep track so they may find a way to participate in upcoming studies.
http://www.businesswire.com/news/ho...s-Academic-Collaborations-Support-Development


----------



## Scared1

wildbill_52280 said:


> Results of a new study On U.C. using Fecal Microbiota transplants.
> http://www.medscape.com/viewarticle/860690
> 
> My thoughts:
> I'm just really waiting for FMT pills to be used in IBD, but this study helps give the idea of FMT more merit because it was a placebo controlled study and demonstrated much greater efficacy compared to placebo. Supposedly these are  some of the best ways to demonstrate the effectiveness of any therapy, but even in some single case studies FMT has shown such a dramatic effect, it's hard to ignore, but this study will always help further the cause.


Hi, this is great. If crohn's was just an autoimmune disease - I dont think fmt would work because your not altering the immune system - so there must be more to it


----------



## wildbill_52280

New round of funding coming for microbiome research and this most likely means more studies for fecal transplants, well I'm hoping anyways.
http://www.nytimes.com/2016/05/13/u...ms-to-solve-tiny-riddles-of-science.html?_r=1


----------



## wildbill_52280

Here is link to a recent study covering the dizzying complexity of trying to answer the question of whether microbiome alterations/disruptions are the cause or the result of IBD. It is now clear that there are major alterations in the microbiome, we just don't fully understand the implications and meaning of this data. It seems it is still possible the microbiome could be the sole cause if IBD as opposed to genetic mutations/heredity. Attempting to normalize the altered microbiome in IBD patients to appear more normal/healthy to improve or cure the disease is what Fecal Microbiota Transplants are all about.

Microbiota Alterations in Inflammatory Bowel Diseases: From Correlation to Causality
Published Online: May 14, 2016
http://www.cmghjournal.org/article/S2352-345X(16)30040-6/fulltext


----------



## Scared1

wildbill_52280 said:


> Here is link to a recent study covering the dizzying complexity of trying to answer the question of whether microbiome alterations/disruptions are the cause or the result of IBD. It is now clear that there are major alterations in the microbiome, we just don't fully understand the implications and meaning of this data. It seems it is still possible the microbiome could be the sole cause if IBD as opposed to genetic mutations/heredity. Attempting to normalize the altered microbiome in IBD patients to appear more normal/healthy to improve or cure the disease is what Fecal Microbiota Transplants are all about.
> 
> Microbiota Alterations in Inflammatory Bowel Diseases: From Correlation to Causality
> Published Online: May 14, 2016
> http://www.cmghjournal.org/article/S2352-345X(16)30040-6/fulltext


This is very interesting, thank you! I do think fecal transplants are a big piece of the puzzle as will other methods to help clear out any existing pathogens in the system. It is nice that people are researching the CAUSE of the disease now as a trend, rather than the symptoms.


----------



## Scared1

This is very interesting - has to do with UC but a version is also being made for Crohn's based on the website....

http://www.serestherapeutics.com/clinical-trials/overview/ser-287-seres-101-study


----------



## xeridea

Scared1 said:


> This is very interesting - has to do with UC but a version is also being made for Crohn's based on the website....
> 
> http://www.serestherapeutics.com/clinical-trials/overview/ser-287-seres-101-study


Scared1, you may be interested in the site thepowerofpoop.com whose original curator was somewhat of a pioneer in bringing together a lot of information regarding FMT to the web. And in particular, given the sort of companies you're linking, you might be interested in the listings on this page, where a lot of the companies that were/are doing next-generation FMT research (e.g. poop in a pill) are listed. You'll see Seres, Enterome, Second Genome, Vedanta and some other less known names. And many of these companies are now backed by the giants of the Pharma industry. True, it's an exciting field, but so far, definitely promising research in recurrent CDI, and to some extent UC, but I haven't seen anything too exciting yet for CD. I'm keeping my fingers crossed though.


----------



## wildbill_52280

Scared1 said:


> This is very interesting - has to do with UC but a version is also being made for Crohn's based on the website....
> 
> http://www.serestherapeutics.com/clinical-trials/overview/ser-287-seres-101-study


I'm pretty sure this is in this thread somewhere, but it doesnt hurt to bring it up again because it is awesome. There is also a synthetic FMT pill being studied right now for crohn's. The pills are usually a selected mixture of different types of good bacteria.


----------



## Scared1

wildbill_52280 said:


> I'm pretty sure this is in this thread somewhere, but it doesnt hurt to bring it up again because it is awesome. There is also a synthetic FMT pill being studied right now for crohn's. The pills are usually a selected mixture of different types of good bacteria.


Yeah, I didn't see it anywhere. I find this very interesting and I hope it leads to something in the next few years. I know there is a version for the pill - except the website just talks about the UC one but they are doing the same thing.

I really think the whole dysbiosis is a piece of it - not the whole piece to the puzzle. But, with that said, its a BIG piece of it and I am following so many trials and news on a daily basis (weird, it has become part of my morning coffee routine - sit and literally look at any postings/news/etc from the prior 24 hours), and it helps seeing that there are some interesting things in the pipeline


----------



## wildbill_52280

Scared1 said:


> Yeah, I didn't see it anywhere. I find this very interesting and I hope it leads to something in the next few years. I know there is a version for the pill - except the website just talks about the UC one but they are doing the same thing.
> 
> I really think the whole dysbiosis is a piece of it - not the whole piece to the puzzle. But, with that said, its a BIG piece of it and I am following so many trials and news on a daily basis (weird, it has become part of my morning coffee routine - sit and literally look at any postings/news/etc from the prior 24 hours), and it helps seeing that there are some interesting things in the pipeline


This article mentions an FMT pill for crohn's being studied, third paragraph from the bottom.
http://www.nytimes.com/2015/11/10/health/fecal-transplants-made-somewhat-more-palatable.html?_r=1


----------



## Scared1

Has anyone hears about this trial? I came across it it today and thought it was interesting - it is not yet recruiting and in phase 2 and last updated and entered in this month...

https://clinicaltrials.gov/ct2/show/NCT02765256


----------



## irishgal

Wow, that's even more antibiotics than AMAT! Shorter duration though. Not thrilled about the PEG.


----------



## Scared1

irishgal said:


> Wow, that's even more antibiotics than AMAT! Shorter duration though. Not thrilled about the PEG.


I know! All antibiotics - here is a "layman version" per the website abstract:

The available evidence suggests that it is the commensal gut microbiota responsible for the stimulation of the intestinal immune system in the inflammatory bowel diseases (IBD). *Thus, many IBD researchers and providers have questioned the current therapeutic approach. For instance, if the gut flora plays a role in the development of IBD, then perhaps targeting the microbes rather than the immune system, or an approach which targets a combination of the two, would be more efficacious. *

*We hypothesize that immune suppressive medications lead to persistent colonization with potentially pathogenic microbes that perpetuate disease chronicity in IBD patients.* Additionally, we hypothesize that host immunosuppression could allow indolent colonizers of the colonic mucosa (symbionts) to behave as pathobionts, thereby causing progressive loss of response (LOR) to immune suppression. About 50% of patients with IBD lose response to conventional, immune suppressive medications for reasons that cannot be explained by the pharmacokinetics and pharmacodynamics of the drugs. This is a major challenge faced by providers who care for patients with IBD. 

This study would evaluate for microbes that become more abundant in the feces of patients with IBD who are treated with immune suppression. This alone would represent a significant advance in the field. As proof of concept, we will then attempt to fundamentally change the intestinal environment. We will change the gut microbiota with a colonoscopy preparation, antibiotics, and an anti-fungal medication. We will allow the inflamed gastrointestinal tract a “Holiday” from gut microbes that may be perpetuating the inflammatory response. We will be studying this intervention in the sickest of IBD patients, ages 3-70, who are refractory to conventional therapies, in an attempt to “reset” the luminal environment and either treat the disease itself, or rescue response to therapy. This study could lead to new therapies for IBD and it will also advance our understanding of the gut flora in this vulnerable population.

I couldn't find anything (yet) if this short term antibiotic (very aggressive) regime is intended as a "Cure" meaning no maintenance after and why these were selected - I am hoping to find some info to see. I mean why this pattern of administering these antiobiotics in a successive way and what science was behind it, curious to see if it is similar to the whole pathogen concept like SSI and MAP. At least it is encouraging to see SOME shift -I will post whatever info I find


----------



## wildbill_52280

Scared1 said:


> Has anyone hears about this trial? I came across it it today and thought it was interesting - it is not yet recruiting and in phase 2 and last updated and entered in this month...
> 
> https://clinicaltrials.gov/ct2/show/NCT02765256


I think this is a horrible idea to give someone all these antibiotics when we already suspect the destruction of the natural microbiota to be the cause of many diseases.  If anything, they should try to select antibiotics specific to a certain group of pathogens and also try to verify the good bacteria will not be affected by the antibiotics.

 If I were to approve such a study those would be the only criteria under which something like this would be tried. Also start in mice and rats first as usual for any groups of chemicals, and only after that perhaps on only a few patients because who knows what could happen.


----------



## Scared1

wildbill_52280 said:


> I think this is a horrible idea to give someone all these antibiotics when we already suspect the destruction of the natural microbiota to be the cause of many diseases.  If anything, they should try to select antibiotics specific to a certain group of pathogens and also try to verify the good bacteria will not be affected by the antibiotics.
> 
> If I were to approve such a study those would be the only criteria under which something like this would be tried. Also start in mice and rats first as usual for any groups of chemicals, and only after that perhaps on only a few patients because who knows what could happen.


I wouldn't rule it out - I mean, I am just curious to see what the reasoning is - perhaps they are trying to aggressively kill of the bad bacteria and these antibiotics were selected for a reason - too soon to tell. At least they are trying to look at the CAUSE as opposed to another symptom focused treatment. I do think that this is a step in the right direction from that regards, whether or not the reasoning is as sound right now - I can't tell, too premature without further data. I always check those clinical trials - I like to see what the status is and it gives you a nice overview.  Interesting, I was looking at historical archives of PUD (Peptic Ulcer Disease) and here is some clips I found in scientific articles at the time (this is an article from 1985):

"Genetic factors appear to play a role and a polygenic mode of inheritance has been proposed. Emotional factors also seem to be important. Children with peptic ulcer disease tend to be of above-average intelligence, are often overachievers who have trouble dealing with frustation, and tend to internalize their feelings. Hydrochloric acid has traditionally been implicated in the pathogenesis of peptic ulcer and most therapies are directed at either "neutralizing" acid or blocking its secretion. Recently, local factors such as gastric mucus, alkaline secretion by the gastric mucosal cells, gastric blood flow, and prostaglandins have been shown to be important in local tissue resistance to acid and to digestive enzymes. The diagnosis of peptic ulcer disease depends on a high index of suspicion. Although pain is the most common symptom, there is no typical or characteristic pattern. Nausea and vomiting may also occur in conjunction with the pain."

I can't help but notice the similarities with that and how Crohn's is being looked at - i.e. genetic implications, treating the symptoms, etc...Just thought it was interesting because it seems to be history may be repeating itself. I am just glad I am seeing more and more related to treatment of actual disease rather than the manifestations of the disease - if the MAP vaccine works and SSI works - then I would push for my husband to do both treatments, honestly, because I am sure there may be more than one pathogen or maybe just one (either way), going that route makes a world of a different then living on what medication can I use next as I get worse and worse....and after reading everyone's stories on these forums, it breaks my heart all the time and hope it doesn't always have to be this way....


----------



## irishgal

I at least like that they are moving away from immunosuppresives! I kind of agree partly with Wildbill, in that I'd be curious to see which microbes they're targeting and with what meds. I worry about damaging things with AMAT, but at least I know I am specifically targeting something that I have tested culture positive for. It's likely killing more, and I may be on to fecal transplants after AMAT, but since I feel so well and that has corresponded with a large drop in my mycobacteria culture load, I deal. I still think some of this microbiota research, while super interesting, is destracting to the debate of MAP. Wish they'd just fund the full MAP research and give us proof once and for all! Then we can move on to looking for other harmful pathogens.


----------



## Scared1

I definitely agree Irishgirl - it is aggressive, yet I wonder why they got the funding?! I mean, you would think that if something like this can get the funding to do proof of concept and the initial trials, I am sure the evidence behind MAP is more convincing to warrant some financial backing to put this to bed. I read somewhere on the post that MAP has been suspected for way too long and it hasn't been proven conclusively yet as a cause for Crohn's and that should mean that it isn't cause otherwise, everyone would be on board. I honestly took that to mean well this must mean they HAVEN'T been able to prove conclusively it DOESN'T and so it remains a possibility, which to me, warrants some serious research investment.


----------



## wildbill_52280

irishgal said:


> I at least like that they are moving away from immunosuppresives! I kind of agree partly with Wildbill, in that I'd be curious to see which microbes they're targeting and with what meds. I worry about damaging things with AMAT, but at least I know I am specifically targeting something that I have tested culture positive for. It's likely killing more, and I may be on to fecal transplants after AMAT, but since I feel so well and that has corresponded with a large drop in my mycobacteria culture load, I deal. I still think some of this microbiota research, while super interesting, is destracting to the debate of MAP. Wish they'd just fund the full MAP research and give us proof once and for all! Then we can move on to looking for other harmful pathogens.


The topics of Map and the microbiome are not that much different. One of the main purposes of the natural bacteria(microbiome) in our guts is to defend against pathogens, like MAP.  This defense provided by the good bacteria is called colonization resistance, the creation of short chain fattys acids is one main purpose of the bacteria when they ferment fiber from our food. This lowers intestinal PH to inhibit pathogens. other molecules are created as well like antibacterials AKA biocins. So theoretically the main cause could be a damaged microbiome that could allow map to persist in the gut.


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## wildbill_52280

This is actually from an older article written july 2014, even though FMT has progressed or likely will progress to a pill form, I thought this was still interesting, and I wonder if this device is still in development in China.



> FMT: Quality Control and Feasibility
> It would be ideal to standardize FMT. If the purification of fecal microbiota
> can be technically controlled it might be more available; otherwise
> its application in the world would be restricted by health policy if there is
> no quality control. The best solution for this problem
> is to allow the procedures to be performed automatically with
> machines, GenFMTer. The latest news, from my team cooperating with
> Dr. Youquan Zhao and Dr. Huiquan Wang at Tianjin University Precision
> Instrument College in China, is the successful development of a new
> automatic system for purification of fecal microbiota from fresh feces. This
> will advance the standardized FMT from a bio-safety cabinet to automatic
> instruments. The operator only needs to press the buttons related to the
> designated processes and all procedures can be done in less than a half
> an hour. Since we do not know the changing of fecal viable organism after
> the feces is expulsed from the colon, it may be the best way to transplant
> those microbiota back to the gut as soon as possible.


http://www.worldgastroenterology.org/UserFiles/file/e-wgn/e-wgn-2014-july.pdf


----------



## wildbill_52280

Here is an older article/Interview from Jan 2015 of a researcher who conducted one of the most amazing and successful studies on FMT.  

http://www.gutmicrobiotaforhealth.c...isease-with-fecal-microbiota-transplantation/


----------



## wildbill_52280

Fecal Transplants Effective for Healing Ulcerative Colitis. 
http://www.hcplive.com/medical-news...aling-ulcerative-colitis#sthash.t9Rh7MHz.dpuf


----------



## eleanor_rigby

Is there any role for this in small bowel Crohn's disease?


----------



## wildbill_52280

Vedanta biosciences gets 50 million to continue developing Fecal transplant pills for IBD and other health conditions.

http://www.forbes.com/sites/luketim...ionally-defined-bugs-into-drugs/#64702ff46e03


----------



## Scared1

wildbill_52280 said:


> Vedanta biosciences gets 50 million to continue developing Fecal transplant pills for IBD and other health conditions.
> 
> http://www.forbes.com/sites/luketim...ionally-defined-bugs-into-drugs/#64702ff46e03


Thanks! This is encouraging - I don't know if its me because I have just been looking into this since April (my husband's diagnosis), but it seems a lot has been going on with research regarding IBDs in general. Sorry if this is a stupid question - but for those that have had Crohn's for a long time (10+), how do you feel that research has changed and/or GI's methods personally during your treatments? My husband's GI made a statement that when he started practice, there were no options and through his lifetime, he has seen so many changes....so I wonder from your guy's perspective, have you always seen this much research/interest in this area or is this just me having been involved now in this disease that it SEEMS that way?


----------



## ppk

Fecal transplants can be used to clear antibiotic-resistant bacteria out of the gut:

Colonization of the gastrointestinal tract with multidrug-resistant (MDR) bacteria is a consequence of gut dysbiosis. We describe the successful utilization of fecal microbiota transplantation to inhibit Klebsiella pneumoniae MBL+ and Escherichia coli ESBL+ gut colonization in the immunocompromised host as a novel tool in the battle against MDR microorganisms.

http://link.springer.com/article/10.1007/s00005-016-0387-9


----------



## Scared1

ppk said:


> Fecal transplants can be used to clear antibiotic-resistant bacteria out of the gut:
> 
> Colonization of the gastrointestinal tract with multidrug-resistant (MDR) bacteria is a consequence of gut dysbiosis. We describe the successful utilization of fecal microbiota transplantation to inhibit Klebsiella pneumoniae MBL+ and Escherichia coli ESBL+ gut colonization in the immunocompromised host as a novel tool in the battle against MDR microorganisms.
> 
> http://link.springer.com/article/10.1007/s00005-016-0387-9


Thanks for the article! Its time like this I love this forum - sharing knowledge and at the same time hope based on actual evidence Thank you!


----------



## Scared1

Hi ppk,
Upon my first skimming of the article this seems very interesting - will need to -re-read and digest. But honestly, I do think that with any treatment down the line - any of the vaccine initiatives (MAP, SSI for AEIC, and some of the pending trials about using antibiotics directed at AEIC), that fecal transplants will be a part of the therapy to a cure. I do believe that antibiotics could lead to the dysbiosis - my husband was on antibiotics for three years (minocycline, and prior those three years, another few years of accutane), so I do believe that contributed. He may have the genetic predisposition but no one in his entire family has every had crohn's - so he would be the first. So at a certain point, I think this fecal transplant will become more of a standard treatment down the line (complimenting other therapies as well).


----------



## irishgal

Scared - you know Accutane is linked to Crohn's. Not sure of the exact mechanism, but about a year ago I saw the research and it was crazy. There was a class action lawsuit and all. Bad stuff with Accutane and Crohn's.


----------



## Scared1

Hi Irishgirl, yeah - I had heard about it and need to look into the exact mechanism. Its weird - I mean what doctor kept prescribing it to him for YEARS and he never questioned it, his first comment when I told him it was dangerous was - well the doctor said it was ok so I trusted him...:-|


----------



## irishgal

Pretty typical of docs involvement in Big Pharma! They take them at their word, which is really a shame that they can't. I've found, especially with GIs, that they really minimize the side effects of everything. I've been told on three different occasions that the black box warning (for three different meds) was really not a big deal. More technical details than anything else. In one instance, it was for a med for my three year old child!! For God's sake, even the FDA, which I think does a terrible job on many things, thought it wise to put a black box warning on it. Don't tell me there's no risk!

I was never able to connect the mechanism of Accutane/CD to what I knew of MAP. Maybe it's a dysbiosis thing that acts as a trigger.


----------



## wildbill_52280

Scared1 said:


> Hi ppk,
> Upon my first skimming of the article this seems very interesting - will need to -re-read and digest. But honestly, I do think that with any treatment down the line - any of the vaccine initiatives (MAP, SSI for AEIC, and some of the pending trials about using antibiotics directed at AEIC), that fecal transplants will be a part of the therapy to a cure. I do believe that antibiotics could lead to the dysbiosis - my husband was on antibiotics for three years (minocycline, and prior those three years, another few years of accutane), so I do believe that contributed. He may have the genetic predisposition but no one in his entire family has every had crohn's - so he would be the first. So at a certain point, I think this fecal transplant will become more of a standard treatment down the line (complimenting other therapies as well).


 I also took antibiotics for years for acne, I never went ahead with accutane though because I read on forums of people taking 3-6 courses and still having acne I decided doctors don't fully understand this disease, and when I eliminated milk and reduced sugar and other dietary improvements my skin improved. But it was learning about the emerging studies on antibiotics and IBD that I made the connection the years of doxycycline most likely contributed to Crohn's diagnoses. Below is a link to one of many studies that show a connection. This study was also done to explore the theory that antibiotics were a confounding(hidden) variable which made the studies connecting accutane use to IBD and that the real culprit is antibiotics not accutane because almost everyone who had been on accutane already were given lots of antibiotics by their dermatologist.
*


Potential association between the oral tetracycline class of antimicrobials used to treat acne and inflammatory bowel disease.*
http://www.ncbi.nlm.nih.gov/pubmed/20700115

 It is a very good scientific hypothesis that we have eliminated beneficial bacteria somehow and that their restoration from a healthy person will correct the IBD disease process permanently.


----------



## Scared1

Thanks Wildbill,
You know I wonder - the various types of Crohn's (and i am not referring to the 5 types they have) but you know, the spectrum of mild, moderate, etc...each with its own manifestations and so on and progression (i.e. some progress, some don't) if that could be stratified like drug-induced Crohn's, or certain mutations based Crohn's, etc....have you come across any articles that attempt to at least stratify the types of crohn's and associated dysbiosis based on genetics, drug use, etc...some sort of stratification? The sheer variability of this disease makes it such a trial and error issue - which is probably one of the most annoying things about it. I wonder if anyone has tried to research this at least for treatment recommendation's sake...


----------



## xeridea

Scared1 said:


> Thanks Wildbill,
> You know I wonder - the various types of Crohn's (and i am not referring to the 5 types they have) but you know, the spectrum of mild, moderate, etc...each with its own manifestations and so on and progression (i.e. some progress, some don't) if that could be stratified like drug-induced Crohn's, or certain mutations based Crohn's, etc....have you come across any articles that attempt to at least stratify the types of crohn's and associated dysbiosis based on genetics, drug use, etc...some sort of stratification? The sheer variability of this disease makes it such a trial and error issue - which is probably one of the most annoying things about it. I wonder if anyone has tried to research this at least for treatment recommendation's sake...


This here touches on the topic you mention, and it has a lot of good references to related papers.


----------



## wildbill_52280

Scared1 said:


> Thanks Wildbill,
> You know I wonder - the various types of Crohn's (and i am not referring to the 5 types they have) but you know, the spectrum of mild, moderate, etc...each with its own manifestations and so on and progression (i.e. some progress, some don't) if that could be stratified like drug-induced Crohn's, or certain mutations based Crohn's, etc....have you come across any articles that attempt to at least stratify the types of crohn's and associated dysbiosis based on genetics, drug use, etc...some sort of stratification? The sheer variability of this disease makes it such a trial and error issue - which is probably one of the most annoying things about it. I wonder if anyone has tried to research this at least for treatment recommendation's sake...


I don't recall there being 5 types of crohn's but levels of severity sure, but I have read studies which say they could classify the disease into different types in the future. I dont think we are at the point where we know exactly what causes what type or severity, because there are still so many factors that can cause IBD. Like vitamin d, dietary fiber, antibiotics, artificial sweeteners, animal fat, omega 6 fats, etc, and any combination of the above, but i think they will be able to classify the types by the bacterial makeup. If you looked hard enough and collected most of the latest studies you might be able to piece some of that information together, but I'm pretty sure we don't have enough studies yet, getting closer though.


----------



## wildbill_52280

Here is a really old study i forgot about that is like a super risky form of a fecal transplant.
They tried to eliminate as much gut bacteria as they could and repopulate the IBD patients gut with just a few good bacteria. Apparently it seemed to help.

http://www.currenttherapeuticres.com/article/S0011-393X(97)80067-7/pdf


----------



## Scared1

wildbill_52280 said:


> Here is a really old study i forgot about that is like a super risky form of a fecal transplant.
> They tried to eliminate as much gut bacteria as they could and repopulate the IBD patients gut with just a few good bacteria. Apparently it seemed to help.
> 
> http://www.currenttherapeuticres.com/article/S0011-393X(97)80067-7/pdf


Thanks for the article! I do think that FT are going to be a piece of the puzzle - the more I think about this dysbiosis caused by whatever the underlying reason in immune deficient hosts (i.e. my husband) due to antibiotics, a pathogen, etc.... I think once that underlying cause is gone - i.e. pathogen, then they would need to replenish or repopulate the microbiome and FT would be the way to go about it. For my husband, I think he would prefer a FT every 2 years rather than daily pills, symptoms, etc....that would be much a more ideal maintenance regime than many of the medications and their potential side effects.


----------



## Scared1

Here is an interesting article summary from this year - very recent entitled:

Fecal transplantation: any real hope for inflammatory bowel disease?

Purpose of review: Fecal microbiota transplant (FMT) has emerged as an important treatment for antibiotic resistant or recurrent Clostridium difficile infection. There has been a great deal of media coverage of the efficacy of FMT, and patients with inflammatory bowel disease (IBD) understandably wonder if this approach would also work for them. There are also instructions on ‘do it yourself’ FMT therapy on the web. It is important to understand whether there is evidence that this approach is effective in IBD so that we can advise our patients appropriately.

Recent findings: Systematic reviews have identified four case series involving 27 ulcerative colitis patients with a pooled remission rate of 24% (95% confidence interval (CI) = 11–45%). Two randomized controlled trials evaluating a total of 123 active ulcerative colitis patients have given conflicting results but the pooled data do suggest benefit with a number needed to treat of 6 (95% CI = 3–33). There are four case series involving 38 patients with Crohn's disease with a clinical response in 60.5% (95% CI = 28–86%). There are no randomized trials in Crohn's disease.

Summary: At present there are insufficient data to recommend FMT in IBD, and patients certainly should not be administering this themselves. This remains an interesting approach to treating IBD and more studies are needed to establish the optimal method of delivery as well as randomized, placebo controlled trials to establish the efficacy of FMT.


----------



## wildbill_52280

Scared1 said:


> Here is an interesting article summary from this year - very recent entitled:
> 
> Fecal transplantation: any real hope for inflammatory bowel disease?
> 
> Purpose of review: Fecal microbiota transplant (FMT) has emerged as an important treatment for antibiotic resistant or recurrent Clostridium difficile infection. There has been a great deal of media coverage of the efficacy of FMT, and patients with inflammatory bowel disease (IBD) understandably wonder if this approach would also work for them. There are also instructions on ‘do it yourself’ FMT therapy on the web. It is important to understand whether there is evidence that this approach is effective in IBD so that we can advise our patients appropriately.
> 
> Recent findings: Systematic reviews have identified four case series involving 27 ulcerative colitis patients with a pooled remission rate of 24% (95% confidence interval (CI) = 11–45%). Two randomized controlled trials evaluating a total of 123 active ulcerative colitis patients have given conflicting results but the pooled data do suggest benefit with a number needed to treat of 6 (95% CI = 3–33). There are four case series involving 38 patients with Crohn's disease with a clinical response in 60.5% (95% CI = 28–86%). There are no randomized trials in Crohn's disease.
> 
> Summary: At present there are insufficient data to recommend FMT in IBD, and patients certainly should not be administering this themselves. This remains an interesting approach to treating IBD and more studies are needed to establish the optimal method of delivery as well as randomized, placebo controlled trials to establish the efficacy of FMT.


This is true, the research has a way to go yet. Doing it yourself requires an understanding of the process and the risks involved. But there is even an FMT recently done by professionals that went wrong because they didn't follow proper donor selection criteria, http://ofid.oxfordjournals.org/content/2/1/ofv004.full

 So it doesn't matter who you are, even professionals mess things up. And anyone who properly educates themselves can consider themselves an educated professional and do an FMT safely, that's initially what this thread was all about when I started it. Even when taking every precaution there are unknown risks involved, it's just so new. But lots of animals naturally eat feces with seemingly no harm whatsoever, and actually their life depends on it.

https://www.youtube.com/watch?v=TrqRYSvfwhQ
http://www.bbc.co.uk/nature/adaptations/Coprophagia#p0097kyl


----------



## Scipio

Scared1 said:


> Thanks Wildbill,
> You know I wonder - the various types of Crohn's (and i am not referring to the 5 types they have) but you know, the spectrum of mild, moderate, etc...each with its own manifestations and so on and progression (i.e. some progress, some don't) if that could be stratified like drug-induced Crohn's, or certain mutations based Crohn's, etc....have you come across any articles that attempt to at least stratify the types of crohn's and associated dysbiosis based on genetics, drug use, etc...some sort of stratification?


Yes, there is an interesting and very recent publication on this very question, although they looked in terms of gene expression across all of IBD and not just Crohn's.  And they found that IBD really consists of three distinct diseases instead of the usual two.  Instead of the usual CD/UC breakdown, their genetic data indicates that IBD should really be classified as either UC, or Colonic Crohn's, or Ileal Crohn's.  

They also rank these three in terms of progression of severity over time with UC being the mildest and Ileal Crohn's being the most aggressive, which bad news for me since I have ileal Crohn's.

The paper is here:  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4714968/pdf/main.pdf


----------



## xeridea

Fecal transplants are a bit of a paradox to me in regards to Crohn's. And I'm talking about small bowel disease. The small intestine bacterial density is orders of magnitude less than the large bowel composition. The species are markedly different as well. Upper small bowel are primarily gram-positive aerobes. At the terminal ileum the composition transitions more toward a 50/50 areobes/anaerobes, and in the colon (large intestine), the bacterial diversity explodes with anaerobes. It seems at odds with nature's design to introduce fecal species into the upper gut. She wouldn't have spent millions of years evolving the the illececal valve in vertabrae if she didn't mind the mixing of small and large bowel contents. Most animals don't go around eating each other's poops.

I'll apologize in advance if my views don't align with yours. Just saying FMT may have therapeutic value for disease in the large bowel, which doesn't really cover Crohn's spectrum completely.


----------



## Scipio

Xeridea - the points you raise are good ones, which is why much of the research into FMT is focused on UC rather than Crohn's.  There is such a thing as colonic Crohn's of course.  And FMT may still be able to help to some degree in the small bowel, so it's worth a try as far as research is concerned.  But like other therapies it may not prove the be a cure-all for all IBD.


----------



## wildbill_52280

xeridea said:


> Fecal transplants are a bit of a paradox to me in regards to Crohn's. And I'm talking about small bowel disease. The small intestine bacterial density is orders of magnitude less than the large bowel composition. The species are markedly different as well. Upper small bowel are primarily gram-positive aerobes. At the terminal ileum the composition transitions more toward a 50/50 areobes/anaerobes, and in the colon (large intestine), the bacterial diversity explodes with anaerobes. It seems at odds with nature's design to introduce fecal species into the upper gut. She wouldn't have spent millions of years evolving the the illececal valve in vertabrae if she didn't mind the mixing of small and large bowel contents. Most animals don't go around eating each other's poops.
> 
> I'll apologize in advance if my views don't align with yours. Just saying FMT may have therapeutic value for disease in the large bowel, which doesn't really cover Crohn's spectrum completely.


All good theory aside, the most dramatic and effective FMT's performed to date have been through a nasogastric tube and this was in crohn's disease, in some cases just one fmt makes a big difference. FMT enemas or through colonoscope have been labor intensive and take a long time like 30-60 enemas.

The underlying universal concept here with FMT is all these intestinal disease's may develop from a lack of diversity/extinction in beneficial microbes. So regardless of the specific's of which bacteria are missing and what pathogens moved in and what genetic differences the person has, when you restore the good bacteria, everything could normalize. For the most part the scientific evidence we have supports this theory so far. 

Also if the ileum is before the ileocecal valve and you claim nature intends on keeping the contents of the large intestine absolutly seperate, then how should an enema reliably reach the affected ileum of a crohn's patient? An oral FMT would have much better luck at treating every inch of the intestine large and small.


----------



## wildbill_52280

Fecal Microbiota Transplantation for Ulcerative Colitis: A Systematic Review and Meta-Analysis
Published: June 13, 2016 
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0157259#pone.0157259.ref016

Abstract

Background
Fecal microbiota transplantation (FMT) has been recognized as a novel treatment for ulcerative colitis (UC). However, its efficacy and safety remain unclear.

Objective
We conducted this systematic review to assess the efficacy and safety of FMT in UC.

Results
Twenty five studies (2 randomized controlled trials, 15 cohort studies, and 8 case studies) with 234 UC patients were included. Overall, 41.58% (84/202) patients achieved clinical remission (CR) and 65.28% (126/193) achieved clinical response. Among the cohort studies, the pooled estimate of patients who achieved CR and clinical response were 40.5% (95% CI 24.7%-58.7%), and 66.1% (95% CI 43.7%-83.0%). Most adverse events were slight and self-resolving. The analyses of gut microbiota in 7 studies showed that FMT could increase microbiota diversity and richness, similarity, and certain change of bacterial composition.

Conclusion
FMT provides a promising effect for UC with few adverse events. Successful FMT may be associated with an increase in microbiota diversity and richness, similarity, and certain change of bacterial composition.


----------



## wildbill_52280

xeridea said:


> Most animals don't go around eating each other's poops.


You may find this interesting.



> Buffington next tested whether the specific differences in the microbiome were causative factors underlying the social impairments in offspring of mothers fed a high-fat diet. Because mice eat each other's poop, the researchers housed the animals together so that they would acquire microbiota from their cagemates. When socially impaired three-week-old mice born to mothers on a high-fat diet were paired with normal mice, a full restoration of the gut microbiome and a concurrent improvement in behavior was observed within four weeks.


http://www.eurekalert.org/pub_releases/2016-06/bcom-ass061516.php


----------



## Scared1

A study going on - not sure if this was completed and if any results were posted somewhere?

https://clinicaltrials.gov/ct2/show/NCT02097797?term=crohn's+fecal&rank=1


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## wildbill_52280

Scared1 said:


> A study going on - not sure if this was completed and if any results were posted somewhere?
> 
> https://clinicaltrials.gov/ct2/show/NCT02097797?term=crohn's+fecal&rank=1


Read the first post of this thread. This study is in the list of studies being done on FMT. results? not sure.


----------



## Lady Organic

Not sure if this case report has been posted before in the thread. FMT on a child failing big drugs and who was on way to colectomy. stories of this kind bring tears to me eyes... Im so happy for this child and his family, I feel so hopeful on day we could all make it...:

''Repeated fecal microbiota transplantation in a child with ulcerative colitis.''

http://www.ncbi.nlm.nih.gov/pubmed/27324973


----------



## Scared1

Lady Organic said:


> Not sure if this case report has been posted before in the thread. FMT on a child failing big drugs and who was on way to colectomy. stories of this kind bring tears to me eyes... Im so happy for this child and his family, I feel so hopeful on day we could all make it...:
> 
> ''Repeated fecal microbiota transplantation in a child with ulcerative colitis.''
> 
> http://www.ncbi.nlm.nih.gov/pubmed/27324973


Thanks for posting Lady Organic! I definitely agree - I am so happy for that family!


----------



## Lady Organic

another case report of long term disease resolved by FMT:

''Coordinated Hospital-Home Fecal Microbiota Transplantation via Percutaneous Endoscopic Cecostomy for Recurrent Steroid-Dependent Ulcerative Colitis.'':

http://www.ncbi.nlm.nih.gov/pubmed/27282271


----------



## wildbill_52280

Lady Organic said:


> Not sure if this case report has been posted before in the thread. FMT on a child failing big drugs and who was on way to colectomy. stories of this kind bring tears to me eyes... Im so happy for this child and his family, I feel so hopeful on day we could all make it...:
> 
> ''Repeated fecal microbiota transplantation in a child with ulcerative colitis.''
> 
> http://www.ncbi.nlm.nih.gov/pubmed/27324973


thanks Lady Organic, I don't think we have seen this before so this is a good contribution to this thread. There is a study that was posted before that similarly used FMT orally in 30 patients with refractory crohn's that didn't respond well to med's. Amazing stuff. http://www.ncbi.nlm.nih.gov/pubmed/25168749


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## wildbill_52280

Lady Organic said:


> another case report of long term disease resolved by FMT:
> 
> ''Coordinated Hospital-Home Fecal Microbiota Transplantation via Percutaneous Endoscopic Cecostomy for Recurrent Steroid-Dependent Ulcerative Colitis.'':
> 
> http://www.ncbi.nlm.nih.gov/pubmed/27282271


Thanks again! This is great!
I had to learn what a cecostomy was, supposedly a tube that is placed into the body to insert liquid medication into the beginning of the large intestine(cecum).


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## xeridea

I'll give it to you guys. The case for FMT in UC may be there. But it's less convincing in Crohn's. 

You all keep posting UC studies.


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## Scared1

xeridea said:


> I'll give it to you guys. The case for FMT in UC may be there. But it's less convincing in Crohn's.
> 
> You all keep posting UC studies.


I think the studies just show there is promise - perhaps more so for UC but I think for Crohn's it will serve as a complimentary therapy to the other prospective treatments out there (SSI Vaccine & MAP Vaccine/Redhill Triple Therapy). It is still nice to hear people get better though - UC or otherwise


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## wildbill_52280

An interesting video about the microbiome connection to diabetes and other diseases. 
http://www.medscape.com/viewarticle...5xjQWzmy7celdopOO+jG6s7CF3wx2Tu1U792SxywYLg==


----------



## wildbill_52280

4 new studies on FMT in IBD. 

This one is attempting to put donors and patients on a special diet, something I've been waiting to see for a while which could increase success.
https://clinicaltrials.gov/ct2/show/NCT02734589?term=fecal+transplant+ibd&rank=6
https://clinicaltrials.gov/ct2/show/NCT02335281?term=fecal+transplant+ibd&rank=5
https://clinicaltrials.gov/ct2/show/NCT02391012?term=fecal+transplant+ibd&rank=10
https://clinicaltrials.gov/ct2/show/NCT02575040?term=fecal+transplant+ibd&rank=12


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## wildbill_52280

Just an article.
http://www.bloomberg.com/news/artic...-gut-bacteria-that-actually-cure-your-disease


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## Spooky1

Ha ha, trust the Chinese to get there first, lol.


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## wildbill_52280

A new book coming out July 12.

https://www.amazon.com/Human-Superorganism-Microbiome-Revolutionizing-Pursuit/dp/1101983906

Here is an article written by the author of this book.
http://www.the-scientist.com/?articles.view/articleNo/43379/title/The-Sum-of-Our-Parts/


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## wildbill_52280

Learned about this a few years ago not sure if I ever posted it until now. It's Korean medicine made from feces. Now I'm sure the idea is not so strange given what we know about good bacteria and Fecal Microbiota Transplants. Watch the documentary at the bottom of the page.

http://busanhaps.com/poo-wine-age-old-traditional-korean-remedy/


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## wildbill_52280

I previously was informed that bacteria made up 99% of the human Microbiome and that other organisms were lower in number and lesser in their influence. Now I believe I fell victim to possible propaganda from scientists to get funding for Microbiome research!! Joking of course but here is a recent paper that talks about this in relation to Fecal Transplants. Makes me believe a real fecal transplant will still be preferable over a FMT pill with a defined set of bacteria, but FMT pill could still hold much promise and of course over time the pills would eventually include every organism you would need to restore health, its just could be 10-20 years from now. Thankfully the bacterial FMT pills are only a few years away. http://journals.plos.org/plosbiology/article/asset?id=10.1371/journal.pbio.1002503.PDF


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## wildbill_52280

> “There is no doubt that poo can save lives,” said Bordenstein. Take the case of the use of fecal transplants to treat Clostridium difficile infections. According to the literature, it has a 95 percent cure rate. “Right now fecal transplants are used as the treatment of last resort, but their effectiveness raises an important question: When will doctors start prescribing them, or some derivative, first?” Bordenstein asked.


These days, fecal transplantation is no joke
by David Salisbury | Jul. 12, 2016, 1:30 PM
http://news.vanderbilt.edu/2016/07/these-days-fecal-transplantation-is-no-joke/


----------



## wildbill_52280

Gut bacteria can cause, predict and prevent rheumatoid arthritis
https://www.sciencedaily.com/releases/2016/07/160711151315.htm


----------



## wildbill_52280

Fecal Transplants Can Be Life-Saving, but How?
http://www.nytimes.com/2016/07/15/science/fecal-transplants-bacteria-viruses.html?_r=0



> Still, it’s often hard to improve on nature. “We’ve tried for decades to make artificial blood, and we ultimately failed,” Dr. Khoruts said. “And so we still have blood banks.”
> 
> It may also prove difficult to outdo our own stool. “This is something nature put together over millions and millions of years,” Dr. Khoruts said.


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## wildbill_52280

A completed study of FMT in U.C. shows positive results over placebo. 3x as many patients reached steroid free remission and endoscopic remission compared to placebo group. They gave the patients 40 enemas for 8 weeks from multiple donors. There were some negative responses though where 2 patients became worse in FMT where 1 patient became worse in Placebo. http://www.gastroendonews.com/In-th...Fecal-Transplant-for-Ulcerative-Colitis/37001


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## xeridea

Some recent research suggests that different populations will have different gut bacteria composition due to a concept called cospeciation, that says our gut bacteria co-evolved with us,.

What I get from this is that if we get into donor bacteriotherapy, we may need to look to get them from individuals in a similar ancestral halpogroup, otherwise some species from them might get reject by our immune system.

That, he adds, could have implications for the burgeoning use of faecal transplants - often used in patients whose own gut bacteria have been suppressed with antibiotics. “It’s a very positive enterprise, but our results suggest those efforts need to consider that our bacteria are tracking our lineage.”


----------



## Scipio

A disappointing failure for the microbiome approach to controlling recurrent _C. diff. _infections.  No better than placebo and in some cases worse.  

It looks like this microbiome approach is not going ot be as quick and easy as some have predicted:

http://www.cnbc.com/2016/07/29/gut-...nge-after-microbiome-drug-fails-in-trial.html


----------



## wildbill_52280

Scipio said:


> A disappointing failure for the microbiome approach to controlling recurrent _C. diff. _infections.  No better than placebo and in some cases worse.
> 
> It looks like this microbiome approach is not going ot be as quick and easy as some have predicted:
> 
> http://www.cnbc.com/2016/07/29/gut-...nge-after-microbiome-drug-fails-in-trial.html


Thanks, I was just about to post on this. disappointing for sure. this pill from seres is just a handfull of bacteria though, spores to be precise.  As a comparison a different type of FMT pills used for c diff were "full spectrum" containing a much wider range of bacteria and were just as effective as regular fecal transplants.http://www.cleveland.com/healthfit/index.ssf/2013/10/a_canadian_doctor_is_curing_st.html 

these pills are made one by one with a centrifuge which seperates and concentrates the bacteria from other stool contents. It's actually a very simple process, but hard to gaurantee that's its free of any unknown risks, like the seres targeted approach could have been since they know exactly whats in it.


----------



## wildbill_52280

Systematic Review: Adverse Events of Fecal Microbiota Transplantation

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0161174


----------



## wildbill_52280

Vedanta biosciences issued broad patent for microbiome therapies utilizing clostridia species of bacteria. As far as I know this means any company that wants to use them for any medications must consult with them for a period of time.
http://www.kctv5.com/story/32766682...ome-therapeutics-based-on-bacterial-consortia


----------



## Scipio

wildbill_52280 said:


> Vedanta biosciences issued broad patent for microbiome therapies utilizing clostridia species of bacteria. As far as I know this means any company that wants to use them for any medications must consult with them for a period of time.
> http://www.kctv5.com/story/32766682...ome-therapeutics-based-on-bacterial-consortia


The "consultation" with Vendanta will consist almost entirely of haggling over how much the other company must pay for a license to use the technology covered by the patent.


----------



## wildbill_52280

Here is a piece of evidence that supports the concept of damage to the microbiome possibly involved in many diseases and not just C. diff or IBD, in this mouse experiment they used antibiotics to cause diabetes. http://www.nature.com/articles/nmicrobiol2016140

Restoration of the natural microbiome with a fecal microbiota transplant would likely be able to reverse this and that is the hopes we have for the upcoming experiments when applied to humans, many studies are happening right now. There are also 4 studies in the last 5 years linking antibiotics to increased risk of IBD, many of my serious health problems began 2 weeks after taking an antibiotic, within a year i was diagnosed with crohn's. I found a study on amoxicillin-clavulanic acid in human's and the effects it had on their gi microbiome, it pretty much obliterated the clostridia species, and these are the ones that are messed up in IBD, and this is the antibiotic i took right before my health seriously declined. These are also the species they are trying to use in FMT pills now. So much evidence now points to that antibiotic I took as the cause of my crohn's.


----------



## Scared1

wildbill_52280 said:


> Here is a piece of evidence that supports the concept of damage to the microbiome possibly involved in many diseases and not just C. diff or IBD, in this cases using antibiotics. http://www.nature.com/articles/nmicrobiol2016140
> 
> Restoration of the natural microbiome with a fecal microbiota transplant would likely be able to reverse this and that is the hopes we have for the upcoming experiments when applied to humans, many studies are happening right now. There are also 4 studies in the last 5 years linking antibiotics to increased risk of IBD, many of my serious health problems began 2 weeks after taking an antibiotic, within a year i was diagnosed with crohn's.


I can definitely believe that - my husband took antiobiotics (minocycline for 3-4 years before he was diagnosed), no family history, very healthy, 28 years old, never been to a doctor (literally). Plus, he is overly clean (hygiene hypothesis - not like normal clean, like obssessive). So I definitely believe that part of it.


----------



## wildbill_52280

Supposedly people in ancient Rome used animals feces as medicine. SO not just china or korea or even a few other medicinal systems, the use of feces as medicine has been around for while apparently.

https://books.google.com/books?id=z...epage&q=Pliny, Natural History 28.238&f=false


----------



## Scared1

Interesting article just came out in journal:

Any Future for Fecal Microbiota Transplantation as Treatment Strategy for Inflammatory Bowel Diseases?
Kump P, Högenauer C.
Abstract
Fecal microbiota transplantation (FMT) is a novel therapeutic procedure aiming at restoring a normal intestinal microbiota by application of fecal microorganisms from a healthy subject into the gastrointestinal tract of a patient. FMT is the most effective treatment for recurrent Clostridium difficile infections (CDI). These infections also occur in patients with inflammatory bowel diseases (IBDs), where case series demonstrated a successful treatment of CDI by FMT in 83-92% of patients. The effect of FMT on the activity of IBD has mainly been investigated in ulcerative colitis (UC) patients, including 3 randomized controlled trials. So far, 2 randomized controlled trials showed a superiority of FMT compared to placebo in inducing remission in UC, while 1 study found no significant difference to placebo. The variation in response to FMT between these studies as well as in the uncontrolled trials might be explained by many differences in the way of FMT application, patient pretreatment and patient and donor selection. The data for the use of FMT in Crohn's disease and pouchitis are sparse; currently, no conclusion can be drawn regarding the effectiveness of FMT in these indications. It needs to be noted that cases of IBD activation after FMT have been reported. So far, FMT can only be recommended to be used for the treatment of concomitant CDI in IBD in clinical practice. For treating IBD irrespective of CDI, FMT should be only used in clinical trials. Current forms of FMT, especially protocols using repeated application, are very time and personnel consuming. Future trends are the use of defined stable microbiota preparations, in particular oral preparations, which will enable better and larger controlled trails for investigating FMT in IBD.


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## wildbill_52280

More info about viruses being involved in IBD and health in general. 
http://www.npr.org/sections/health-...-viral-and-that-might-be-good-for-your-health


----------



## wantok

Another anecdote:  while I have lots of family with Crohn's and I am of Ashkenazi descent and my family environment was super-clean, my history of getting Crohn's directly follows repeatedly being given 2 week regimens of full-spectrum antibiotics for chronic urinary tract infections when I was in my 20s.


----------



## wildbill_52280

wantok said:


> Another anecdote:  while I have lots of family with Crohn's and I am of Ashkenazi descent and my family environment was super-clean, my history of getting Crohn's directly follows repeatedly being given 2 week regimens of full-spectrum antibiotics for chronic urinary tract infections when I was in my 20s.


These are studies linking antibiotics to increasing the risk of developing IBD in other words "causing" the disease.

2004
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1774910/
2010
http://www.ncbi.nlm.nih.gov/pubmed/20700115
2011
http://faculty.vet.upenn.edu/gastro/documents/Hwang12-19-11ajg2011304a.pdf
2012
http://pediatrics.aappublications.org/content/130/4/e794.full
2013
http://journals.lww.com/ibdjournal/...4_YI_Antibiotics_and_Risk_of_New_Onset.4.aspx

While It's hard to say antibiotics alone can cause IBD because many people take antibiotic's and do not develop IBD, it can depends on the type of antibiotic, how many times you have taken it, the length of time etc, and other risk factors that are present like diet etc. But when you look at all the scientific evidence that exists, damage to the microbiome and the correction of this damage with restoration of missing bacteria with Fecal transplants, you can see it all starts to come together and make more sense, maybe we are on the right track here, I believe we are.



*More evidence that suggests a link between antibiotics as a cause of IBD and destruction of microbiome:*

Antibiotic Associated Hemorrhagic Colitis: The Need to Distinguish
from Clostridium difficile Colitis!
http://www.practicalgastro.com/pdf/January09/PG_Jan09_DharmarajanArticle.pdf
(this case report strongly showing the ability of antibiotics to promote diarrhea and colitis(colonic inflammation),so to make a small analogical leap and suggest antibiotics could also cause chronic colitis such as in IBD, doesn't sound so far fetched now) 


Here is another study of someone with antibiotics associated diarrhea. Quote "Antibiotic administration was associated with distinct changes in the diversity of the gut microbiota, including a marked decrease in the prevalence of butyrate-producing bacteria." (Is it just a coincidence that IBD patients are lacking in diversity of beneficial clostridia which are butyrate producing bacteria)
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC356823/

Another study of microbiome changes during antibiotic associated diarrhea of someone taking amoxicillin-clavulanic acid. Clostridia species were so inhibited by antibiotics they undetectable, but grew back after removal of antibiotics.  (this is the antibiotic I took before my health changed in a serious way one year later I was diagnosed with crohn's disease.) 
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC356823/

Clinical onset of the Crohn's disease after eradication therapy of Helicobacteria pylori infection. Does Helicobacter pylori infection interact with natural history of inflammatory bowel diseases?(this is an anecdotal report, but i think it was the amoxicillin that cause the crohn's and certain antibiotics can make a similar pattern of bacterial changes in people? i suggest some people may recover, and some may not)
http://www.ncbi.nlm.nih.gov/pubmed/11208510


Is Crohn's disease caused by antibiotics?
http://www.ncbi.nlm.nih.gov/pubmed/7721242


----------



## Scipio

Apparently just a few days in the ICU is enough to wreck the microbiome:

http://www.medicalnewstoday.com/releases/312656.php


----------



## mf15

Here is another new one, when I was a kid back in the 50's they mostly used
penicillins and in the form of shots.
So since then they have pretty much switched from narrow spectrum to wide spectrum antibiotics. 
But even this does not quite explain the increase in IBD from say around
1920 ish.
Old Mike
http://medicalxpress.com/news/2016-09-young-children-antibiotic-exposure-higher.html


----------



## wildbill_52280

Two recent videos on FMT.
https://www.youtube.com/watch?v=yD--XThDJyE
https://www.youtube.com/watch?v=e_dF1N-Ckbw


----------



## Spooky1

Can't watch the second one as it is unavailable in the UK.  the first was interesting, thanks


----------



## wildbill_52280

As part of its international microbiome series, Global Engage is pleased to announce the co-located 4th Microbiome R&D and Business Collaboration
Forum: USA and Probiotics Congress: USA which will be held on 3-4 October 2016 at the San Diego Marriott La Jolla.

http://www.globalengage.co.uk/microbiome/MicrobiomeUSAAgenda2016.pdf


----------



## wildbill_52280

*Increased Intestinal Microbial Diversity Following Fecal Microbiota Transplant for Active Crohn's Disease.*

Inflamm Bowel Dis. 2016 Sep;22
Abstract

BACKGROUND:
The microbiota in the lumen of patients with Crohn's disease (CD) is characterized by reduced diversity, particularly Firmicutes and Bacteroidetes. It is unknown whether the introduction of the intestinal microbiota from healthy individuals could correct this dysbiosis and reverse mucosal inflammation. We investigated the response to fecal microbial transplantation (FMT) from healthy individuals to subjects with active CD.

METHODS:
We performed a prospective open-label study (uncontrolled) of FMT from healthy donors to subjects with active CD. A single FMT was performed by colonoscopy. Recipients' microbial diversity, mucosal T-cell phenotypes, and clinical and inflammatory parameters were measured over 12 weeks, and safety over 26 weeks.

RESULTS:
Nineteen subjects were treated with FMT and completed the study follow-up. Fifty-eight percent (11/19) demonstrated a clinical response (Harvey-Bradshaw Index decrease >3) following FMT. Fifteen subjects had sufficient pre/postfecal samples for analysis. A significant increase in microbial diversity occurred after FMT (P = 0.02). This was greater in clinical responders than nonresponders. Patients who experienced a clinical response demonstrated a significant shift in fecal microbial composition toward their donor's profile as assessed by the Bray-Curtis index at 4 weeks (P = 0.003). An increase in regulatory T cells (CD4CD25CD127lo) was also noted in recipients' lamina propria following FMT. No serious adverse events were noted over the 26-week study period.

CONCLUSIONS:
In this open-label study, FMT led to an expansion in microbial bacterial diversity in patients with active CD. FMT was overall safe, although the clinical response was variable. Determining donor microbial factors that influence clinical response is needed before randomized clinical trials of FMT in CD.

https://www.ncbi.nlm.nih.gov/pubmed/27542133


----------



## Malgrave

My son's diagnosis has changed from Crohn's to UC. He is cortisone dependent (at the moment on 30 mg of prednisolone per day, has been on prednisolone for 9 months now, 30-60 mg day), currently also on Humira and 75 mg of Azathpriorine, IVIG and Eusaprim antibiotics. We are considering FMT. Is he too immunocomprimised to get a FMT? Any risks for serious side effects?


----------



## wildbill_52280

Malgrave said:


> My son's diagnosis has changed from Crohn's to UC. He is cortisone dependent (at the moment on 30 mg of prednisolone per day, has been on prednisolone for 9 months now, 30-60 mg day), currently also on Humira and 75 mg of Azathpriorine, IVIG and Eusaprim antibiotics. We are considering FMT. Is he too immunocomprimised to get a FMT? Any risks for serious side effects?


As far as I recall most people who have received FMT for crohn's were refractory and failed most med's. There hasn't been much negative effects from it, some cases people who were stable went into a flare, one guy who did a home FMT with U.C. became much worse but who knows what he was doing without proper guidance. But of course, this is all early info on an experimental but promising treatment. Take the precautions of course if you DIY.


----------



## wildbill_52280

SO which came first? The dysbiosis or the inflammation? A new study shows it looks like the dysbiosis came first.
This evidence could further support the concept that dysbiosis is the first step in IBD development, and that could mean that it is also the cause of the disease itself and restoring dysbiosis with Fecal Microbiota transplant could be the cure. 



> If a dysbiosis is an instigator, then in principle it should be possible to detect this defect in otherwise healthy populations who are at increased risk for disease, such as healthy relatives of IBD patients.
> 
> In a new study published in this issue of Cellular and Molecular Gastroenterology and Hepatology, Jacobs et al 3 do exactly that. Performing a thorough analysis of fecal microbial profiles from 36 IBD patients in remission (26 with Crohn’s disease and 10 with ulcerative colitis) and 54 healthy first-degree relatives, they showed that it is possible to identify an IBD-like intestinal microbiome in at-risk healthy individuals who do not have clinically detectable inflammation.


http://www.sciencedirect.com/science/article/pii/S2352345X16301060

I also recall a study examining the microbiome in crohn's patients who were in remission and on immunosuppressant therapy, a dysbiotic state was still evident when inflammation was suppressed, suggesting that the inflammatory response is not the sole cause of a dysbiotic state. But inflammation does have a strong influence on dysbiosis, so inhibiting inflammation does improve things just doesn't seem to correct things completely, I'll have to find that study though.


----------



## Scipio

wildbill_52280 said:


> SO which came first? The dysbiosis or the inflammation?


My guess (and it's just a guess - no data) is that it's either or both.  I'm thinking the dysbiosis and the inflammation form a self-feeding loop, a vicious cycle that can start with either one.


----------



## wildbill_52280

Scipio said:


> My guess (and it's just a guess - no data) is that it's either or both.  I'm thinking the dysbiosis and the inflammation form a self-feeding loop, a vicious cycle that can start with either one.


Under what natural or semi natural circumstance would that happen though, inflammation is generally a response to bacterial threat, or tissues damage/repair, as far as I know. What circumstance could inflammation be triggered entirely independent of any changes in the microbiome? I'm not arguing any given position just thinking out out loud really. 
Generally speaking my position is that 90% of IBD cases are not genetically determined and the condition is reversible, through a FMT. Whether dysbiosis is a cause of inflammation of inflammation is a cause of dysbiosis, I would say that these questions are important because this evidence would point to the correction of the microbiome as a therapeutic strategy, rather then the prevailing paradigm of suppressing the inflammation or immune system to influence symptoms.

I would say at this point the evidence is really good to justify treating the state of dysbiosis, perhaps affecting symptoms through that variable/pathway instead, and I do believe it will lead to the cure. I really don't know what is taking so long to get these FMT pill studies for crohn's going though, the evidence has been here for a while now, we can do it now. The colonoscopic enemas and home enemas are unreliable way of studying this, we are beyond that by now.


----------



## Scipio

wildbill_52280 said:


> Under what natural or semi natural circumstance would that happen though, inflammation is generally a response to bacterial threat, or tissues damage/repair, as far as I know. What circumstance could inflammation be triggered entirely independent of any changes in the microbiome? I'm not arguing any given position just thinking out out loud really.


There are many ways the gut can become directly inflamed without first disrupting the bacterial microbiome - celiac disease, viral enteritis, NSAIDS, all sorts of autoimmune inflammation, etc.  And once inflamed the inflammation could easily result in disruption of the microbiome, which in turn could lead to more inflammation. It's a chicken and egg thing.

Successful FMT could indeed prove to be a useful tool to break this vicious cycle and restore good health, but there is no particular reason think that disruption of the microbiome is only way the process can get started in the first place.


----------



## wildbill_52280

Healing effect of fecal microbiota transplantation lasts for long
October 11, 2016
https://www.sciencedaily.com/releases/2016/10/161011085352.htm



> The researchers in the University of Helsinki and Helsinki University Hospital have studied in detail the intestinal microbiota of 14 patients treated with a faecal microbiota transplant. The patients suffered from recurrent Clostridium difficile -infection, also known as antibiotic associated diarrhea, and they had not responded to antibiotic treatment. After the faecal microbiota transplantation therapy, the patient's microbiota was followed for a year.
> 
> The researchers found out that the patient's intestinal microbiota highly resembled the donor's microbiota and this composition remained stable through-out the 1-year follow-up period.
> 
> "Our results suggest that intestinal microbiota can be modified relatively permanently. This opens new possibilities to the use this treatment for other diseases related to microbial dysbiosis," says the Academy Research Fellow Reetta Satokari from the University of Helsinki.


----------



## wildbill_52280

Tapping the Human Gut Microbiome
The Next Frontier for Novel Therapeutics
October 17, 2016

Part 1
http://www.genengnews.com/insight-and-intelligence/tapping-the-human-gut-microbiome-part-1/77900760

Part 2
http://www.genengnews.com/gen-exclusives/tapping-the-human-gut-microbiome-part-2/77900761


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## wildbill_52280

My father's poo saved my life': Woman who could not leave her bed due to her agonising chronic constipation reveals how a VERY personal transplant saved her life
October 23rd 2016


http://www.dailymail.co.uk/femail/article-3863580/Sydney-woman-receives-poo-transplant-father.html


----------



## Scared1

Great progress:
http://www.news-medical.net/news/20...tine-to-study-inflammatory-bowel-disease.aspx


----------



## wildbill_52280

ARE YOU READY TO SWALLOW A PILL FULL OF POOP?
11.02.16

https://www.wired.com/2016/11/microbiome-therapy-making-fecal-transplants-better/



> COLLEEN KELLY STARTED using fecal microbiota transplants in 2008—one of the first gastroenterologists in the US to do so. Over the years, she has noticed some strange side effects. One of her C. diff patients, for instance, also suffered from alopecia universalis. He hadn’t been able to grow any hair since he was 16: not on his head, not in his armpits, not even on his eyebrows. But when he got a stool transplant from his sister, he started sprouting fresh patches.
> 
> When Kelly told a colleague about the result, she got a second shock: He had seen a fecal transplant recipient regrow hair too. The two doctors were stuck. They didn’t have the resources to analyze their patients’ microbiomes to see what bugs might have been responsible for the change. “You don’t know how bad I wish I had that,” she says.
> 
> Tabletop robots sort through fecal samples from around the world, identify species of bacteria, and use those to grow more.
> She’s not alone. It’s becoming more and more clear that the microbiome has therapeutic potential beyond the gut. Some patients undergo significant weight changes after a transplant; others say their depression goes away. Yet doctors still can’t figure out how it works.
> 
> Which is why, in early August, the National Institutes of Health announced that it would fund a fecal transplant registry, maintained by the American Gastroenterological Association. For the first time, thousands of transplant patients will have their microbiomes sequenced before and after treatment so doctors can have a better shot at identifying not only the bugs that fight C. diff but also what’s causing all those side effects. If Kelly had access to that kind of analysis with her alopecia patient, she might have stumbled onto a new, targeted microbiome therapy—delivering just the right bacteria to trigger hair growth


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## wildbill_52280

Pectin fiber(for example from an apple)makes Fecal Transplants more effective. 
For the sake of interpreting this abstract, a lower number on the MAYO score indicates lower amount of symptoms in U.C. This was a very small study though but since good results were observed larger studies would likely be replicated in the future and anything that makes FMT more effective is a great step forward.

BMC Microbiol. 2016 Nov 3;16(1):255.
*Pectin enhances the effect of fecal microbiota transplantation in ulcerative colitis by delaying the loss of diversity of gut flora.*

Abstract

BACKGROUND:
Fecal microbiota transplantation (FMT) induces remission in ulcerative colitis (UC). However, the treatment effect of FMT diminishes over time. Maintaining the diversity of the gut flora for long periods may improve the effects of FMT in UC. Pectin, which can be fermented by gut microbiota into short-chain fatty acids, is postulated to shape the composition and maintain the balance of gut microbiota following transplantation. This study investigated whether pectin could enhance the effects of FMT in UC patients.

RESULTS:
Three FMT patients and four FMTP(FMT plus Pectin fiber) patients achieved the primary outcome. The Mayo scores of the FMTP group were lower than those of the FMT group at weeks 4 and 12 (P = 0.042 and P = 0.042, respectively). There were no differences in the diversity of the gut flora between the two groups at weeks 4 and 12; however, the composition of the gut flora of the FMTP group was more similar than the FMT group to that of the donor at all-time points post-treatment.

CONCLUSIONS:
Pectin decreased the Mayo score by preserving the diversity of the gut flora following FMT for UC.


----------



## wildbill_52280

WOW!!

Crit Care. 2016 Oct 18;20(1):332.
*Successful treatment with fecal microbiota transplantation in patients with multiple organ dysfunction syndrome and diarrhea following severe sepsis.*
Abstract
BACKGROUND:
The dysbiosis of intestinal microbiota plays an important role in the development of gut-derived infections, making it a potential therapeutic target against multiple organ dysfunction syndrome (MODS) after sepsis. However, the effectiveness of fecal microbiota transplantation (FMT) in treating this disease has been rarely investigated.

METHODS:
Two male patients, a 65-year-old and an 84-year-old, were initially diagnosed with cerebellar hemorrhage and cerebral infarction, respectively, after admission. During the course of hospitalization, both patients developed MODS, septic shock, and severe watery diarrhea. Demographic and clinical data were collected. Intestinal dysbiosis was confirmed by 16S rDNA-based molecular analysis of microbiota composition in fecal samples from the two patients. The two patients each received a single nasogastric infusion of sterile-filtered, pathogen-free feces from a healthy donor. Fecal samples were collected every two days post infusion to monitor changes in microbiota composition in response to treatment.

RESULTS:
Following FMT, MODS and severe diarrhea were alleviated in both patients. Their stool output and body temperature markedly declined and normalized. Significant modification of microbiota composition, characterized by a profound increase of commensals in the Firmicutes phylum and depletion of opportunistic organisms in the Proteobacteria phylum, was observed in both patients. Furthermore, we identified a reconstituted bacterial community enriched in Firmicutes and depleted of Proteobacteria that was associated with a decrease in the patients' fecal output and in the levels of plasma inflammation markers.

CONCLUSIONS:
The outcome of treating two patients with FMT indicates that restoration of the intestinal microbiota barrier can alleviate the infection and modulate the immune response. These findings warrant further investigation of FMT as a putative new therapy for treating microbiota-related diseases such as MODS.


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## wildbill_52280

Medicine (Baltimore). 2016 Jul;95(30):e4055. doi: 10.1097/MD.0000000000004055.

*Clinical efficacy maintains patients' positive attitudes toward fecal microbiota transplantation.*

Abstract
Few studies have been conducted on the attitudes of patients seeking fecal microbiota transplantation (FMT). This study aimed to investigate the reasons for patients with Crohn's disease (CD) seeking FMT and their attitude changes after FMT.In this prospective study, all included patients were diagnosed with CD for at least 6 months and intended to receive FMT. A questionnaire was designed to investigate the history of medical visits and patients' attitudes toward FMT. Only refractory patients who failed to clinically respond to previous treatment were selected for undergoing FMT. Three months after the first FMT, patients were required to complete the second questionnaire on attitudes toward the first FMT.A total of 207 patients with CD were included for questionnaire survey. In 118 refractory patients, 94.07% sought FMT because they had no other choice. In 89 nonrefractory patients, 78.65% sought FMT for the reason that they wanted to achieve better clinical results or even a cure, although the current treatment was effective for them. In all, 118 refractory patients received FMT. Three months after the first FMT, 88.98% (105/118) patients completed the questionnaire on patients' attitudes toward FMT. Of these 105 patients, 56.19% reported to have satisfactory clinical efficacy and 74.29% were willing to receive the second FMT. Moreover, 89.52% (94/105) showed their willingness to recommend FMT to other patients.In conclusion, this study at least first time demonstrated that patients with CD were willing to accept FMT due to its efficacy.


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## wildbill_52280

YouTube Video Published on Nov 4, 2016

Experts from the AGA Center for Gut Microbiome Research and Education share updates on one of the most important medical breakthroughs -- fecal transplants. Drs. Loren Laine, Colleen Kelly, and Gary Wu serve as co-principal investigators on AGA's new FMT national registry
https://www.youtube.com/watch?v=fAUUpP5HiFA


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## wildbill_52280

Inflamm Bowel Dis. 2016 Nov 7. [Epub ahead of print]
A Single Species of Clostridium Subcluster XIVa Decreased in Ulcerative Colitis Patients.


Abstract
BACKGROUND:
Imbalance of the intestinal microbiota is associated with gastrointestinal disease and autoimmune disease and metabolic syndrome. Analysis of the intestinal microbiota has recently progressed, and the association with inflammatory bowel disease has been reported at the species level. Such findings suggest that the recovery of homeostasis in the intestinal microbiota could cure inflammatory bowel disease. We aimed to search new probiotic candidates for inflammatory bowel disease through translational research by analysis of ulcerative colitis (UC) patients' intestinal microbiota and clarify the effects of them on inflammation. Here, we focused on Fusicatenibacter saccharivorans, which belongs to Clostridium subcluster XIVa and was successfully isolated and cultured in 2013. We analyzed the association of F. saccharivorans to UC patients' activity and inflammation for the first time.

METHODS:
Feces from UC patients and healthy controls were analyzed by 16S ribosomal RNA gene sequences. F. saccharivorans was administered to murine colitis model. Colitic lamina propria mononuclear cells from UC patients and mice were stimulated with F. saccharivorans.

RESULTS:
The whole fecal bacteria in active UC patients were less than that in quiescent UC patients. Furthermore, F. saccharivorans was decreased in active UC patients and increased in quiescent. The administration of F. saccharivorans improved murine colitis. F. saccharivorans induced interleukin 10 production by lamina propria mononuclear cells from not only colitis model mice but also UC patients.

CONCLUSIONS:
F. saccharivorans decreased in correlation to UC activity and suppresses intestinal inflammation. These results suggest that F. saccharivorans could lead to a novel UC treatment.


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## Scared1

Thank you WildBill - all these are very helpful!


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## wildbill_52280

I already posted this study but see what I highlighted here. It's nice to hear a scientific article say this straight out, it's rare to hear it but it's high probability for FMT to correct GI microbiome to be a cure for IBD, most articles talk about FMT as a treatment but cure is a real possibilty and some cases people seemed to be cured. 



wildbill_52280 said:


> Inflamm Bowel Dis. 2016 Nov 7. [Epub ahead of print]
> A Single Species of Clostridium Subcluster XIVa Decreased in Ulcerative Colitis Patients.
> 
> 
> Abstract
> BACKGROUND:
> Imbalance of the intestinal microbiota is associated with gastrointestinal disease and autoimmune disease and metabolic syndrome. Analysis of the intestinal microbiota has recently progressed, and the association with inflammatory bowel disease has been reported at the species level. *Such findings suggest that the recovery of homeostasis in the intestinal microbiota could cure inflammatory bowel disease*. We aimed to search new probiotic candidates for inflammatory bowel disease through translational research by analysis of ulcerative colitis (UC) patients' intestinal microbiota and clarify the effects of them on inflammation. Here, we focused on Fusicatenibacter saccharivorans, which belongs to Clostridium subcluster XIVa and was successfully isolated and cultured in 2013. We analyzed the association of F. saccharivorans to UC patients' activity and inflammation for the first time.
> 
> METHODS:
> Feces from UC patients and healthy controls were analyzed by 16S ribosomal RNA gene sequences. F. saccharivorans was administered to murine colitis model. Colitic lamina propria mononuclear cells from UC patients and mice were stimulated with F. saccharivorans.
> 
> RESULTS:
> The whole fecal bacteria in active UC patients were less than that in quiescent UC patients. Furthermore, F. saccharivorans was decreased in active UC patients and increased in quiescent. The administration of F. saccharivorans improved murine colitis. F. saccharivorans induced interleukin 10 production by lamina propria mononuclear cells from not only colitis model mice but also UC patients.
> 
> CONCLUSIONS:
> F. saccharivorans decreased in correlation to UC activity and suppresses intestinal inflammation. These results suggest that F. saccharivorans could lead to a novel UC treatment.


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## wildbill_52280

new video made about FMT.
https://www.youtube.com/watch?v=eXH3NtEBFe0


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## wildbill_52280

New video on FMT.
https://www.youtube.com/watch?v=eXH3NtEBFe0


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## Alliesavage

I've researched the fecal transplant and don't think I could do it. Probiotics are very helpful. Even if someone seems healthy they could still carry unknown pathogens or parasites. Not only is the idea gross but the risk is incredible.


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## wildbill_52280

Alliesavage said:


> I've researched the fecal transplant and don't think I could do it. Probiotics are very helpful. Even if someone seems healthy they could still carry unknown pathogens or parasites. Not only is the idea gross but the risk is incredible.


Yes some risks exist, so far studies have shown its pretty safe. I think it's been done at least 1000 times for C. diff infection, very few problems but some events like people developing new autoimmune disease have occured as well as some diseases like parkinsons and multiple sclerosis improving. None of them clearly related to the fecal transplant. This is why screening and knowing your donor is super important. Without a doubt, you just cant choose any random person to become a donor, they have to be very healthy. By way of comparison antibiotics are now known to be very destructive to the microbiome causing 80% of c. difficile cases which can lead to death, but we currently call this "medicine" which is actually is in many cases. Despite these known risks, doctors continue to prescribe them.


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## wildbill_52280

Alliesavage said:


> I've researched the fecal transplant and don't think I could do it. Probiotics are very helpful. Even if someone seems healthy they could still carry unknown pathogens or parasites. Not only is the idea gross but the risk is incredible.


A Video from a professor who studies FMT and his opinion on FMT safety.
https://www.youtube.com/watch?v=ot7e9bQO2U8


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## wildbill_52280

Here is my article/blog on Fecal Microbiota Transplant and its use for IBD. It is a more condensed version of the information on this thread.
http://fecaltransplant2015.blogspot.com/2014/09/transplants-effective-for-ibd-fecal.html


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## wildbill_52280

Women had a FMT in 2011 via colonoscopy and claims she is still in remission with no meds to this day. She is one of the lucky ones I guess. If your donor has good stool and the procedure is done well then this is one possible scenario, but always seemed less likely to achieve these results with colonoscopic method rather then enema or nasogastric tube, but i guess it can happen.

http://www.healingwell.com/community/default.aspx?f=38&m=3757835


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## wildbill_52280

wildbill_52280 said:


> Women had a FMT in 2011 via colonoscopy and claims she is still in remission with no meds to this day. She is one of the lucky ones I guess. If your donor has good stool and the procedure is done well then this is one possible scenario, but always seemed less likely to achieve these results with colonoscopic method rather then enema or nasogastric tube, but i guess it can happen.
> 
> http://www.healingwell.com/community/default.aspx?f=38&m=3757835


One other thing, I think this was before the regulations on FMT became really strict. Could you imagine there was a time when doctors could have done this to people with IBD 4 years ago? Only after the procedure was shown to be so effective for c diff was when they restricted access to it, it's kind of strange if you ask me. I vaguely recall its use was restricted because now that it was shown to be so good for treat c diff, they MUST protect people who will want to try it, which doesn't make much sense. I would think if it was shown to be so dangerous they would then restrict it for safety reasons and that was never the case so I believe it was restricted mainly for business reasons. Either way the DIY Fecal Transplant was what this thread was always about and maybe now i recall what motivated me to do it, the idea that something so promising had been ignored and misunderstood for a while and then restricted. 3 .5 years after I started this thread and a few good examples of success in IBD, we are still waiting to gain access to this  treatment. But I do agree more research needs to be done to learn how to perform a successfull FMT in IBD, It's still a little hard to understand why it's taking so long when stool/bacteria is free and everywhere. Maybe its 150 years of believing bad bacteria is the sole cause of disease that has slowed things down, when we now see many bacteria are good and essential for health.


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## wildbill_52280

Microbiota: Reseeding the gut
Liam Drew
Nature 540, S109–S112 (22 December 2016) doi:10.1038/540S109a
Published online 21 December 2016

http://www.nature.com/nature/journal/v540/n7634_supp/full/540S109a.html


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## wildbill_52280

Openbiome has a full spectrum Fecal Transplant Pill. http://www.openbiome.org/fmtcapsules

These pills are not available to the public, but it would be nice to gain access for IBD studies or personal use as some of us are convinced it could cure us.
Openbiome is a stool bank which provides frozen stool samples to clinics around the USA for the use of performing a Fecal Microbiota Transplant, mainly for C. difficle because FMT is only approved for the use of that condition as of date. A recent trial of a small bacteria selection in an FMT pill failed for C. difficle, so a full spectrum pill is likely more promising and actually has been effective as a regular FMT for C diff in one study.


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## Scipio

Good overview of the state of FMT for IBD recently published in _Nature_:

http://www.nature.com/nature/journal/v540/n7634_supp/pdf/540S109a.pdf


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## wildbill_52280

Minor correction on this, they may be using the FMT pill form openbiome I was under the impression it was a room temp stable rather then frozen, open biome pill is frozen so this study may be using openbiome's pill.



> Viability: 6 months at -20°C; 12 months at -80°C


 so you can keep it in a standard freezer for up to 6 months.
http://www.openbiome.org/treatment-information/


Just found this study in Boston, Massachusets, USA using Fecal Transplant pills for the treatment of IBD. They are not recruiting patients yet, I wonder why? either way its pretty cool and this is the second mention of FMT pill study in IBD. Been waiting for this like 3-4 years now. i dont think they are using the pills from openbiome though. https://clinicaltrials.gov/ct2/show/NCT02330211?term=fecal+microbiota+transplant&rank=5


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## wildbill_52280

This study is recruiting patients for UC and using a FMT pill.

https://clinicaltrials.gov/ct2/show/NCT02330653?term=fecal+microbiota+transplant&rank=6


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## Scipio

Interesting new trial is now recruiting at one site in the UK:

https://clinicaltrials.gov/ct2/show/NCT02998190?term=EB8018&rank=1

Trial description:

"Crohn's Disease is a chronic inflammatory disease of the gastrointestinal tract. Emerging evidence suggests that the microbiome plays an important role in triggering an abnormal mucosal immune response in patients with Crohn's Disease. Independent studies have demonstrated an imbalance of the microbiome with a significant increase of E coli with invasive properties, termed adherent-invasive E coli (AIEC). These AIEC bacteria attach to the gut wall of susceptible patients via the fimbrial adhesion protein FimH, and subsequently trigger inflammation by invading and proliferating within the gut wall. EB8018 is an oral small molecule that is designed to block FimH thereby preventing the entry of AIEC into the gut wall thereby disarming the bacteria without disrupting the gut microbiome."


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## wildbill_52280

A clinical trial recruiting for IBS using FMT pills.

https://clinicaltrials.gov/ct2/show/NCT02328547?term=ibs+fecal&rank=4


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## wildbill_52280

Rebiotix supposedly is testing a new FMT pill in C diff that is shelf stable and doesn't have to be frozen. http://www.rebiotix.com/clinical-trials/rbx7455-oral-c-diff-prevention/ 

http://tcbmag.com/News/Recent-News/2017/January/Rebiotix-Mayo-Team-Up-To-Test-Orally-Administered


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## wildbill_52280

Not related to IBD but FMT study has been done on autism with positive results.

https://news.osu.edu/news/2017/01/23/yes/


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## wildbill_52280

AMazing!! Here is an interview of researchers who did  the Fecal Microbiota Transplant study in Autism. They gave daily doses of FMT pills and not only did the patients acquire the donors bacteria, they were able to recruit new bacteria from there environment. So it seems the more your microbiome is restored, the better it is at selecting new bacteria from the environment to add the the community. Which also seems to explain why only  a few FMT doses have little effect on IBD. 

https://www.youtube.com/watch?v=3N4nZ26aw8Y


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## Scipio

Randomized placebo-controlled research announced at the current ECCO meeting shows significant benefit for FMT in UC patients using multi-donor transplant:

https://www.ecco-ibd.eu/index.php/p...-randomised-placebo-controlledx00a0trial.html


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## wildbill_52280

Scipio said:


> Randomized placebo-controlled research announced at the current ECCO meeting shows significant benefit for FMT in UC patients using multi-donor transplant:
> 
> https://www.ecco-ibd.eu/index.php/p...-randomised-placebo-controlledx00a0trial.html


this study did show greater benefit of FMT compared placebo which is great, and I recall this report by Doctor Borody where they used 3 donors for FMT in Crohn's where the woman seemed completely cured 13 years later. 



> "When Professor Borody offered this chance of a cure I thought: what if it works?" she said.
> 
> "They put a nasal tube down into my small intestine. I had three donors - about 950 mils -  and all up it took about five hours."


http://www.abc.net.au/news/2014-03-18/sydney-doctor-claims-poo-transplants-curing-diseases/5329836


the day when we get consistent results is hopefully around the corner now that openbiome is manufacturing FMT pills, but i would have hoped this UC study would have more effective using mutiple donors, but there are perhaps other variables to each experiment that aren't listed which would help further explain why one protocol would be more effective over the other.


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## wildbill_52280

Here is more evidence of antibiotics negative effect on the Microbiome.

"Our study shows that the C difficile epidemic was an unintended consequence of intensive use of an antibiotic class, fluoroquinolones, and control was achieved by specifically reducing use of this antibiotic class, because only the C difficile bugs that were resistant to fluoroquinolones went away," Crook explained. "Reducing the type of antibiotics like ciprofloxacin was, therefore, the best way of stopping this national epidemic of C difficile, and routine, expensive deep cleaning was unnecessary."

http://www.infectiousdiseaseadvisor...resulted-in-cdi-decline-in-uk/article/634329/


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## wildbill_52280

Really making some progress on FMT pills!! Just waiting for them to be used in IBD!



> For the study, UTHealth and Kelsey Research Foundation investigators enrolled 72 patients who had at least three bouts of recurrent C-diff in a clinical trial and treated them with either fresh, frozen or freeze-dried FMT product via colonoscopy. Fresh FMT product produced a 100 percent cure rate among participants; frozen product produced an 83 percent cure rate and freeze-dried product produced a 69 percent cure rate.
> _Frozen and fresh product fully restored the microbiota diversity among participants within seven days_ after treatment.
> 
> _Researchers saw some improvement in microbiota diversity among participants treated with freeze-dried product after seven days and full restoration of healthy bacteria within 30 days._
> 
> "This is the first study to show that frozen and freeze-dried microbiota are as good as fresh material, so that we never have to use fresh again. It's a logistical nightmare to use fresh product. If we were going to treat you today, a donor would have come in two hours before, we would have already isolated the sample and then we would have to administer it the same day. A pill form of the product could make all of this easier," said Herbert L. DuPont, M.D., senior author and director of the Center for Infectious Diseases at UTHealth School of Public Health.
> 
> 
> Read more at: https://medicalxpress.com/news/2017-03-paves-clostridium-difficile-treatment-pill.html#jCp


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## wildbill_52280

The company Seres created an FMT pill with a select species of bacteria to treat c. difficle infection as a replacement for a traditional Fecal Microbiota Transplant. This recent clinical trial was considered a failure but they are going to do the experiment again and make a few changes to hopefully make the drug more effective.



> Seres has said that a misdiagnosis of certain patients in the earlier trial meant that some participants did not actually have C. diff., and that some patients may not have gotten a high-enough dose of SER-109. In the new trial, the company says it will use a more accurate mechanism to measure the infection, and patients will receive a dose that is 10 times higher.


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## wildbill_52280

Another company plans to make a FMT pill for IBD. http://www.businesswire.com/news/ho...-Takeda-Announce-Global-Collaboration-Develop

 I'm still wondering whats going on with the other companies that were supposed to make one. Also we are still waiting on the IBD studies using FMT pills now Openbiome makes them!! So I know they are available to every researcher and doctor now since December of 2016. Pills could have been made manually by scientists with a centrifuge for years now. I'm sure it's all right around the corner though, and it seems that way. I'm an impatient person I guess.


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## wildbill_52280

An article written by Bill Gates about the microbiome. I'm glad he is now on board with this.

https://www.gatesnotes.com/Books/I-...017_10_IContainMultitudes_BG-TW_&WT.tsrc=BGTW


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## wildbill_52280

Another example of fecal transplant's benefits beyond C. difficile or IBD.

https://www.sciencedaily.com/releases/2017/04/170421084925.htm


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## wildbill_52280

Study of colonoscopic FMT in U.C. combining multiple donors to increase Bacterial diversity in the dosage. http://journals.lww.com/ibdjournal/...of_High_Diversity_Fecal_Microbiota.98583.aspx

This was cool to see another study on FMT but I'm not sure this is enough to demonstrate whether or not a multi donor FMT is more effective then a single donor FMT, it still helps I'm sure, but there are many variables that affect the outcome and if there is little attempt to track them all in one study, it's just going to take longer to improve the success rate. Just waiting for us to use a long term oral dose FMT pill in IBD patients which also ensures a high fiber diet in the patient, maybe that's enough to get a 90% success rate, then we wont need any further manipulations of a protocol.


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## Lady Organic

Im glad this fallowing trial is already active (second or 3rd FMT trial from this Canadian medical team.) 80 patients will be recruited, that's a pretty big group! Only the donor who gave best results in the previous trial will be used:
https://clinicaltrials.gov/ct2/show/NCT02606032?term=ulcerative+colitis+fecal+transplant&rank=16


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## wildbill_52280

Another successful case for FMT in a Crohn's patient. They went from 394 to 132 CDAI score in one week after FMT. This was in Korea.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5430018/


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## wildbill_52280

This will be one of the most important studies to watch because for the first time they will treat crohn's with a full spectrum FMT pill for 8 weeks. I'm not sure if the dose will be daily or weekly I'm assuming daily but ill have to find out more. 

https://vector.childrenshospital.org/2017/05/could-fecal-transplants-heal-crohns-colitis-children/

https://clinicaltrials.gov/ct2/show/NCT02330211?term=stacy+kahn&rank=3


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## wildbill_52280

This Genomicist with a Ph.d gave herself a DIY FMT after analyzing her microbiome and hypothesizing that antibiotics she took for lyme disease led to her long term health problems. 
http://www.the-scientist.com/?artic...thletes--Microbiomes-Differ-from-Nonathletes/


----------



## wildbill_52280

Fecal microbiota transplantation cured epilepsy in a case with Crohn's disease: The first report.

Abstract

Fecal microbiota transplantation (FMT) is a promising strategy that involves reconstruction of gut microbiota. Recently, it has been considered as a treatment of Crohn's disease (CD) and certain neurological diseases. Here, to the best of our knowledge, we report the first case that used FMT to achieve remission of intestinal and neurological symptoms in a girl with CD and a 17-year history of epilepsy. During the 20 mo of follow-up, FMT has proved its efficacy in preventing relapse of seizures after withdrawing the antiepileptic drugs. Furthermore, this finding highlights the role of microbiota-gut-brain axis and inspires a novel treatment for epilepsy through remodeling gut microbiota.  

https://www.ncbi.nlm.nih.gov/pubmed/28596693


----------



## wildbill_52280

The University of Vermont is recruiting U.C. patients for an FMT study. They will be using an FMT pill daily so it may be a more effective and easier way to perform an FMT then enemas, colonoscopies or nasogastric tubes. 
UVM Medical Center: You are still looking for patients for the trial. If somebody’s interested, what do they do?



> Dr. Peter Moses: Well, they just contact us. Our trial is registered with the FDA. If you go to clinicaltrials.gov and in the search box type in FMT Vermont, it’ll come right up and the contact information is there. People can contact me and they can contact Megan Phillips who is our study coordinator.
> 
> UVM Medical Center: Probably, the easiest way to remember is switchboard at the UVM Medical Center is 847-0000. You could just ask for Dr. Peter Moses or Megan Phillips, as he said.






> UVM Medical Center: Your trial is about all ulcerative colitis. Why’d you pick that and what are you finding?
> 
> Dr. Peter Moses: Well, ulcerative colitis and Crohn’s disease, the two major forms of inflammatory bowel disease, have long been thought to have to do with the interaction of an individual who may be genetically susceptible and their environment, and the environmental piece has been thought to be their microbiology or their microbiome. There were a number of studies that have been published over the last five, maybe eight years that have been equivocal in their findings, but they’re mostly descriptive so they have to do with a patient’s clinical experience. We felt very strongly that we should back up and try to understand what the science of first disrupting and then replacing someone’s microbiome might be on this immune-mediated disease ulcerative colitis.
> 
> Our patients have some testing. Some of it is unique. We’re looking at T-cell function. We’re looking at inflammatory mediators. We’re looking at how much inflammation we can see under the microscope, but we’re also asking them how they feel. Their normal microbiome is disrupted with antibiotics. Then, after that disruption, it’s replaced with an FMT. Then, after the FMT, they undergo daily treatment bacteriotherapy with a capsule containing human stool from the same donor that they received the FMT.



https://medcenterblog.uvmhealth.org/digestion/ulcerative-colitis-clinical-trial/


----------



## Scipio

Nestle funds a joint venture to use microbiome testing in IBD:

http://www.fiercebiotech.com/medtech/nestle-enterome-form-microbiome-diagnostic-joint-venture


----------



## wildbill_52280

Not a remarkably successful study on FMT, but still pretty good.

Sci Rep. 2017 Jul 6;7(1):4753. doi: 10.1038/s41598-017-04984-z.
*Multiple fresh fecal microbiota transplants induces and maintains clinical remission in Crohn's disease complicated with inflammatory mass.*

Abstract
The ancient Chinese medical literature, as well as our prior clinical experience, suggests that fecal microbiota transplantation (FMT) could treat the inflammatory mass. We aimed to evaluate the efficacy and safety of multiple fresh FMTs for Crohn's disease (CD) complicated with intraabdominal inflammatory mass. The "one-hour FMT protocol" was followed in all patients. Twenty-five patients were diagnosed with CD and related inflammatory mass by CT or MRI. All patients received the initial FMT followed by repeated FMTs every 3 months. The primary endpoint was clinical response (improvement and remission) and sustained clinical remission at 12 months. Secondary endpoints were improvement in size of phegmon/abscess based upon cross-sectional imaging and safety of FMT. 68.0% (17/25) and 52.0% (13/25) of patients achieved clinical response and clinical remission at 3 months post the initial FMT, respectively. 

The proportion of patients at 6 months, 12 months and 18 months achieving sustained clinical remission with sequential FMTs was 48.0% (12/25), 32.0% (8/25) and 22.7% (5/22), respectively. 9.5% (2/21) of patients achieved radiological healing and 71.4% (15/21) achieved radiological improvement. No severe adverse events related to FMT were observed. This pragmatic study suggested that sequential fresh FMTs might be a promising, safe and effective therapy to induce and maintain clinical remission in CD with intraabdominal inflammatory mass.


----------



## wildbill_52280

Video titled, The Microbiome May Reinvent Medicine As We Know It.
https://www.youtube.com/watch?v=YWXbpbIvADw


----------



## Lady Organic

Anyone know if complete cleaning with prep is needed just before colonoscopy transplant with most doctors and researchers performing it today? Thanks.


----------



## wildbill_52280

Lady Organic said:


> Anyone know if complete cleaning with prep is needed just before colonoscopy transplant with most doctors and researchers performing it today? Thanks.


At this point i think everyone is trying different things still and documenting them, with not much of a clue how each variable effects the efficacy rate. look up a few of the latest studies i suppose, that could give you some answers but it would be along the lines using antibiotics before hand to better prepare the microbiome to accept new organisms which i vaguely recall did show greater efficacy rates. Don't quote me on that though ,so again, that could be looked up.

 I would personally like to keep as many original organisms I had, skip the antibiotics, and just increase the treatment dosage of bacteria and use other means to increase the transfer of bacteria like a high fiber diet which also has been shown to increase FMT efficacy, or I'm referring to the pectin study which showed that. But I assume most types of fiber found in food could do the same thing.


----------



## lucycui

Hi,

I'm new to this forum and very interested in this topic. I have viewed all in this thread and didn't see any canadian clinic trial on CD. Is there any doctor doing this in Canada?

Thanks,
Lucy


----------



## Lady Organic

lucycui said:


> Hi,
> 
> I'm new to this forum and very interested in this topic. I have viewed all in this thread and didn't see any canadian clinic trial on CD. Is there any doctor doing this in Canada?
> 
> Thanks,
> Lucy


Hi Lucy and welcome!
there is a trial for CD in Toronto, but the main criteria to meet is: Admission for IV steroid therapy.
https://clinicaltrials.gov/ct2/show...a&cond=ulcerative+colitis&cntry1=NA:CA&rank=3


----------



## Lady Organic

Thank WildBill, but by ''prep'' I meant the cleaning of the colon with PG-Lyte to empty it!
Do we have to do it for most trials? Do we know?
thanks again!


----------



## Scipio

Yes, they are investigating this in Canada too:

http://crohnsandcolitis.ca/Research/Participate-in-Research#project-arcc


----------



## lucycui

Thank you all!

My husband got CD more than 16 years ago. He used to take both Imuran and Ascal and stopped Imuran after diagnosed merkel cell carcinoma. We decided to not take any immune suppressor drugs as these are the root cause of the cancer. He's doing ok for now but  we are seeking alternative way to treat CD. This is very good news for all of us. Hope it will be approved soon. Looks like we don't meet the requirement of the clinic trial in canaca.

Regards,
Lucy


----------



## wildbill_52280

Lady Organic said:


> Thank WildBill, but by ''prep'' I meant the cleaning of the colon with PG-Lyte to empty it!
> Do we have to do it for most trials? Do we know?
> thanks again!


  That is kind of along the lines/similar goal of clearing out the former microbiome, to make way for a new one, kind of like antibiotics would do. I'm not sure its necessary, but for an enema, perhaps it is beneficial.


----------



## wildbill_52280

FMT was given to someone with C.diff and FMT seemed to also eliminate their celiac disease symptoms, pretty cool! 



> Treatment of refractory celiac disease type II (RCD II) and preventing the development of an enteropathy associated T-cell lymphoma in these patients is still difficult. In this case report, we describe a patient with RCD II who received fecal microbiota transfer as treatment for a recurrent Clostridium difficile infection,
> and remarkably showed a full recovery of duodenal villi and disappearance of celiac symptoms. This case suggests that altering the gut microbiota may hold promise in improving the clinical and histological consequences of celiac disease and/or RCD II.


http://www.jgld.ro/wp/y2016/n3/a20.pdf


----------



## wildbill_52280

Advancing Bio is the second stool bank to open up recently in the U.S. since Openbiome started in 2012. These stool banks collect and store stool samples to perform Fecal Microbiota transplants for C. difficile infection. 

https://www.advancingbio.org/Trusted-Services

http://www.openbiome.org/


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## wildbill_52280

Seres therapeutics tests Fecal transplant pill in Ulcerative colitis and soon will test it in crohn's disease.

http://ir.serestherapeutics.com/phoenix.zhtml?c=254006&p=irol-newsArticle&ID=2303923


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## wildbill_52280

Early studies for FMT in Diabetes shows some promise.
https://medicalxpress.com/news/2017-10-fecal-transplant-success-diabetes-recipient.html


----------



## Guerrero

Any succes of FMT with CD in the ileum?


----------



## Spooky1

I'd be happy to know that too, but I also have Crohn's in the mouth.


----------



## wildbill_52280

Guerrero said:


> Any succes of FMT with CD in the ileum?



26 out of 30 crohn's patients achieved remission with one oral FMT in 2015. These were patients that failed all medications. There are other studies as well they should be in the first post of this thread although I'm not sure.   
https://www.ncbi.nlm.nih.gov/pubmed/25168749


----------



## Guerrero

Very interesting. Why this therapy is not tested widely?


----------



## Spooky1

I wish they would hurry on with this.  It really could make a difference to the quality of our lives.


----------



## wildbill_52280

Guerrero said:


> Very interesting. Why this therapy is not tested widely?



There are some more studies they should be in the first post.
It's hard to find donors that are willing and educated, and also hard to determine that the donors are healthy.  Also, the concept of FMT has challenged roughly 100 years of how the human body works, the prevailing theory is that bacteria are all bad for us so the concept of a probiotic and the degree at which it can influence our health takes time for people to learn and accept. 

One piece of good news is that FMT is FDA approved for a similar but more deadly G.I. condition called C. difficile, but not for any other condition. This does seem odd given all the evidence for IBD, but there are still studies that show no effect, so its all this contradictory information that confuses some people, one problem is that many of the protocols that are followed aren't well documented in these studies so they are sometimes hard to build upon and interpret which variables play a role in doing it successfully, regardless, we have still made progress even though it isn't super perfect and organized.

One solution is a stool bank that was started mainly to find healthy donors and store frozen stool samples for supply doctors to treat c. difficile, but last year they also created a pill version, and I vaguely recall some studies have used it for c diff, but I know it's available and could be used to treat IBD but I don't recall if they have done that yet. That could be more successful and super easy for the patient's and doctors but we don't know that yet, Still waiting for that FMT pill study. Openbiome makes  full spectrum FMT pill, where other companies are trying to use a small selection of bacteria. Either strategy could work to restore the healthy diversity of microbes that live in the intestine.


----------



## wildbill_52280

Pretty amazing study using FMT on U.C.

https://www.ncbi.nlm.nih.gov/pubmed/28991839


----------



## vnag

I have been doing FMT for a while now (to address my Crohns not caused by C.Diff).. more frequently before and gradually tapering out. It has provided fantastic results (thanks to my donor). My colonoscopy last month for the first time ever showed no traces of inflammation.
(Had 2 resection surgeries before I started this).

I however did a combination of food restrictions, enteragam, probiotics and FMT (for a year and half).


----------



## wildbill_52280

vnag said:


> I have been doing FMT for a while now (to address my Crohns not caused by C.Diff).. more frequently before and gradually tapering out. It has provided fantastic results (thanks to my donor). My colonoscopy last month for the first time ever showed no traces of inflammation.
> (Had 2 resection surgeries before I started this).
> 
> I however did a combination of food restrictions, enteragam, probiotics and FMT (for a year and half).


how often have you done FMT? how are you doing it, enema?


----------



## vnag

started with doing them 3 times/week for 2 months, later down to 2 times/week. Now down to 1 time/week. Will stop this for good in Dec.  I may have done a few more but I started tapering out based on the Calprotectin test results. Enema worked for me as it could be self-administered.


----------



## Guerrero

Are you doing it by yourself or under the supervision of doctors or at the hospital?


----------



## vnag

I am doing this on my own (since FDA permits FMT in a hospital setting only for C Diff. induced Crohns). I do have a doctor monitor my overall health though.


----------



## wildbill_52280

vnag, how old is your donor and did you get a blood test for your donor, and other precautions? I assume you did but just making sure.  

Have you ever frozen any of the samples? it seriously damages the bacteria and I've seen some people do this but not understand that it should not be done unless you use glycerol as a cryoprotectant, freezing kills about 80% of the bacteria or more.

Also, did you request the donor and yourself follow a high fiber diet? Doing All this will help your success.


----------



## vnag

I took the recommended precautions (screened the donor for all possible diseases).

I did not really have any food restrictions for the donor. Based on my personal research and knowledge from others, I picked a donor in my age group and ethnicity and a vegetarian (just like me).

I am not freezing the samples because of the reasons you described.. which is probably what got reflected on my biopsy (which came out as negative for colitis) and colonoscopy results (which showed no traces of inflammation)..


----------



## Mommabear

Really interesting Vnag! Before trying FMT, did you try the food restrictions and probiotics? In other words, do you think had you only done the FMT without the other things, it would have worked? 

In any case, bravo!


----------



## Spooky1

I wish I had the courage to do this.  Not that I know of someone willing.  Most don't know anything about FMT.  Good on you.  Please keep us informed.


----------



## vnag

Spooky 1,

Since there was at least 1 research paper on the nih website based on clinical trials for FMT for Crohns, that gave me more confidence to try this out. It is a calculated gamble (supported by research papers that I had to read to convince myself to try this) . 

I took a bit further when I found a research paper on 'tara gum' where tara gum (a food additive to icecreams, etc) with s. themophilus helped fixed the leaky gut by tightening the cell junctions in the gut as tara gum makes the flora stick to the gut walls longer.

I did FMTs with tara gum powder mixed to it .


I can share the research papers if it helps..


----------



## vnag

Mommabear,


I have been doing food restrictions for a few years  (being a vegetarian helped a lot). That helped minimize the symptoms. However, if/when cheated on food, symptoms got worse. So I wanted to look for a more permanent + natural option.

With probiotics, there was 1 particular family of bacteria which is found only in the gut  (fecal bacteria prausnitzii) which (till date) cannot be produced commercially and it constitutes roughly sizable percentage of a healthy gut. (This was based on a research paper I found on the nih website). So that lead me to try FMT.

The one thing I found out about much later was "enteragam" (which provides the nutrients available in mother's milk - which is provided to the infants which helps build the immune system). 

I added that recently to my probiotic cocktail with fantastic results. For the ones that are hesitating to do FMT, this maybe something to explore.


----------



## Spooky1

So taragum and enteragam might help for those of us that can't do the FMT?


----------



## vnag

It definitely worked for me. 

I came across this single research paper and decided to try tara gum (as it has no known side effects). No doctor's advise for me on this one .

https://www.ncbi.nlm.nih.gov/pubmed/25291130

Notes: 
1. Tara gum (powder) mixed with s. thermophilus is the key. Tara gum  helps the probiotic bacteria stick to the gut wall longer. I mixed tara gum with my probiotic drink. 

2. Tara gum is very hard to find in stores. I had to call a few companies  that supplied this commercially to the food industry and got a sample.  (10 lbs = $200 approx and with last for 4 - 5 years as you only need 500 mg - 1g/day)

A minor side effect: It gives you the feeling that your stomach is full/heavy for a while.
-----
For enteragam, my doc suggested this one. Your insurance may not cover this one as it is considered medical food.


----------



## vnag

For enteragam, my doc suggested this one. Your insurance may not cover this one as it is considered medical food.


----------



## wildbill_52280

vnag said:


> Spooky 1,
> 
> Since there was at least 1 research paper on the nih website based on clinical trials for FMT for Crohns, that gave me more confidence to try this out. It is a calculated gamble (supported by research papers that I had to read to convince myself to try this) .
> 
> I took a bit further when I found a research paper on 'tara gum' where tara gum (a food additive to icecreams, etc) with s. themophilus helped fixed the leaky gut by tightening the cell junctions in the gut as tara gum makes the flora stick to the gut walls longer.
> 
> I did FMTs with tara gum powder mixed to it .
> 
> 
> I can share the research papers if it helps..


Tara gum most likely has properties like dietary fiber, which would encourage good bacteria to grow. Good bacteria can feed on dietary fiber. IT probably not a good idea to add any microbes to the FMT solution before you administer it, upsetting the natural balance could be a negative consequence. 

This study showed that pectin fiber led to more restoration of microbiome diversity after FMT. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5095982/
 I'm not so sure it's that different from consuming a high fiber diet orally though, but it could be.


----------



## vnag

In my case, I did about 50+ FMTs without it.. then added tara gum with 50+ FMTs. I am not sure if it helped but definitely did not make it worse.


----------



## wildbill_52280

vnag said:


> In my case, I did about 50+ FMTs without it.. then added tara gum with 50+ FMTs. I am not sure if it helped but definitely did not make it worse.


I will send you pic of a dropper design to make pills, if you are not aware yet oral FMT has been more successful then enemas. but then again you have already done 100 FMT enemas, the most i recall ever hearing in a study was 80, so you've done alot of them! I've done about 3 oral fmt's only one had a noticeable effect where I gained 25 pounds in about 6 months and led to some improvements in appearance of stools and lower anxiety.


----------



## vnag

I used to monitor the calprotectin tests and symptoms and then decide on the frequency of FMTs.

Interesting (oral FMTs)... Since the immune system (microbiome) resides in the large bowel (and not the small), you may run into the scenario of SIBO (small intestinal Bacterial Overgrowth) if you do a pill. You way want to account for that (and the stomach acid).

Since I am at the end of my FMTs (will do 2 more and stop), I might just continue with the protocol I have customized for myself (which I have found it rather convenient/comfortable to do).


----------



## wildbill_52280

vnag said:


> I used to monitor the calprotectin tests and symptoms and then decide on the frequency of FMTs.
> 
> Interesting (oral FMTs)... Since the immune system (microbiome) resides in the large bowel (and not the small), you may run into the scenario of SIBO (small intestinal Bacterial Overgrowth) if you do a pill. You way want to account for that (and the stomach acid).
> 
> Since I am at the end of my FMTs (will do 2 more and stop), I might just continue with the protocol I have customized for myself (which I have found it rather convenient/comfortable to do).


All theory aside, there is actual science that does show oral is more effective, so there is not much need to worry, crohn's generally does effect the small intestine though, and enemas don't go very far into the colon, plus you can eat a high fiber meal right after wards, which would likely be very beneficial.


----------



## Guerrero

wildbill_52280 said:


> I will send you pic of a dropper design to make pills, if you are not aware yet oral FMT has been more successful then enemas. but then again you have already done 100 FMT enemas, the most i recall ever hearing in a study was 80, so you've done alot of them! I've done about 3 oral fmt's only one had a noticeable effect where I gained 25 pounds in about 6 months and led to some improvements in appearance of stools and lower anxiety.


Hi wildbill
Could you explain how you do oral fmt?


----------



## vnag

Please share the method (and pic of the dropper design) for this. 

While my colon is normal now, I still have a stomach ulcer (not sure if it is Crohns induced). My doc is wanting me to take Dexilant or Carafate for this and I am looking to avoid this. I recently came across Siberian Pine nut oil for treatment of ulcers in general. So I have started on that one.


----------



## wildbill_52280

Guerrero said:


> Hi wildbill
> Could you explain how you do oral fmt?


Sure ill do my best, but generally I don't recall all the specifics at the moment. Remember this is all experimental so no guaranties, and always screen your donor with a blood test for transmissable diseases and if possible other chronic diseases. 

The next time I do an oral FMT, I plan to use my device to make pills making one then taking it and repeating that process for about 20min or until all are consumed.  I'll put a pic up of my design soon but basically it's a large syringe on a wooden stand. The only thing I'm worried about is if the stool releases any gas while in the syringe i don't know if it will push the plunger out, since i haven't had a chance to use it, that's really the only question I have yet to answer. It's a simple design but you have to find the right size syringe. I'm not sure what the ratio of stool to saline will be, and i will be mixing it in a freezer bag and not a blender this is to limit exposure to oxygen as the bacteria are very sensitive to oxygen, they are strict anaerobes, oxygen kills them so mixing in an , almost, airtight bag will limit exposure to oxygen or way less compared to blender. The pills should be taken on an empty stomach or 4 hours after a meal and after 30-60 minutes you should eat a high fiber meal or take a fiber supplement immediately after the oral FMT. Donor should follow high fiber low sugar diet no chemicals for 2 weeks and I also suggest vitamin d supplements, their stool sample has to look good refer to bristol stool chart scale but I'm sure you know what a healthy stool looks like by now.

In the past I've mixed the stool sample in a blender with apple juice and then drank it straight, maybe 1 cups worth or two cups worth, don't recall. You'll have to keep your nose plugged to limit the smell and taste it really isn't all that bad though.  The juice which is high in sugars was probably working against me but that was the one where I gained 25 lbs and now I'm back to my regular weight. Ever since diagnosis of crohn's, I've been about 10 pounds underweight. The second time I used saline and drank it straight but experienced no benefits I think they stool sample i had was not good that time. The saline or juice must be very cold, this will also make your taste buds a little numb and you wont taste much. 

I'll try and get some good pics of the new pill maker!


----------



## wildbill_52280

vnag said:


> Please share the method (and pic of the dropper design) for this.
> 
> While my colon is normal now, I still have a stomach ulcer (not sure if it is Crohns induced). My doc is wanting me to take Dexilant or Carafate for this and I am looking to avoid this. I recently came across Siberian Pine nut oil for treatment of ulcers in general. So I have started on that one.


Ill try and take some pics soon! busy next few days though!


----------



## 7vNH

Over several years I've been posting in this thread about my condition and actions I've taken.  Some background is in 
this post, which also spells out a multi-donor FMT I had done.  But in short, I've had UC a long time and it's been mostly under control using 5-ASA's, but when they quit working, instead of down-regulating my immune system, I started exploring alteration of my gut microbiome.  Results 13 months later were not promising, though.

But this post is good news.  I'm feeling better than I have in years and I'm not taking the 5-ASA (mesalamine) any more.  I'm not suggesting any one do this or anything like it, I'm just telling you what I've done.

About one year ago, I decided to do a food allergy test.  It wasn't something I did under the instruction of a doctor.  I can't recall where I even read about the test (maybe on this forum?), but I did the E95 and A95 food panels (after eating everything under the sun so as to cause the markers to show-up).  It said "no eggs".  I've never noticed any problem with eggs, but I quit eating eggs themselves.  I severely cut back on things that were made with eggs, but eggs are everywhere (mayo was tough to give-up).  The panel also had me limited to once every 4 days on soft dairy, some kinds of beans, and a few other things.  The E95 indicated wheat was fine, but an earlier Cyrex wheat panel (a more detailed analysis) showed sensitivity on a few gluten variations, so I go without bread and most products with obvious wheat (but still drink beer).

So that's one thing I changed: no eggs. * The next change was about 8 months ago, I took a box (60 capsules) of "Mutaflor" (E coli Nissle 1917 in a pill).*  I tried to follow the same procedure as in a paper I read.  I ran out of Mutaflor and didn't replenish right away; it's kind of expensive and I had to order it from Canada.  Then, in an unrelated heath monitoring action, I noticed that I had high creatinine (blood test).  Figuring that was caused by the maximum dose of Lialda for so many years, I quit that 5-ASA in June (five months ago) and started with a maintenance dose (1 capsule per day) of Mutaflor.  I went off Mutaflor for over a month without noticing a big difference in health, but I just ordered some more; I don't want to change anything while I'm feeling good!

So although I'm not in perfect GI health, I feel better than I've felt in a long while.  Certainly no overt UC symptoms (no blood).  I'm not sure if getting rid of eggs helped, using Mutaflor helped, both together helped, or if it's just a conincidence.  I'm also a few years past a life change, so maybe even stress has gone down some.

I'm not completely discounting the multi-donor FMT I had done almost 3 years ago either.  One just never knows how this stuff works.  I've had my gut biome checked three or four times by ubiome, and answered hundreds of health questions...not so I'm not learn anything from that, but with our help, they might put together the puzzle. I encourage everyone to help ubiome, by the way.  The more data, the better.


----------



## wildbill_52280

7vNH said:


> Over several years I've been posting in this thread about my condition and actions I've taken.  Some background is in
> this post, which also spells out a multi-donor FMT I had done.  But in short, I've had UC a long time and it's been mostly under control using 5-ASA's, but when they quit working, instead of down-regulating my immune system, I started exploring alteration of my gut microbiome.  Results 13 months later were not promising, though.
> 
> But this post is good news.  I'm feeling better than I have in years and I'm not taking the 5-ASA (mesalamine) any more.  I'm not suggesting any one do this or anything like it, I'm just telling you what I've done.
> 
> About one year ago, I decided to do a food allergy test.  It wasn't something I did under the instruction of a doctor.  I can't recall where I even read about the test (maybe on this forum?), but I did the E95 and A95 food panels (after eating everything under the sun so as to cause the markers to show-up).  It said "no eggs".  I've never noticed any problem with eggs, but I quit eating eggs themselves.  I severely cut back on things that were made with eggs, but eggs are everywhere (mayo was tough to give-up).  The panel also had me limited to once every 4 days on soft dairy, some kinds of beans, and a few other things.  The E95 indicated wheat was fine, but an earlier Cyrex wheat panel (a more detailed analysis) showed sensitivity on a few gluten variations, so I go without bread and most products with obvious wheat (but still drink beer).
> 
> So that's one thing I changed: no eggs. * The next change was about 8 months ago, I took a box (60 capsules) of "Mutaflor" (E coli Nissle 1917 in a pill).*  I tried to follow the same procedure as in a paper I read.  I ran out of Mutaflor and didn't replenish right away; it's kind of expensive and I had to order it from Canada.  Then, in an unrelated heath monitoring action, I noticed that I had high creatinine (blood test).  Figuring that was caused by the maximum dose of Lialda for so many years, I quit that 5-ASA in June (five months ago) and started with a maintenance dose (1 capsule per day) of Mutaflor.  I went off Mutaflor for over a month without noticing a big difference in health, but I just ordered some more; I don't want to change anything while I'm feeling good!
> 
> So although I'm not in perfect GI health, I feel better than I've felt in a long while.  Certainly no overt UC symptoms (no blood).  I'm not sure if getting rid of eggs helped, using Mutaflor helped, both together helped, or if it's just a conincidence.  I'm also a few years past a life change, so maybe even stress has gone down some.
> 
> I'm not completely discounting the multi-donor FMT I had done almost 3 years ago either.  One just never knows how this stuff works.  I've had my gut biome checked three or four times by ubiome, and answered hundreds of health questions...not so I'm not learn anything from that, but with our help, they might put together the puzzle. I encourage everyone to help ubiome, by the way.  The more data, the better.


Thanks! the choice to do multi donor was a good one. It is very important to describe what protocol you followed for FMT though. If your donor is not on a high fiber diet free of harmful chemicals, then the quantity of good bacteria in the stool could be so low it wouldn't make much of an impact. Also for enemas 30-80 FMTs is the range that has been shown somewhat effective for IBD. Oral routes of FMT have now been shown to be more effective. Exposure of feces to too much oxygen due to excessive processing can kill bacteria further reducing the dosage and efficacy. 

So doing an DIY FMT is still pretty difficult. I applaud anyone who found a way and succeeded! or even tried, safely!


----------



## 7vNH

7vNH said:


> But this post is good news.  I'm feeling better than I have in years and I'm not taking the 5-ASA (mesalamine) any more.


There is one more thing that I did, and I didn't think it had much to do with my UC, but maybe it did:  I took vitamin D and B complex.

The reason I took vitamin D was because "everyone" was saying that mostly, we air-conditioned humans are making a lot less vitamin D than our outdoor predecessors did.  And the B complex was because I figured I wasn't selecting the best foods to eat, and B vitamins, being water soluble, it couldn't hurt.

Well, now I read that vitamin D can do a lot for the gut microbiome.

This neurologist MD, SC Gominak, that's been treating people with headaches, but that's the thing that landed them in her office.  Most of them also present with sleep problems and "IBD".  Anyway, after seeing many hundreds of patients, she's got this theory about how lack of vitamin D leads to a crummy set of gut microbiota.  Apparently, the bugs in our gut need vitamin D and those bugs make B vitamins for us.  Gominak posits that getting vitamin D up to the 60+ ng/ml level will align the gut microbiome.

There's a blood test for vitamin D, but with the B vitamins, she recommends relying on how you feel when you get up in the morning.  For me, I was taking a B-complex that was pretty high.  I had no idea it had anything to do with B vitamins, but my finger joints started hurting when I arose in the morning.  At that point, I stopped all supplements, and the pain went away.  I added-back fish oil first, then vitamin D.  I came across this article before I added-back the B complex.

The idea is to get the vitamin D level up, and to have plenty of vitamin B around (all 8 kinds).  But if you keep those B levels up for a long time, there will be too much, and you'll get the pain in your joints.  At that point, quit the B supplements (except B12, which doesn't seem to build up).  It's certainly a departure to say that B vitamins are somehow stored, because we've all been trained in the dogma that they're excreted if unneeded.

Anyway, here's a link to one paper.  There are several others on that site.  
https://drgominak.com/wp-content/uploads/2017/03/Gominak-commensal-Gi-D.pdf


----------



## wildbill_52280

7vNH said:


> There is one more thing that I did, and I didn't think it had much to do with my UC, but maybe it did:  I took vitamin D and B complex.
> 
> The reason I took vitamin D was because "everyone" was saying that mostly, we air-conditioned humans are making a lot less vitamin D than our outdoor predecessors did.  And the B complex was because I figured I wasn't selecting the best foods to eat, and B vitamins, being water soluble, it couldn't hurt.
> 
> Well, now I read that vitamin D can do a lot for the gut microbiome.
> 
> This neurologist MD, SC Gominak, that's been treating people with headaches, but that's the thing that landed them in her office.  Most of them also present with sleep problems and "IBD".  Anyway, after seeing many hundreds of patients, she's got this theory about how lack of vitamin D leads to a crummy set of gut microbiota.  Apparently, the bugs in our gut need vitamin D and those bugs make B vitamins for us.  Gominak posits that getting vitamin D up to the 60+ ng/ml level will align the gut microbiome.
> 
> There's a blood test for vitamin D, but with the B vitamins, she recommends relying on how you feel when you get up in the morning.  For me, I was taking a B-complex that was pretty high.  I had no idea it had anything to do with B vitamins, but my finger joints started hurting when I arose in the morning.  At that point, I stopped all supplements, and the pain went away.  I added-back fish oil first, then vitamin D.  I came across this article before I added-back the B complex.
> 
> The idea is to get the vitamin D level up, and to have plenty of vitamin B around (all 8 kinds).  But if you keep those B levels up for a long time, there will be too much, and you'll get the pain in your joints.  At that point, quit the B supplements (except B12, which doesn't seem to build up).  It's certainly a departure to say that B vitamins are somehow stored, because we've all been trained in the dogma that they're excreted if unneeded.
> 
> Anyway, here's a link to one paper.  There are several others on that site.
> https://drgominak.com/wp-content/uploads/2017/03/Gominak-commensal-Gi-D.pdf


Yes I have read some of this before! and it is true our bacteria create b vitamins. I think donors should get their vit d level up before an FMT as well as patients, I don't know for sure though if this makes any difference but it is likely helpful. Nicotinic acid i recall was used as an antipsychotic for schizophrenia. one thing about the b vitamins though, the supp you took may have also had emulsifiers in them, which are bad for the microbiome, not only as filler but also the capsule are made of these chemically altered fiber like substances, that could have made your arthritis symptoms worse, many IBD patients have arthritis. http://www.arthritis.org/about-arthritis/types/inflammatory-bowel-disease/ 

Its also possible your dosage of b vitamins were also too high.


----------



## wildbill_52280

News article on Microbiome/FMT. 
http://www.wfaa.com/news/local/verify/verify-the-healing-power-of-poop-1/492802237


----------



## wildbill_52280

A recent study used eight doses of freshly prepared FMT via a naso-duodenal tube or gastroscopy over the course of 2 weeks for either U.C. or Crohn's. Clinical remission, defined as a PCDAI score ≤ 10 and PUCAI score < 10 measured at the same time point, was observed in 3/8 UC patients and 2/2 CD patients. No major side effects reported.

https://www.ncbi.nlm.nih.gov/pubmed/29151253


----------



## wildbill_52280

Establishing causality in microbiome studies , NIH vcast.
https://www.youtube.com/watch?v=XsR9H62vcvg


----------



## Guerrero

Is there any research team/company working on FMT we can help or finance?


----------



## wildbill_52280

Guerrero said:


> Is there any research team/company working on FMT we can help or finance?


Sure I'll take your money!! just kidding of course. I think most of the companies are privately funded, and not publicly traded although I've never looked into it, otherwise, that's how you could invest, and really, I'd put all money on it!! but you never know which route will work until it's tested. Look into Seres health and Vedanta biosciences. might be few more companies cant recall all of them at the moment, maybe rebiotix? 

Seems rebiotix is only planning on microbiome therapy for UC and not crohn's http://www.rebiotix.com/rebiotix-product-pipeline/


----------



## Guerrero

interesting...
unfortunately results of seres phase 1 study were not too positive
http://ir.serestherapeutics.com/phoenix.zhtml?c=254006&p=irol-newsArticle&ID=2303923
shares drop 19% after their publication
https://www.marketwatch.com/story/s...drops-19-on-clinical-trial-results-2017-10-02

seems the other two companies are not listed


----------



## wildbill_52280

Guerrero said:


> interesting...
> unfortunately results of seres phase 1 study were not too positive
> http://ir.serestherapeutics.com/phoenix.zhtml?c=254006&p=irol-newsArticle&ID=2303923
> shares drop 19% after their publication
> https://www.marketwatch.com/story/s...drops-19-on-clinical-trial-results-2017-10-02
> 
> seems the other two companies are not listed


I vaguely recall Seres is adjusting its dosing amount and doing another study soon on the same product.  

Finch therapeutics is another company developing bacterial based FMT pills. http://finchtherapeutics.com/news/2...herapeutics-in-inflammatory-bowel-disease-ibd


----------



## wildbill_52280

A study from the University of Pittsburgh showed that 71% and 50% of patients with Crohn’s and UC, respectively, experienced a clinical response to fecal microbiota transplantation (FMT) one month after the procedure.

http://www.gastroendonews.com/In-th...s-Colitis-Benefit-From-Fecal-Transplant/45075


----------



## wildbill_52280

FMT pill just as good as colonoscopy for treating recurrent C. diff infection.
http://www.cidrap.umn.edu/news-pers...ansplant-capsule-may-match-colonoscopy-c-diff


----------



## Spooky1

Omg, I wish they would just hurry this along and give it to all Crohnies to try.  But the evidence shows it's making some progress albeit slow.


----------



## wildbill_52280

One method of extracting bacteria/microbiome from whole stool. They use sieve/strainer, then a centrifuge to seperate the bacteria from the remaining particles. 
https://www.youtube.com/watch?v=twwAtdFbeKY

I read about this at least 3 years ago, one guy even tried making his own centrifuge with a drill to spin it, treated his gi issues and says his condition has improved quite a bit.


----------



## wildbill_52280

I may have missed this in the news last october, but Seres health released results on a bacterial pill SER-287, or a type of FMT pill, in ulcerative colitis and it was generally successful and put patients in remission. and also this! 





> We plan to further evaluate SER-287 in mild, moderate and severe forms of ulcerative colitis, in maintenance after induction therapy, and we also intend to assess development in Crohn’s disease, and pediatric forms of inflammatory bowel disease.


https://www.healio.com/gastroentero...signation-to-microbiome-drug-for-pediatric-uc 

https://www.healio.com/gastroentero...e-therapy-shows-benefit-in-ulcerative-colitis

I'm skeptical that this pill of bacteria will be the same as a full spectrum fecal microbiota transplant, and reflects my fears that selecting bacteria which only treat the disease rather then cure it, like some studies have shown already.


----------



## wildbill_52280

Dr. Sonnenburg, bestselling author of The Good Gut, will explain the link between our Western diet and chronic illness. Dec 14, 2017 , Original video from Stanford University.

https://www.technologynetworks.com/...-is-it-and-how-can-it-help-or-hurt-you-295201


----------



## wildbill_52280

WANT POOP TRANSPLANTS. HERE'S HOW TO MAKE THEM SAFE, Wired Magazine.

https://www.wired.com/story/patients-want-poop-transplants-heres-how-to-make-them-safe/



> “If you ask 99 percent of physicians who do this, they will tell you anything that came along to limit access to stool banks would be catastrophic,” he says. Plus, there’s no guarantee the microbiome even can be successfully be pulled apart and put back together in pill form. “People have spent 50 years trying to come up with synthetic blood and we still have a blood bank," says Stollman. "Who’s to say stool will be any different?”


And this is one reason I put a little more hope into full spectrum fecal transplants. As it has been shown in mice experiments, and in human experiments using whole stool, the more depleted the microbes are, the more resistant the community is in accepting any new species into that community. throwing just a few down there might not stick to well as a cure, they'll just pass on through. But throwing a large diverse amount down there, even though it's a little bit of a "crap shoot", might be the best strategy for the time being. 

The first report of cure from Crohn's with FMT was a women who received a large volume FMT through nasogastric tube using 3 donors all in the same day,  whereas almost every other experiment using a single donor and enemas took 30-80 FMT enemas.


----------



## wildbill_52280

This study is recruiting pediatric crohn's patients to try an oral FMT pill, the pill is made by Rebiotix. 

https://clinicaltrials.gov/ct2/show/NCT03378167


----------



## wildbill_52280

Sere's Health reported an analysis of a recent study on their bacterial pill SER-287 , it's kind of like a fecal microbiota transplant pill, showing that the bacteria was successfully engrafted/implanted in the G.I. systems of the patients and that the patients improvements were related to how well these bacteria were transplanted. The bacteria was confirmed to still be present 4 weeks after the last dose. I'm wondering how long those bacteria will stay and which species they actually are.

https://www.businesswire.com/news/h...rapeutics-Reports-SER-287-Phase-1b-Microbiome


----------



## wildbill_52280

I was just reading a new study on IBD microbiome and genetics and they found very little relationship between genetics and the state of the microbiome, this seems to be an important factor in considering causation of the disease suggesting genes have little to do with it and that the composition of the microbiome itself is a force that acts upon the human body. So again if there was a cure it could very well be by manipulating the microbiome composition such as what is being done with Fecal Microbiota Transplants. https://www.nature.com/articles/ctg201758


----------



## wildbill_52280

Researchers gave a fecal microbiota transplant to a child with tourette's and all symptom's disappeared.
https://www.hindawi.com/journals/crim/2017/6165239/


----------



## Spooky1

I read this in the news too, Bill.  I'm still waiting although it seems tempting to go to South Korea, Japan, or China to get this treatment


----------



## wildbill_52280

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5790872/


----------



## Spooky1

I'll be taking that one a bit at a time, Bill.  Thanks though.  I have also sent off for some CBD drops to see if it helps.  Some claim it helps with pain and joints although this is the legal version.  Can't get the real stuff as it's too expensive and I don't know anyone that can make the cannabis oil.  Let's hope it works.


----------



## wildbill_52280

Here is a quote which seems to give clues to why performing a fecal transplant might be so difficult at least in IBD, but this was from researchers studying FMT in C. difficile infection. Scientists are wondering to what degree the human microbiome can be separated and put back together, it seems it cannot be separated too much, and that groups of similar bacteria seem to only be implanted at a time. IF you threw a only a few unrelated strains down there it is highly unlikely they would stay down there, so you need multiple similar strains or even the entire microbiome at all at once. 



> "Furthermore, donor strains within a species engraft in an all-or-nothing manner and previously undetected strains frequently colonize patients receiving FMT."


 https://www.genomeweb.com/sequencin...yses-offer-fecal-transplant-engraftment-clues 

Another article on the same topic.
https://medicalxpress.com/news/2018-02-fecal-transplantation-bacteria-flourish.html


----------



## Spooky1

Would this mean that taking mega doses of healthy bacteria, such as 50 billion Immuprobio, won't take hold?  Seems to help for 24 hours but unless I take loads of them they don't have much effect and certainly nothing lasting beyond the 24 hours.


----------



## wildbill_52280

Spooky1 said:


> Would this mean that taking mega doses of healthy bacteria, such as 50 billion Immuprobio, won't take hold?  Seems to help for 24 hours but unless I take loads of them they don't have much effect and certainly nothing lasting beyond the 24 hours.


Those supplements aren't anywhere near a fecal transplant, as far as my opinion goes.


----------



## wildbill_52280

http://www.startribune.com/minnesot...ers-in-treatments-of-the-human-gut/474390953/


----------



## wildbill_52280

So here is more information that shows the composition of the microbiome is not determined by genetics. This could mean that any disease showing a connection to an altered microbiome is likely reversible with a fecal transplant. 

https://www.the-scientist.com/?arti...ics--Primarily-Shapes-Microbiome-Composition/


----------



## wildbill_52280

> The study results were very surprising—for most of these clinical measures, the association with bacterial genomes was at least as strong, and in some cases stronger, than the association with the host's human genome. These findings, according to the study investigators, provide solid evidence that understanding the factors that shape our microbiome may be key to understanding and treating many common health problems.
> 
> "We cannot change our genes, but we now know that we can affect—and even reshape—the composition of the different kinds of bacteria we host in our bodies,” concluded senior study investigator Eran Segal, Ph.D., a professor in the department of computer science and applied mathematics at the Weizmann Institute. “So, the findings of our research are quite hopeful; they suggest that our microbiome could be a powerful means for improving our health."


https://www.genengnews.com/gen-news...e-vs-nurture-debate-comes-into-focus/81255542


----------



## Scipio

Local NPR station feature report on FMT:

http://www.kpbs.org/news/2018/mar/06/fecal-transplants-potent-remedy-defies-regulation/


----------



## Spooky1

Interesting.  I'm just waiting for them to give it the go ahead for Crohn's.  I still expect it to be a long way off, and i'm not young.  I have lived with it virtually all my life.  I think China, Korea and Japan have/had a poo soup for 2,000 years.  They know how to deal with this.  Quite how, I don't know.  But they have had answers for this length of time, but the west is holding out on us.  I have thought about researching Korea and poo soup to see how much it cost and could I go there?  One day, we'll be cured.

Probably not before my clogs are popped.
Thanks for the link.

PS, have tried to get out to my creative writing class tonight, and hey, guess what?  Yep, I had to turn around at the next village and get in quick for the loo.  Mind, I was feeling totally exhausted and ill. I should have known better than to even attempt tonight.  Wow, we Crohnies miss out on a lot.


----------



## wildbill_52280

> Mark Davis said FMT is in a state of limbo as it is classified as a drug but can never be licensed as such because the FDA requires every drug to be identical from one dose to the next.
> 
> “FMT is not that and it will never be that,” he said, “so they defined it as a drug but a drug that could never be approved.”
> 
> Davis said one solution, suggested by other clinicians, would be to reclassify it as a tissue, like blood or bone marrow — something that treats and prevents disease but is never the same in every batch. But, he said, since the product is not composed of human cells, but rather bacterial cells, it couldn’t be defined as tissue by the FDA.
> 
> “What I would like the FDA to do is to say, ‘You know what? FMT is not a drug, it’s something else’,” Davis said. “And we should classify it as its own unique thing and give clinicians some more latitude to be able to treat patients with a variety of conditions.”


 http://www.kpbs.org/news/2018/mar/06/fecal-transplants-potent-remedy-defies-regulation/


----------



## Poppysocks

I wonder if I could try this. 

Most of my inflammation is located in my rectum, and I don't have Cdiff. I am also on a large dose of remicade.


----------



## Poppysocks

Does anyone know if you can be on remicade while trying a Fecal Transplant?


----------



## Crohn2357

Poppysocks, have you ever tried rectal tacrolimus? I've read it has good results on rectal inflammation.


----------



## Poppysocks

Crohn2357 said:


> Poppysocks, have you ever tried rectal tacrolimus? I've read it has good results on rectal inflammation.


I have not. Is that something new? I've never heard of it.


----------



## Crohn2357

Poppysocks said:


> I have not. Is that something new? I've never heard of it.


I don't know much. These are what I had read before:

Rectal Therapy with Prograf Helped Patients with Resistant UC, Study Shows

Patients with resistant ulcerative proctitis, a mild form of ulcerative colitis (UC), respond to therapy with rectal Prograf (tacrolimus) ointment, achieving clinical remission and mucosal healing, according to the results of a small clinical trial.
ibdnewstoday.com/2017/10/17/prograf-tacrolimus-rectal-therapy-resistant-ulcerative-proctitis/

The Clinical Trial
One of the newer medications is the immunosuppressing medication, tacrolimus that has been shown to be effective in UC when taken orally. Unfortunately, the oral use of this medication can have numerous serious side effects. In order to overcome these side effects, the use of topical rectal tacrolimus has been examined. Pilot studies in ulcerative proctitis (inflammation confined to the rectum) resistant to conventional therapies have demonstrated a clinical remission in 75% of patients and although the medication was well absorbed through the lining of the bowel, the levels in the blood were very low and no serious side effects were reported. The findings suggest that this preparation is indeed effective for inflammation in the distal bowel and that the method of administration reduces side effects. Further work, however, now needs to be undertaken to validate the original findings.
clinicaltrials.gov/ct2/show/NCT01418131

The Published Paper of That Trial
www.cghjournal.org/article/S1542-3565(17)30258-6/fulltext

You can search in the forums for more information. I don't know if this treatment is available to patients right now; but it seems worthy of searching about it.

Like yourself, I have been dealing with a very stubborn rectal inflammation (Crohn's) for a long time, and I am starting a new treatment for it: 6mp + Cimzia + rectal mesalazine. I've already been using max. dose of 6mp, and now adding Cimzia and rectal mesalazine. I'll see how well it's going to work in three to four months.

I find drinking bone broth soup helps with my rectal inflammation.

I have a question for you: Does eating fruits (fructose) increase your rectal bleeding? It does that to me.

Have you tried vitamin E enema? SCFA/butyrate enema?


----------



## Poppysocks

Crohn2357 said:


> I don't know much. These are what I had read before:
> 
> Rectal Therapy with Prograf Helped Patients with Resistant UC, Study Shows
> 
> Patients with resistant ulcerative proctitis, a mild form of ulcerative colitis (UC), respond to therapy with rectal Prograf (tacrolimus) ointment, achieving clinical remission and mucosal healing, according to the results of a small clinical trial.
> ibdnewstoday.com/2017/10/17/prograf-tacrolimus-rectal-therapy-resistant-ulcerative-proctitis/
> 
> The Clinical Trial
> One of the newer medications is the immunosuppressing medication, tacrolimus that has been shown to be effective in UC when taken orally. Unfortunately, the oral use of this medication can have numerous serious side effects. In order to overcome these side effects, the use of topical rectal tacrolimus has been examined. Pilot studies in ulcerative proctitis (inflammation confined to the rectum) resistant to conventional therapies have demonstrated a clinical remission in 75% of patients and although the medication was well absorbed through the lining of the bowel, the levels in the blood were very low and no serious side effects were reported. The findings suggest that this preparation is indeed effective for inflammation in the distal bowel and that the method of administration reduces side effects. Further work, however, now needs to be undertaken to validate the original findings.
> clinicaltrials.gov/ct2/show/NCT01418131
> 
> The Published Paper of That Trial
> www.cghjournal.org/article/S1542-3565(17)30258-6/fulltext
> 
> You can search in the forums for more information. I don't know if this treatment is available to patients right now; but it seems worthy of searching about it.
> 
> Like yourself, I have been dealing with a very stubborn rectal inflammation (Crohn's) for a long time, and I am starting a new treatment for it: 6mp + Cimzia + rectal mesalazine. I've already been using max. dose of 6mp, and now adding Cimzia and rectal mesalazine. I'll see how well it's going to work in three to four months.
> 
> I find drinking bone broth soup helps with my rectal inflammation.
> 
> I have a question for you: Does eating fruits (fructose) increase your rectal bleeding? It does that to me.
> 
> Have you tried vitamin E enema? SCFA/butyrate enema?


i tried a mesalamine enema for a little while about 3-4 years ago, I don't think it helped very much though. I am only on remicade right now.

I've only recently been flaring up. I've been on remicade for a very long time (15+ years), and I've been trying to modify my diet the past 7-8 years.

I was in pretty bad shape a few years ago until I discovered sushi. Sushi has been my miracle food (only the most plain sushi). It's very expensive but its held me in check and has actually helped my stools greatly (honestly to the point where they were the best they've ever been since I was diagnosed). When I'm feeling bad I stick to sushi and white rice and chicken for dinner. I've been getting very cocky though the past couple months and have been eating many things I shouldn't be (red meat, bread, espresso) and have seemed to come down with a flare. My BM's are no longer looking good and I can't seem to get back on the right track, even while sticking to my sushi, white rice and chicken diet. 

I usually stay away from fruits, and rough veggies like broccoli. I try to eat things that are soft and not very crunchy. When I'm doing well though and my BM's are looking good I can usually sneak a banana in here and some apples there, and I'm usually fine.

I will ask my GI though next week about the rectal tacrolimus. It seems like an interesting treatment because it seems very specific to that area, and not something so "systemic" like remicade.

These fecal transplants though still interest me, but I feel as if these are things people that are on imunosuppressant drugs should not take.


----------



## Crohn2357

Poppysocks said:


> i tried a mesalamine enema for a little while about 3-4 years ago, I don't think it helped very much though. I am only on remicade right now.
> 
> I've only recently been flaring up. I've been on remicade for a very long time (15+ years), and I've been trying to modify my diet the past 7-8 years.
> 
> I was in pretty bad shape a few years ago until I discovered sushi. Sushi has been my miracle food (only the most plain sushi). It's very expensive but its held me in check and has actually helped my stools greatly (honestly to the point where they were the best they've ever been since I was diagnosed). When I'm feeling bad I stick to sushi and white rice and chicken for dinner. I've been getting very cocky though the past couple months and have been eating many things I shouldn't be (red meat, bread, espresso) and have seemed to come down with a flare. My BM's are no longer looking good and I can't seem to get back on the right track, even while sticking to my sushi, white rice and chicken diet.
> 
> I usually stay away from fruits, and rough veggies like broccoli. I try to eat things that are soft and not very crunchy. When I'm doing well though and my BM's are looking good I can usually sneak a banana in here and some apples there, and I'm usually fine.
> 
> I will ask my GI though next week about the rectal tacrolimus. It seems like an interesting treatment because it seems very specific to that area, and not something so "systemic" like remicade.
> 
> These fecal transplants though still interest me, but I feel as if these are things people that are on imunosuppressant drugs should not take.


Yes, tacrolimus enema looks very good both for effectiveness and safety. If tacrolimus enema is not a available as a treatment yet, then you might want to give mesalazine enemas a longer try again. It takes time to show its full effectiveness. 

I remember your thread in the diet section of this forum about how sushi and sushi rice were helping you. I found that intriguing at that time. 

Diet is definitely a huge factor. I know what you mean by getting cocky after a while and paying the price for it. That's why after similar experiences like yours I started to stick to a diet no matter how I feel. 
This is the diet I've been following: https://www.thepaleomom.com/start-here/the-autoimmune-protocol/
I think it is a good idea to do an elimination diet to know how your body reacts to certain foods.

Regarding bone broth, its effects are almost too good to be true. It decreases the intestinal inflammation like a powerful medicine. You may be surprised if you try it. If you want to try, I suggest you to make it in your house. It's not hard to prepare. Make sure it comes off as jelly-like after you finish cooking. I use a recipe similar to this one: http://whole9life.com/2013/12/whole9-bone-broth-faq/  You don't have to add all those vegetables in the soup. I only use bones, salt, water, vinegar and carrots. I also make it in pressure cooker to make it quickly.

I too find white rice to be very soothing. It greatly decreases diarrhea and never hurts my gut. It's a good carb source. I eat it at every meal.

If you are really struggling, then you can try other treatment options, like Stelara or Stelara+6mp or Humira etc. These variations. I'd still add the rectal mesalazine though.

Another thing you can try is a short course of antibiotics like flagyl, cipro (if you can tolerate this, it can cause serious tendon problems). 

Fecal transplants seem more effective for UC patients than Crohn's patients. 

If you want to learn more about treating rectal inflammation you might want to ask your questions in the Healingwell UC forum. Folks in there have more experience and knowledge in regards to this issue than Crohn's patients. They might give you new ideas.


----------



## wildbill_52280

https://denver.craigslist.org/com/d/become-feces-donor-earn-up-to/6549114967.html


----------



## TumAl

I'm intrigued by the idea of using someone with great healthy stool to help others with our health concerns be able to be healthy too. I'm a little frustrated that doctors in Indiana do not seem to take IBSD and these issues seriously. I don't even see my doctor anymore and have been told by my regular doctor I need to go back. I know I do but they don't help me and I'm just wasting money so why go see them? Anyways I also tried the Everlywell blood test to see if there were foods that were making my IBSD worse and I had several show up and now I do not eat gluten or milk products. I know I still have IBSD but at least I know some of what triggers my problem as well.


----------



## wildbill_52280

TumAl said:


> I'm intrigued by the idea of using someone with great healthy stool to help others with our health concerns be able to be healthy too. I'm a little frustrated that doctors in Indiana do not seem to take IBSD and these issues seriously. I don't even see my doctor anymore and have been told by my regular doctor I need to go back. I know I do but they don't help me and I'm just wasting money so why go see them? Anyways I also tried the Everlywell blood test to see if there were foods that were making my IBSD worse and I had several show up and now I do not eat gluten or milk products. I know I still have IBSD but at least I know some of what triggers my problem as well.


There are a few studies using Fecal Microbiota Transplants to treat IBS showing some success, here is one of them. https://www.ncbi.nlm.nih.gov/pubmed/28628918


----------



## wildbill_52280

Yea, it's kind of weird Fecal Transplants were only regulated by the F.D.A. when they were proven effective in C. difficile in a controlled study in 2013, not because they were concerned with our safety, otherwise FMT would have always been restricted. Either way, there really are safety concerns.

https://academic.oup.com/ecco-jcc/article/8/2/179/596455


----------



## wildbill_52280

I may have posted this already but FMT seems to have cured epilepsy in one patient. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5442093/


----------



## wildbill_52280

Fecal transplants improve symptoms of cognitive dysfunction in patients with advanced liver disease.
http://www.iflscience.com/health-an...ve-some-patients-improved-cognitive-function/


----------



## wildbill_52280

I was going to email Bill Gate's organization 4 years ago about funding microbiome studies. I never did but I'm glad to hear he is interested now!

https://www.bloomberg.com/news/arti...-in-microbiome-studies-new-vaccine-technology

https://www.gatesnotes.com/Books/I-Contain-Multitudes


----------



## wildbill_52280

Very large study on FMT in crohn's disease in china.



> Brief Summary:
> The gut microbiota is considered to constitute a "microbial organ" which has pivotal roles in the intestinal diseases and body's metabolism. Evidence from animal and human studies strongly supports the link between intestinal bacteria and inflammatory bowel diseases (IBD). Dozens of studies reported its efficacy in treatment of severe Clostridium difficile colitis. Preliminary studies using FMT for Ulcerative Colitis (UC), Crohn's diseases (CD), irritable bowel syndrome (IBS) and constipation have also met with some success. However, the results on CD is very limited. This is an initial step into investigating the potential efficacy of fecal bacteriotherapy for CD, the investigators propose to determine the efficiency, durability and safety of FMT in a series of 500 patients with CD in ten years.


----------



## artheta

That sounds like news indeed, do you have a link to the study?


----------



## wildbill_52280

artheta said:


> That sounds like news indeed, do you have a link to the study?


Yeah sorry here it is, they are recruiting patients, in China though. But I just noticed the same page says they are only enrolling 30 patients for this study,so there must be some mistake or something.
https://clinicaltrials.gov/ct2/show/NCT01793831


----------



## wildbill_52280

Fecal transplant shows promise in IBD, other chronic conditions

https://www.healio.com/gastroentero...shows-promise-in-ibd-other-chronic-conditions


----------



## hugh

wildbill_52280 said:


> Fecal transplant shows promise in IBD, other chronic conditions
> 
> https://www.healio.com/gastroentero...shows-promise-in-ibd-other-chronic-conditions


holy crap.....
The 5 'D's of fecal transplants and not one of those 'd's is diet......
I'll wait till these clueless people work it out...

Compare that to Glenn Taylor of the Taymount (more than 20,000 FMTs), 
from a podcast interview....

Getting a New Gut Microbiota via Fecal Transplant with Glenn Taylor
"GT: Let’s make sure everybody understands here. Bacteria are fussier eaters than teenagers. They like their substrate. They’re quite specific about what their enzymes that they produce can actually break down. So they live in an ordered structure.

They have an order in which bacteria, who make hundreds of times more enzymes than we humans can, when substrate food—what we’ve eaten—when substrate allies with them, species take it in turn to crack and break the molecule in the nutritional food substance down as they work their way through.

So a species will leap, and at the top, they’ll start. Other species will come in and say, “Hey, that’s stuff I can use.” They’ll break that. More species, and the whole thing cascades down.

And to make sure the entire food chain is fed, there’s such a structure that goes with it, which,......

And of course, the antibiotics kill bacteria by particular methodologies. And they kill the pathogenic (which their target species are) and similar styles of commensal. They’re killed by exactly the same mechanism.

So you’ve gone in to kill a pathogen. But at the same time, you’ve killed one of your native, commensal species. Now, if each one of those at a critical point in this digestive cascade as it goes from top to bottom is not there to break the food down further, who feeds the little guys below?.......

....... And I’m totally, totally with you on that one. The treatment package when you have your gut microbiota must include, first of all, understanding your own environment and make sure that you’re eating the right foods. At least you’ve got substrate anyway.......

But as you so accurately said, hormones play havoc with your gut bacteria if they start to respond in different strengths. So gut bacteria are affected by somebody’s emotional state, as you say, stress. Everything within in our environment remodels our gut micro flora. It’s very, very sensitive indeed.

And so, yes, it’s not just the last meal you had but the last row you had. And so we have to sit with patients and make sure they totally understand all of the ramifications of lifestyle. And that is every element of it."
https://drruscio.com/getting-new-gut-microbiota-via-fecal-transplant-glenn-taylor/


----------



## wildbill_52280

https://drruscio.com/getting-new-gut-microbiota-via-fecal-transplant-glenn-taylor/

I read some of this and I've become skeptical of glenn taylor from the taymount clinic. He brings up interesting topics but he doesn't sound educated enough to navigate the territory he is trying to navigate and coming from me, that's a bad sign, because even i don't claim to know it all, so that's why I doubt he does either.

It could be the case they are doing successful FMT's for various conditions, but why since 2009 have they not made any official attempt to document their success? It makes one wonder, but I would never get a FMT from the Taymount clinic at this point, nor would I recommend anyone do that.

The page did have an awesome link to a study I was looking for though! https://www.ncbi.nlm.nih.gov/pubmed/28105618


----------



## wildbill_52280

https://hai.stanford.edu/events/eran-segal-human-gut-microbiome-health-and-disease


----------



## wildbill_52280

Gastroenterol Res Pract. 2018 Apr 3;2018

*The Value of Fecal Microbiota Transplantation in the Treatment of Ulcerative Colitis Patients: A Systematic Review and Meta-Analysis.*

Abstract
BACKGROUND AND AIMS:
Fecal microbiota transplantation (FMT) has challenged the traditional management of ulcerative colitis (UC) in recent years, while it remained controversial. We aimed to provide a systematic protocol of FMT treatment on UC.

METHODS:
Studies reporting on FMT treatment in UC patients were performed. A fixed-effect model was used to assess the efficacy of FMT.

RESULTS:
Eighteen studies were enrolled (n = 446). A pooled proportion of patients who received FMT had a significant efficacy compared to the placebo group (odds ratio (OR): 2.73, P = 0.002) with a low risk of heterogeneity (P = 0.59, I2 = 0%). The Mayo score decreased to 5 points in a state of mild-moderate activity after FMT treatment, and the optimal range of the Mayo score baseline was 6-9 for FMT administration. Then, the baseline of the Shannon diversity index (SDI) had a negative correlation with the clinical response rate (R = -0.992, P = 0.08) or remission rate (R = -0.998, P = 0.036), and the optimal diversity of bacteria was at 7 days to one month. Moreover, the colonoscopy delivery and unrelated fecal donor had slight superiorities of FMT treatment.

CONCLUSION:
FMT treatment had a higher efficacy and shorter time-point of early assessment of effectiveness on UC patients compared to traditional therapies. And the optimal FMT delivery and donor were colonoscopy delivery and unrelated donor in clinical practice.

https://www.ncbi.nlm.nih.gov/pubmed/29849592


----------



## wildbill_52280

Fecal microbiota transplantation improved symptoms in patients with refractory irritable bowel syndrome with severe abdominal bloating. Among 22 responders who were contacted at 1 year, six (27%) reported long-lasting effects, and five of them  were from the FMT group.

https://www.healio.com/gastroentero...proves-refractory-ibs-with-abdominal-bloating


----------



## wildbill_52280

Most protocols processing of stool for FMT destroy the bacteria that are needed due to exposure to oxygen. Finally someone is addressing this issue, I've known about this possibility for years now though. For DIY, using a blender to mix stool with saline will likely expose a lot of oxygen to it, mixing it slowly in a freezer bag that has no air might help protect it.

https://www.healio.com/infectious-d...-stool-processing-for-fmt-may-reduce-efficacy


----------



## wildbill_52280

> more than 150 drug makers globally are working on potential medicines for various disorders that could be linked to the human microbiome, and they have invested more than $2 billion in research, said Mo Langhi, an organizer of this week’s microbiome conference.





> It sounds like a preposterous idea: Collect a sample of every type of bacteria that lives in the human gut. But that’s the goal of Bernat Olle, an MIT-trained chemical engineer. Over the past three years, the Cambridge biotech startup he runs, Vedanta Biosciences Inc., has assembled a menagerie of some 60,000 bacteria types.


https://www.bostonglobe.com/business/2018/06/18/microbiome/4qkHpemmUCWcNVO1ERuIyH/story.html


----------



## wildbill_52280

WebMD health news: Research Flourishes on Promise of Fecal Transplants, Aug. 1, 2018.



> Madelynn Hernandez was in a battle. The California teenager loved to draw, dance, and study math, but her Crohn’s disease was seriously getting in the way.
> 
> “I had so much nausea, and my head was often spinning,” she says. “Sometimes I had good days and I was fine, but on the bad days, I just wanted to stay at home and lie on the couch. I was missing a lot of school.”
> 
> So last fall, when her doctor talked to her about being part of a study of new treatments for young people with bowel diseases, Hernandez jumped at the chance, even if it meant having someone else’s fecal matter put inside her body.
> 
> 
> Since receiving her fecal transplant, Hernandez’s Crohn’s disease remains in remission, and she has stopped taking most of her medications. In the next few months, the now 16-year-old expects to eliminate all of them.
> 
> “I feel so much better,” Hernandez says. “No stomach pain, no diarrhea.”


https://www.webmd.com/digestive-dis...ch-flourishes-on-promise-of-fecal-transplants


----------



## wildbill_52280

Two studies characterize the transmission of the microbiome from mother to infant during the first months of life.  October 1, 2018 | Andreu Prados 



> the maternal gut microbiome provided the largest contribution of transmitted strains. It was also found that maternal gut strains were more likely to adapt and persist in the infant gut compared with those acquired from other sources.


http://www.gutmicrobiotaforhealth.c...er-to-infant-during-the-first-months-of-life/


----------



## wildbill_52280

Bringing order to the ‘wild frontier’ of microbiome medicine.
By BERNAT OLLE, OCTOBER 2, 2018
https://www.statnews.com/2018/10/02/microbiome-medicine-living-drugs/



> Several startups and large pharmaceutical companies are doing important work to advance microbiome-related treatments.
> 
> But there are still many questions, as the FDA workshop made clear. Here are three big ones: How can we ensure that the bacteria included in living drugs won’t contribute to the spread of antibiotic resistance or virulence genes? What are the appropriate assays to ensure the quality of a living drug that will be used in clinical studies and, hopefully, in treatments? Can we ensure the manufacturing process will create consistent products? The industry must answer these correctly before the FDA will approve living drugs.





> Fecal transplants, which are inherently variable mixtures of undefined microbial composition, are no longer the only way to deliver health-promoting microbes to people who need them. Advances in basic science are positioning researchers to use more rigorous and systematic approaches to harnessing the power of the microbiome.
> 
> The company I lead, Vedanta Biosciences in Cambridge, Mass., and others are working to develop drugs that consist of carefully defined consortia of bacteria that have been shown to work together to fight off pathogens or to stimulate immune responses via the gut.
> 
> There will likely be many approaches to doing this. At Vedanta, we select strains of bacteria to include into possible drugs from a collection of tens of thousands of pure single-strain cultures. Once we have identified the strains we believe will work best together, we grow them separately in growth chambers called fermentors — no fecal donations needed. After extracting the bacteria from their fermentors, we freeze-dry them into stable powders, mix the powdered strains together, and pack the mixture into capsules.
> 
> Swallowing such a capsule releases the assemblage of helpful bacteria into the gut, where they are awakened from hibernation. As they colonize the gut and begin fitting in with the existing microbial ecosystem, they can help remodel the patient’s microbiome, creating a more resilient ecosystem better able to fight infections. The right mixtures can also manipulate the immune system in the intestine, either to tone it down (to help those with inflammatory bowel diseases or food allergies) or to rev it up (to help potentiate cancer immunotherapies and vaccines).


----------



## Deleted member 431298

Hi Wildbill.
I frequently stop by this thread to see what news you have found and relay to us. Te latest research projects conclusions seem promising for the wider acceptance of this treatment option. 
Fantastic to ve able to hope options outside immunosuppression.
y GI still refuses FMT has a place in the treatment of IBD but I am warming to the possibility of the DIY approach. Is just that the possibe donors don't do well on the Bristol scale 
But I digress..

What I really wanted though is to extend a warm thank you to you for gathering the relevant research here.
so thank you!


----------



## william4

I look forward to your posts wildbill


----------



## wildbill_52280

Human transition from hunter gathers to Agriculture is linked to changes in the microbiome.



> "the Tharu, the Raute, the Raji and the Chepang -- are longtime residents of the Himalayan foothills, with similar languages, cultural practices and ancestry. Where the four diverge is in their dietary history: The Tharu have practiced agriculture for the past 250 to 300 years; the Raute and the Raji have practiced agriculture for the past 30 to 40 years; and the Chepang are hunter-gatherers. The study found that the composition of the gut microorganisms, or gut microbiome, of each population differed based on whether and how long ago it had departed from a hunter-gatherer lifestyle."


https://www.eurekalert.org/pub_releases/2018-11/sm-vig110918.php


----------



## Scipio

FMT successfully treats colitis brought on by immune checkpoint inhibitor anti-cancer drugs:

https://www.nature.com/articles/s41591-018-0238-9


----------



## wildbill_52280

Scipio said:


> FMT successfully treats colitis brought on by immune checkpoint inhibitor anti-cancer drugs:
> 
> https://www.nature.com/articles/s41591-018-0238-9


Yea I saw this the other day, I was under the impression this new t-cell check point cancer therapy was a "miracle" with no side effects. I guess it kind of still is compared to surgery radiation and chemotherapy which have their own set of downsides independent of cancer itself. Hooray for FMT!! yet again!!

I also recently became aware of newly discovered relationships between cancer, the microbiome and t cell checkpoint therapy. A study in mice found certain probiotics suppressed cancer just as well as the checkpoint therapy. These are commercially available strains commonly found in yogurt. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4873287/

In a recent human study, it was found that differences in the gastrointestinal microbiome could enhance anticancer power of checkpoint therapy and explained the difference in response rates. https://news.uchicago.edu/story/spe...-tract-can-boost-success-cancer-immunotherapy

So it's reasonable to see that the restoration of the human microbiome via FMT even has applications in cancer treatment.


----------



## wildbill_52280

A recent study gave 7 colonoscopic Fecal transplants to ulcerative colitis patients showed a benefit, 46% or 19 patients achieved steroid free remission. They were previously dependent  on steroids.


*Efficacy of fecal microbiota therapy in steroid dependent ulcerative colitis: a real world intention-to-treat analysis.*

Intest Res. 2018 Nov 20.
doi: 10.5217/ir.2018.00089.

Abstract
BACKGROUND/AIMS:
Four high-quality randomized controlled trials have proven the efficacy of fecal microbiota transplantation (FMT) in active ulcerative colitis (UC). We assessed the efficacy of FMT in a real-world setting involving steroid-dependent patients with UC.

METHODS:
This was a single-center prospective analysis of data from steroid-dependent patients with UC treated with FMT from September 2015 to September 2017 at the Dayanand Medical College, a tertiary care center in India. Fecal samples from random unrelated donors were administered through colonoscopy at weeks 0, 2, 6, 10, 14, 18, and 22. The primary outcome was achievement of steroid-free clinical remission, and the secondary outcomes were clinical response and endoscopic remission at 24 weeks. Modified intention-to-treat analysis was performed, which included subjects who underwent at least 1 FMT.

RESULTS:
Of 345 patients with UC treated during the study period, 49 (14.2%) had steroid-dependent UC. Of these 49 patients, 41 underwent FMT: 33 completed 7 sessions over 22 weeks according to the protocol, and 8 discontinued treatment (non-response, 5; lost to follow-up, 2; and fear of adverse effects, 1). At week 24, steroid-free clinical remission was achieved in 19 out of 41 (46.3%) patients, whereas clinical response and endoscopic remission were achieved in 31 out of 41 (75.6%) and 26 out of 41 (63.4%) patients, respectively. All patients with clinical response were able to withdraw steroids. There were no serious adverse events necessitating discontinuation.

CONCLUSIONS:
A multisession FMT via the colonoscopic route is a promising therapeutic option for patients with steroid-dependent UC, as it can induce clinical remission and aid in steroid withdrawal.

https://www.ncbi.nlm.nih.gov/pubmed/30449078


----------



## wildbill_52280

This is the one we have been waiting for, a clinical study now begins testing Vedanta biosciences VE202, a bacterial pill taken orally for IBD which would replenish clostridia bacteria that regulate the inflammatory response. 

These bacteria have been shown to consistently be lower in diversity in microbiome studies of IBD patients. It's a more targeted approach compared to using whole stool. One of my concerns is whether the pill has enough strains to make an impact and whether they will readily and permanently inhabit the microbiome, but chances are pretty good they will. One recent study on FMT in U.C. associated remission in patients who's clostridium bacterial diversity had increased after FMT, this suggests these are the bacteria responsible for efficacy of FMT in IBD.

https://www.pharmaceutical-business-review.com/news/vedanta-biosciences-ve202-trial/


----------



## wildbill_52280

while I don't agree with all of this, I like that she goes over many of the current concepts in IBD treatment and science.

https://www.healio.com/gastroentero...-ibd-related-microbiome-key-to-potential-cure


----------



## wildbill_52280

There is a film coming out in 2019 about fecal transplants and whether it could cure IBD. 
https://designershitdocumentary.com/

https://www.podomatic.com/podcasts/samir3/episodes/2018-12-17T08_21_13-08_00


----------



## wildbill_52280

FMT study planned for allergic conditions.

https://www.boston25news.com/news/f...at-peanut-allergies-in-boston-study/875577919


----------



## Scipio

Important findings from a randomized clinical trial of FMT in treating UC:

https://jamanetwork.com/journals/jama/article-abstract/2720727


----------



## wildbill_52280

New Recipe for Fecal Transplants to Treat Ulcerative Colitis: Multiple Donors and Ditch the Oxygen
Posted January 17, 2019 by Ricki Lewis, PhD in Uncategorized

https://blogs.plos.org/dnascience/2...colitis-multiple-donors-and-ditch-the-oxygen/


----------



## wildbill_52280

A new article on microbiome research linking increasing industrialization, modern medicine/antibiotics to lower diversity of microbes when comparing microbiomes of less industrialized societies to more developed ones. 

This is related to fecal transplantation and IBD in that the ibd microbiome is less diverse then a healthy person and FMT increases the overall diversity, and reduces symptoms.
https://phys.org/news/2019-01-diversity-rural-african-populations-microbiomes.html


----------



## Spooky1

That's interesting, Bill.  Thanks.  Somehow i fully expected those in tribes or more remote areas to have healthier gut flora.  My Crohn's is now at the point where i need surgery.... again!


----------



## wildbill_52280

Spooky1 said:


> That's interesting, Bill.  Thanks.  Somehow i fully expected those in tribes or more remote areas to have healthier gut flora.  My Crohn's is now at the point where i need surgery.... again!


I'll have to get all the details again but generally the people of Botswana are not a remote tribe, this is a recently modernized country, which could include food industrialization and the toxic additives that come with it and modern medicine which include, antibiotics.


----------



## wildbill_52280

https://xconomy.com/boston/2019/02/07/seres-lays-off-30-of-staff-cso-leaves-after-pipeline-review/


----------



## wildbill_52280

An update on bill gates involvement in microbiome science.
https://www.businessinsider.my/bill-gates-diet-breakthrough-microbiome-2019-2/



> Gates’ interest in digestion goes beyond the disgusting and debilitating kinds of bacteria in our systems. The billionaire investor recently said he thinks we can revamp the inner workings of our guts by seeding the microbial colonies that live inside us.
> 
> “One thing that people are not expecting a breakthrough in that I’m quite optimistic we will get a breakthrough in is understanding nutrition,” Gates said during a conversation last week at the 92nd Street Y in New York. He thinks hacking the microbiome is the way to do it.


----------



## wildbill_52280

Just a reconfirmation of previously known facts on the susceptibility of the bacteria in the G.I. microbiome to oxygen, in other words, oxygen kills them.

*Bacterial viability in faecal transplants: Which bacteria survive?*

EBioMedicine. 2019 Feb 19. pii: S2352-3964(19)30095-7. doi: 10.1016/j.ebiom.2019.02.023. [Epub ahead of print]
Abstract

BACKGROUND:
The therapeutic potential of faecal microbiota transplantation (FMT) is under investigation for a range of inflammatory conditions. While mechanisms of benefit are poorly understood, most models rely on the viability of transplanted microbes. We hypothesised that protocols commonly used in the preparation of faecal transplants will substantially reduce the number, diversity and functional potential of viable microbes.

METHODS:
Stools from eight screened donors were processed under strict anaerobic conditions, in ambient air, and freeze-thawed. Propidium monoazide (PMA) sample treatment was combined with quantitative PCR, 16S rRNA gene amplicon sequencing and short-chain fatty acid (SCFA) analysis to define the viable microbiota composition and functional potential.

FINDINGS:
Approximately 50% of bacterial content of stool processed immediately under strict anaerobic conditions was non-viable. Homogenisation in ambient air or freeze-thaw reduced viability to 19% and 23% respectively. Processing of samples in ambient air resulted in up to 12-fold reductions in the abundance of important commensal taxa, including the highly butyrogenic species Faecalibacterium prausnitzii, Subdoligranulum variable, and Eubacterium hallii. The adverse impact of atmospheric oxygen exposure on the capacity of the transplanted microbiota to support SCFA biosynthesis was demonstrated by significantly reduced butyrate and acetate production by faecal slurries processed in ambient air. In contrast, while reducing overall levels of viable bacteria, freeze-thaw did not significantly alter viable microbiota composition.

INTERPRETATION:
The practice of preparing material for faecal transplantation in ambient air profoundly affects viable microbial content, disproportionately reducing the abundance of anaerobic commensals and the capacity for biosynthesis of important anti-inflammatory metabolites.


----------



## wildbill_52280

https://www.khou.com/article/news/d...ease/285-86b1359c-51c4-4d12-b428-0cfa84215b1a


----------



## wildbill_52280

Pretty important article about the future of fecal transplants.
https://www.nytimes.com/2019/03/03/health/fecal-transplants-fda-microbiome.html


----------



## wildbill_52280

https://medicalxpress.com/news/2019-03-linking-bacterial-populations-health.html


----------



## Deleted member 431298

This new study prospectively examined the fecal microbiota in adult CD patients with changing or stable disease course over time.
It concludes that while CD patients have an altered microbiota, quote: "The altered microbiota composition and stability in CD was neither associated with disease activity nor long-term disease course, questioning its involvement in the development of an exacerbation".

https://www.ncbi.nlm.nih.gov/m/pubmed/30810207/


----------



## wildbill_52280

OleJ said:


> This new study prospectively examined the fecal microbiota in adult CD patients with changing or stable disease course over time.
> It concludes that while CD patients have an altered microbiota, quote: "The altered microbiota composition and stability in CD was neither associated with disease activity nor long-term disease course, questioning its involvement in the development of an exacerbation".
> 
> https://www.ncbi.nlm.nih.gov/m/pubmed/30810207/


Yea that is interesting. I don't think it is strong enough to contradict all the research that exists though. The conclusion may also be limited to how they tracked the microbiome, I don't know enough about all the tools or ways that exist but I do know there are advantages and disadvantages to each method, in this one I think they used 16srna. 

Either way, this study also acknowledges less overall diversity of the crohns/IBD microbiome compared to healthy control, so this is in agreement with many other observations, seems to be a general consensus on that fact, that somehow, the microbiome is involved in IBD. 

There also seems to be a growing acknowledgement of the involvement of other organisms like fungi and viruses, so if they were only looking at bacteria, they may not have observed much differences during exacerbation of symptoms. I know a little bit but I'm not an absolute expert. So far I'm still sticking with the concept that our microbiome is messed up and restoring it will lead to a cure.


----------



## wildbill_52280

VCU researchers demonstrate long-term cognitive benefits of fecal transplantation in cirrhosis patients.
https://www.news.vcu.edu/article/VCU_researchers_demonstrate_longterm_cognitive_benefits_of_fecal


----------



## wildbill_52280

Identification of the microbial diversity after fecal microbiota transplantation therapy for chronic intractable constipation using 16s rRNA amplicon sequencing.

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0214085


----------



## wildbill_52280

Exp Ther Med. 2019 Apr;17(4):2581-2586. doi: 10.3892/etm.2019.7263. Epub 2019 Feb 13.

*Effect of fecal microbiota transplantation on experimental colitis in mice.*

Abstract

The aim of the present study was to investigate the effect of fecal microbiota transplantation (FMT) on the acute inflammatory response in a murine model of dextran sulfate sodium (DSS)-induced colitis, and to delineate the putative underlying mechanism(s). Mice were divided into four groups, namely the normal control, DSS, 5-aminosalicylic acid (5-ASA) and FMT group. Mice in the DSS, 5-ASA and FMT groups were orally administered 3% DSS (w/v) solution for 7 days to induce colitis. On days 1, 3, 5 and 7, mice in the DSS, 5-ASA and FMT groups were respectively administered 0.5% carboxymethylcellulose sodium, 5-ASA suspension and fecal suspension by enema. The disease activity index of each mouse was calculated on a daily basis. All mice were sacrificed on day 8, and the length of their colons was measured. 

Myeloperoxidase (MPO) activity, and the levels of tumor necrosis factor α (TNF-α), interleukin (IL)-1β and IL-10 in the colon tissues of each group were also measured. Compared with that in the DSS group, FMT ameliorated the severity of inflammation due to ulcerative colitis in mice, which was accompanied by a significantly decreased MPO activity, reduced levels of TNF-α and IL-1β, and an increased level of IL-10 in colon tissue (all P<0.05). Taken together, these results demonstrated that FMT exerted a therapeutic effect on experimental colitis in mice, and the associated mechanism is likely to involve the remodeling of the intestinal flora and regulation of intestinal T-cell immunity homeostasis.

https://www.ncbi.nlm.nih.gov/pubmed/30906449


----------



## wildbill_52280

This is one of the first studies using FMT pills for U.C, but it's a little disappointing. I wish I had all the details like how they made the pills, were they whole spectrum? just bacteria? and what was the CFU and were there any diet recommendations. Then perhaps id have a better understanding of why it wasn't successful or not. 

It's certainly not enough information to make me give on the the concept with so much other information that is better that supports the merit of FMT for IBD.

https://www.ncbi.nlm.nih.gov/pubmed/30946615


----------



## wildbill_52280

Autism symptoms reduced nearly 50% 2 years after fecal transplant.



> In a new study, “Long-Term Benefit of Microbiota Transfer Therapy in Autism Symptoms and Gut Microbiota,” published in Scientific Reports, Arizona State University researchers Rosa Krajmalnik-Brown, James Adams and lead author Dae-Wook Kang demonstrate long-term beneficial effects for children diagnosed with ASD through a revolutionary technique known as Microbiota Transfer Therapy (MTT), a special type of fecal transplant originally pioneered by Australian gastroenterologist Thomas Borody. Remarkably, improvements in gut health and autism symptoms appear to persist long after treatment.


https://asunow.asu.edu/20190409-dis...y-50-percent-two-years-after-fecal-transplant


----------



## Spooky1

Hmm, i'm really Aspberger's.  Another reason for them to hurry up with fecal transplant.  Thanks, Wildbill.  Mind, gonna have to try that cbd with thc as I am pretty sure I have cancer now.  Ladies cancer, btw.  I'm researching like mad at the moment.  I'm in the UK, I've never had any luck with my health.  I've just sent off for some that has a 16.5% thc, I hope it helps.


----------



## wildbill_52280

Spooky1 said:


> Hmm, i'm really Aspberger's.  Another reason for them to hurry up with fecal transplant.  Thanks, Wildbill.  Mind, gonna have to try that cbd with thc as I am pretty sure I have cancer now.  Ladies cancer, btw.  I'm researching like mad at the moment.  I'm in the UK, I've never had any luck with my health.  I've just sent off for some that has a 16.5% thc, I hope it helps.


I really hope you don't have cancer, if this is a concern then I just want you to know that melatonin has been shown to be effective in wide range of different cancers in a human study done 20 years ago. https://www.ncbi.nlm.nih.gov/pubmed/10674014

many other papers written on the potential for melatonin, and perhaps you are aware this is a hormone our body produces in response to darkness.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5412427/


Here is information on the most powerful cancer fighting foods:

https://nutritionfacts.org/video/1-anticancer-vegetable/
https://nutritionfacts.org/video/which-fruit-fights-cancer-better/
https://nutritionfacts.org/video/which-nut-fights-cancer-better/
https://nutritionfacts.org/video/cancer-interrupted-garlic-flavonoids/


----------



## Spooky1

Thanks, Bill.


----------



## wildbill_52280

https://www.scmp.com/lifestyle/heal...ecal-transplants-irritable-bowel-syndrome-and


----------



## wildbill_52280

https://www.biotechniques.com/micro...-future-of-fecal-microbiota-transplantations/


----------



## wildbill_52280

A company that is developing microbiome based drugs made of bacteria, recently had their patents challenged by competing companies, but they were allowed to keep the patent. They have a broad patent on clostridial species which are important to the gut and regulation of inflammation in the gut. Microbiome studies in IBD shows these species are less diverse compared to healthy patients. 

https://www.apnews.com/Business Wire/dc1c35a728b9409b8fee7b0ab33deea2

https://www.vedantabio.com/news-med...a-biosciences-key-microbiome-patent-upheld-in


----------



## wildbill_52280

Hong Kong faecal donor recruitment drive draws 10,000 applications to Asia Microbiota Bank
https://www.scmp.com/news/hong-kong...ong-kong-faecal-donor-recruitment-drive-draws


----------



## Poppysocks

I've always wanted to try FMT. Is it still only used for Cdiff? Anyway we can do this without getting government or doctor approval?


----------



## wildbill_52280

Poppysocks said:


> I've always wanted to try FMT. Is it still only used for Cdiff? Anyway we can do this without getting government or doctor approval?


If you have a healthy donor, there isn't much else stopping you from doing it, other then its kind of hard to do successfully, its the bacteria sensitivity to oxygen that is an obstacle so don't mix it in a blender.

 And the donor should follow a chemical free high fiber diet 2-3 weeks before hand. Then you can give yourself some FMT enemas and see what happens. I suggest you just plug your nose and swallow it on an empty stomach followed by a high fiber meal 20min afterwards, but that's pretty disgusting. Mix it with saline solution in a freezer bag with as much air squeezed out as possible.


----------



## wildbill_52280

*In search of stool donors: a multicenter study of prior knowledge, perceptions, motivators, and deterrents among potential donors for fecal microbiota transplantation.*

Abstract

Fecal microbiota transplantation (FMT) is a highly effective therapy for recurrent Clostridioides difficile infection. Stool donors are essential, but difficult to recruit and retain. We aimed to identify factors influencing willingness to donate stool. 

We conclude that 1) blood donors and males are more willing to consider stool donation; 2) altruism, economic compensation, and positive feedback are motivators; and 3) screening process, high donation frequency, logistics of collection/transporting feces, lack of public awareness, and negative social perception are deterrents. Considering these variables could maximize donor recruitment and retention.


https://www.ncbi.nlm.nih.gov/pubmed/31122134


----------



## Guerrero

Research first: Study identifies how the microbiome is disrupted by IBD

The biochemical and molecular events that disrupt the microbiome and trigger immune responses during flare-ups of inflammatory bowel disease (IBD) have been observed and reported by scientists for the first time, say those behind the study.


----------



## Flopsy

Wow, Wild Bill. Thanks for all your research. I'm in the San Francisco Bay area and am actively seeking an FMT donor. 

So this is my idea:
A group of us in the San Francisco Bay Area (or other parts of California) can "share" our donors. That way each of us can have more bacterial diversity. All of us need to have a healthy donor who is expertly and verifiably screened. We would pay a specified amount for each "donation".
If this works out, and we recruit more donors, we can invite other people to join who really need FMTs. Let's help each other! I'd love to hear your feedback. Let's start a movement... so to speak.


----------



## wildbill_52280

Flopsy said:


> Wow, Wild Bill. Thanks for all your research. I'm in the San Francisco Bay area and am actively seeking an FMT donor.
> 
> So this is my idea:
> A group of us in the San Francisco Bay Area (or other parts of California) can "share" our donors. That way each of us can have more bacterial diversity. All of us need to have a healthy donor who is expertly and verifiably screened. We would pay a specified amount for each "donation".
> If this works out, and we recruit more donors, we can invite other people to join who really need FMTs. Let's help each other! I'd love to hear your feedback. Let's start a movement... so to speak.


A Movement!! very nice! I do like the idea, I'm not in this mindset at the moment but that's where I was when I posted this years ago. There is a FMT facebook group I one posted there too. Wish you the best of luck!! 

Oxygen is a very big variable to a successful transplant not sure how much you know at this moment, but diversity is too, as the only woman to have been cured of crohn's used 3 donors at once with a nasogastric tube. Mixing in a freezer bag instead of a blender is how you could limit exposure to oxygen for an enema. learning to use a nasogastric tube is one option, just drinking the solution is another.


----------



## Flopsy

why can't the donor just drop their stool directly into a bath of salt water? and then that would be put directly in a baggie.


----------



## Scipio

FDA warns on FMT:

Two immunocompromised adults who received investigational FMT developed invasive infections caused by extended-spectrum beta-lactamase (ESBL)-producing _Escherichia coli (E.coli)_. One of the individuals died.
FMT used in these two individuals were prepared from stool obtained from the same donor.
The donor stool and resulting FMT used in these two individuals were not tested for ESBL-producing gram-negative organisms prior to use. After these adverse events occurred, stored preparations of FMT from this stool donor were tested and found to be positive for ESBL-producing _E. coli_ identical to the organisms isolated from the two patients.

https://www.fda.gov/vaccines-blood-biologics/safety-availability-biologics/important-safety-alert-regarding-use-fecal-microbiota-transplantation-and-risk-serious-adverse


----------



## wildbill_52280

Scipio said:


> FDA warns on FMT:
> 
> Two immunocompromised adults who received investigational FMT developed invasive infections caused by extended-spectrum beta-lactamase (ESBL)-producing _Escherichia coli (E.coli)_. One of the individuals died.
> FMT used in these two individuals were prepared from stool obtained from the same donor.
> The donor stool and resulting FMT used in these two individuals were not tested for ESBL-producing gram-negative organisms prior to use. After these adverse events occurred, stored preparations of FMT from this stool donor were tested and found to be positive for ESBL-producing _E. coli_ identical to the organisms isolated from the two patients.
> https://www.fda.gov/vaccines-blood-biologics/safety-availability-biologics/important-safety-alert-regarding-use-fecal-microbiota-transplantation-and-risk-serious-adverse



You see it isn't that simple when you read the study below reporting FMT being safe in immunocompromised patients in 2016. There were so many variables as to why one of those patients died but most importantly the donor must be screened to some degree and healthy beyond all measures we cannot conclude all FMTs are going to kill people when so many have been done at this point in the tens of thousands now for c diff since it was approved. 
Int J Colorectal Dis. 2016 May; 31(5): 1059–1060.
*Fecal transplant is as effective and safe in immunocompromised as non-immunocompromised patients for Clostridium difficile*








						Fecal transplant is as effective and safe in immunocompromised as non-immunocompromised patients for Clostridium difficile
					






					www.ncbi.nlm.nih.gov


----------



## wildbill_52280

Flopsy said:


> why can't the donor just drop their stool directly into a bath of salt water? and then that would be put directly in a baggie.


 well it would be saline which is a defined concentration of salt water as far as I recall. I forget the details but too much salt and that could negatively affect things perhaps. You can make saline yourself though, and generally it just gets mixed with the stool and yes you should do it in a freezer bag to limit exposure to oxygen.


----------



## Scipio

wildbill_52280 said:


> You see it isn't that simple when you read the study below reporting FMT being safe in immunocompromised patients in 2016. There were so many variables as to why one of those patients died but most importantly the donor must be screened to some degree and healthy beyond all measures we cannot conclude all FMTs are going to kill people when so many have been done at this point in the tens of thousands now for c diff since it was approved.


No one is saying that "all FMTs are going to kill people."  FDA is saying that in light of these new findings that caution must be used and certain donor screening protocols need to be implemented.

From the FDA warning:

Because of these serious adverse reactions that occurred with investigational FMT, FDA has determined that the following protections are needed for any investigational use of FMT:    

Donor screening with questions that specifically address risk factors for colonization with MDROs, and exclusion of individuals at higher risk of colonization with MDROs.
MDRO testing of donor stool and exclusion of stool that tests positive for MDRO. FDA scientists have determined the specific MDRO testing and frequency that should be implemented.


----------



## wildbill_52280

*A Guide for Ex Vivo Handling and Storage of Stool Samples Intended for Fecal Microbiota Transplantation*








						A Guide for Ex Vivo Handling and Storage of Stool Samples Intended for Fecal Microbiota Transplantation - Scientific Reports
					

Owing to the growing recognition of the gut microbiota as a main partner of human health, we are expecting that the number of indications for fecal microbiota transplantation (FMT) will increase. Thus, there is an urgent need for standardization of the entire process of fecal transplant...




					www.nature.com


----------



## wildbill_52280

> A fecal-transplant patient has unexpectedly died just as the FDA is deciding the future of the unconventional procedure.
> The donor for the patient who died was carrying antibiotic-resistant bacteria called extended-spectrum beta lactamase–producing _Escherichia coli_, which normally do not sicken healthy people but can be fatal in patients with already weakened immune systems, like in this recent case.
> 
> The role of this bacterium doesn’t come as a huge surprise. OpenBiome, a nonprofit stool bank, already screens for ESBL-producing _E. coli _along with other antibiotic-resistant bacteria. But individual doctors can still rely on a relative of a patient or find other donors outside of stool banks, and screening practices differ. (OpenBiome did not provide the sample in the fatal case, and the FDA has not made public any further information about the donor or where the procedure was done.)











						Should Human Feces Be Regulated Like a Drug?
					

A fecal-transplant patient has unexpectedly died just as the FDA is deciding the future of the unconventional procedure.




					www.theatlantic.com


----------



## wildbill_52280

*Increasing the Dose and/or Repeating Faecal Microbiota Transplantation (FMT) Increases the Response in Patients with Irritable Bowel Syndrome (IBS)*
_Nutrients_ *2019*, _11_(6), 1415; https://doi.org/10.3390/nu11061415
Received: 7 June 2019 / Revised: 19 June 2019 / Accepted: 21 June 2019 / Published: 24 June 2019




> Ten IBS patients who did not respond to a 30-g transplant subsequently received a 60-g transplant into the duodenum via a gastroscope. Results: Seven patients (70%) responded to the 60-g transplant, with significant clinical improvements in the abdominal symptoms, fatigue and quality of life in 57%, 80% and 67% of these patients. The 60-g transplant also reduced the DI (dysbiosis index). Conclusion: FMT is an effective treatment for IBS. A high-dose transplant and/or repeated FMT increase the response rate and the intensity of the effects of FMT











						Increasing the Dose and/or Repeating Faecal Microbiota Transplantation (FMT) Increases the Response in Patients with Irritable Bowel Syndrome (IBS)
					

Background: Faecal microbiome transplantation (FMT) appears to be an effective method for treating irritable bowel syndrome (IBS) patients. However, it is not clear if a high transplant dose and/or repeating FMT are/is needed to ensure a response. The present study was undertaken to clarify this...




					www.mdpi.com


----------



## wildbill_52280

> On 29 May, a treasure trove of data from the US National Institutes of Health’s (NIH) Human Microbiome Project (HMP) was published. This set of studies, known as the integrative HMP (iHMP), explored the complex interactions between humans and their resident microbiomes during disease.
> 
> For example, the study confirmed the depletion of obligate anaerobic bacteria in IBD. Two of the major species affected, Faecalibacterium prausnitzii and Rosburia hominus, are the main components of preclinical-stage pipeline therapies for IBD from Nextbiotix (NBX-1650) and 4D Pharma PLC’s (Rosburix), respectively. F. prausnitzii in particular accounted for some of the strongest associations overall with IBD-related dysbiosis, including the downregulation of numerous enzyme classes. Interestingly, members of the Roseburia genus were closely associated with gut metabolites, bile acids and acylcarnitines in particular, that were found to be dysregulated in IBD dysbiosis and featured prominently in the multi-omics association network.











						The microbiome in IBD: multiomics analysis may help clarify an elusive mechanism of action
					

Microbiome in IBD: One of the key takeaways from the study was that the gut microbiome was far more unstable longitudinally in people with IBD than in people without IBD.




					www.pharmaceutical-technology.com


----------



## wildbill_52280

New visions into the transmission of the mammalian gut microbiota
					

Published in Science




					microbiomepost.com


----------



## wildbill_52280

> mice that received an FMT from obese donors had a significantly different microbiome compared to mice that received an FMT from lean donors. However, after 22 weeks, diet influenced the microbiome composition irrespective of donor body type, suggesting that diet is a key variable in the shaping of the gut microbiome after FMT.











						Basal Diet Determined Long-Term Composition of the Gut Microbiome and Mouse Phenotype to a Greater Extent than Fecal Microbiome Transfer from Lean or Obese Human Donors
					

The Western dietary pattern can alter the gut microbiome and cause obesity and metabolic disorders. To examine the interactions between diet, the microbiome, and obesity, we transplanted gut microbiota from lean or obese human donors into mice fed one of three diets for 22 weeks: (1) a control...




					www.mdpi.com
				




This was in mice but it kind of shows the importance of diet in shaping the microbiome, for either a donor or a patient of FMT. This was evidence for the patient, but I'll bet a similar importance for the donor as well.


----------



## wildbill_52280

*Fecal Microbiota Transplantation Effect on Amyotrophic Lateral Sclerosis Patients*









						Fecal Microbiota Transplantation Effect on Amyotrophic Lateral Sclerosis Patients - Full Text View - ClinicalTrials.gov
					

Fecal Microbiota Transplantation Effect on Amyotrophic Lateral Sclerosis Patients - Full Text View.




					clinicaltrials.gov


----------



## wildbill_52280

*Cleaning up an image: the crusade to rename fecal microbiota transplant*
*August 26, 2019*








						Cleaning up an image: the crusade to rename fecal microbiota transplant Page 2
					

The intrigue surrounding the use of fecal microbiota transplantation to treat various gastrointestinal disorders and infections has intensified over the last several years. As research continues to ramp up in the area of FMT, more and more people are becoming interested in the use of fecal...




					www.healio.com
				




*



			Healio: What are some of the ways that you can try to influence the changing of the nomenclature?
Khoruts:
		
Click to expand...

*


> It’s part of the crusade. I publish a number of papers on various aspects of this treatment every year. I have pledged to not use the ‘FMT’ term in my own publications, and when I collaborate with other investigators, I insist on the same. At the minimum I try to acknowledge the ‘intestinal microbiota transplant’ term. I do the same in my talks. I have approached OpenBiome about it, and they are mulling it over.
> However, I think the momentum will pick up once people start to experience its effects in their practice. Frankly, I would be perfectly fine if the term ‘microbiota’ continued to be used as originally intended. At least that would maintain accuracy. However, ‘fecal transplant’ is wrong and irritating, and most importantly it is potentially embarrassing, unpleasant, and offensive to patients.


----------



## wildbill_52280

*The recognition and attitudes of postgraduate medical students toward fecal microbiota transplantation: a questionnaire study.*








						The recognition and attitudes of postgraduate medical students toward fecal microbiota transplantation: a questionnaire study - PubMed
					

This study revealed the low recognition level of postgraduate medical students about FMT. Therefore, medical education should not neglect the knowledge of FMT. Studies of FMT and standardized FMT should be carried out to promote its development.




					www.ncbi.nlm.nih.gov


----------



## wildbill_52280

*Framework for rational donor selection in fecal microbiota transplant clinical trials*
Published: October 10, 2019









						Framework for rational donor selection in fecal microbiota transplant clinical trials
					

Early clinical successes are driving enthusiasm for fecal microbiota transplantation (FMT), the transfer of healthy gut bacteria through whole stool, as emerging research is linking the microbiome to many different diseases. However, preliminary trials have yielded mixed results and suggest that...




					journals.plos.org


----------



## wildbill_52280

Am J Gastroenterol. 2020 Jan 10. doi: 10.14309/ajg.0000000000000499. [Epub ahead of print]
*Understanding the Scope of Do-It-Yourself Fecal Microbiota Transplant.*

*Abstract*

*OBJECTIVES:*
Fecal microbiota transplantation (FMT) has emerged as an effective treatment option for Clostridioides difficile infection (CDI) and is considered an investigational therapy for a number of other diseases. Social media has facilitated widespread exposure of the public to the gut microbiome and FMT, ultimately acting as a catalyst for the Do-It-Yourself (DIY)-FMT movement. The aims of this study were to identify factors that influenced willingness to pursue DIY-FMT including common indications, screening processes, sample preparation, and self-reported efficacy and safety outcomes.

*METHODS:*
A twenty-five-point cross-sectional survey was posted online through the websites and social media pages of the Peggy Lillis Foundation, The Fecal Transplant Foundation, and The Power of Poop. Responses were cataloged through the Research Electronic Data Capture tool, and descriptive analyses were performed.

*RESULTS:*
Eighty-four respondents completed the survey between January 2018 and February 2019. The majority were female (71%) and white (92%). Most (80%) reported performing FMT on themselves; 87% used Internet resources to assist in the process, and 92% knew their stool donor. Inflammatory bowel disease (35%) and irritable bowel syndrome (29%) were the 2 most common conditions that respondents attempted to treat. Only 12% reported adverse events, whereas 82% reported improvement in their condition.

*DISCUSSION:*
DIY-FMT is being used for many indications, including those for which there is little evidence. There was a high self-reported success rate among respondents with few adverse events. There is a need for increased awareness around DIY-FMT and research around this phenomenon, which may impact public health.










						Understanding the Scope of Do-It-Yourself Fecal Microbiota Transplant - PubMed
					

DIY-FMT is being used for many indications, including those for which there is little evidence. There was a high self-reported success rate among respondents with few adverse events. There is a need for increased awareness around DIY-FMT and research around this phenomenon, which may impact...




					www.ncbi.nlm.nih.gov


----------



## wildbill_52280

*Drugs From Bugs: Why Gates, Zuck And Benioff Think The Next Blockbusters Will Come From Inside Your Gut*
Forbes magazine Feb 7, 2020.


"The race is on for FDA approval of the first drug made from gut bacteria. But the science is young and unproven. At Oppenheimer in New York, Mark Breidenbach says investor enthusiasm in microbiome companies is on a downswing because “there is no consensus about what the microbiome can do.” Amusa is more bullish. “The science is turning,” he says. “When it comes through with proof, these biotech companies will be worth not hundreds of millions of dollars, but billions. " "

"In the U.S., more than a million people suffer from autism, and there are no drugs to treat it; an additional million have Parkinson’s. What would be the value of an FDA-approved drug for either condition? “I can’t give you a market size,” says Donabedian. “But if either one hits, it will be huge.”

Chris Howerton, a biotechnology analyst at Jefferies, a New York investment bank, is less shy. “If every single microbiome paper turns into a proven therapy, it could impact the drug markets for most major categories of disease, which together were worth $350 billion in 2018 in the U.S. alone,” he says. “The breadth of the microbiome’s potential application is really tantalizing.”











						Drugs From Bugs: Why Gates, Zuck And Benioff Think The Next Blockbusters Will Come From Inside Your Gut
					

A groundswell of cutting-edge research has the potential to deliver a burst of new therapies that will vastly reduce human suffering—and generate huge paydays for the field’s pioneers.




					www.forbes.com


----------



## Spooky1

Really interesting, Wildbill.  Thanks for the update


----------



## Scipio

Two dead and four hospitalized after fecal transplants from OpenBiome:






						1 dead, 6 sickened after OpenBiome fecal transplants, FDA says
					

Two people died and four were hospitalized after receiving OpenBiome stool transplants as a treatment for Clostridium difficile, the FDA said in a March 12 safety alert.




					www.beckershospitalreview.com


----------



## Spooky1

Omg, isn't that a bit of a first?  Grateful for the information.


----------



## wildbill_52280

Scipio said:


> Two dead and four hospitalized after fecal transplants from OpenBiome:
> 
> 
> 
> 
> 
> 
> 1 dead, 6 sickened after OpenBiome fecal transplants, FDA says
> 
> 
> Two people died and four were hospitalized after receiving OpenBiome stool transplants as a treatment for Clostridium difficile, the FDA said in a March 12 safety alert.
> 
> 
> 
> 
> www.beckershospitalreview.com


It's concerning, but this organization has treated about 55,000 people according to the article, so it's still a good track record. No one should ever die though. At times only the sickest patients are getting these FMT treatments, people dying with C. difficile, so considering that, one could say it's still a very good safety record.


----------



## wildbill_52280

I think I made a breakthrough in my understanding of FMT and performing a DIY FMT a few months ago, just to let you all know!! Just not sure how or when I will communicate this. I haven't made another attempt at a DIY FMT yet.


----------



## Spooky1

Wow, sounds interesting.  
I hear that Prof Brorody in Australia has claimed the Crohn's Cure, according to the Daily Mail.  Yeah, just as i'm fighting cancer along comes a Crohn's cure, just my luck.  Let's all be hopeful.


----------



## wildbill_52280

Spooky1 said:


> Wow, sounds interesting.
> I hear that Prof Brorody in Australia has claimed the Crohn's Cure, according to the Daily Mail.  Yeah, just as i'm fighting cancer along comes a Crohn's cure, just my luck.  Let's all be hopeful.


Sorry to hear about the cancer my friend. I did read the latest paper Borody released about crohn's, it was nice to hear more people in very long remission without drugs and with FMT, and very likely cured.


----------



## Lady Organic

*Profound remission in Crohn’s disease requiring no further treatment for 3–23 years: a case series*
Gaurav Agrawal, Annabel Clancy, Roy Huynh & Thomas Borody 
_Gut Pathogens_ *volume 12*, Article number: 16 (2020) 








						Profound remission in Crohn’s disease requiring no further treatment for 3–23 years: a case series - Gut Pathogens
					

Background Crohn’s disease (CD) is rising in incidence and has a high morbidity and increased mortality. Current treatment use immunosuppressives but efficacy is suboptimal, and relapse is common. It has been shown that there is an imbalance present in the gut microbiome (dysbiosis) in CD with a...




					gutpathogens.biomedcentral.com


----------



## Spooky1

I wonder how long we will have to wait for this treatment.  Probably years knowing the UK at least.  But any news is good news.


----------



## wildbill_52280

Here are the results of a search of clinical trials posted/planned from 01/01/2018 to 06/16/2020 for fecal transplant in crohn's disease:
link to clinicaltrials.gov 

There were 6 studies, 2 of them in the USA. This doesn't include any studies that are in progress before this date though. One study is using pills that they are making themselves, not the ones from openbiome found here link, which the cost is now about 4x what it was about a year ago from what I recall.


----------



## wildbill_52280

latest progress on a FMT pill by Vedanta biosciences which contains 16 strains of bacteria from clostridium cluster xiva and iv, intended to treat IBD. There is a phase 2 study planned for the next 12 months. link

This is not a full spectrum Fecal Transplant which would contain many more strains of bacteria from these groups of bacteria but could be enough to colonize the gut and begin to fix some of the damage to the microbiome which could be the main cause of chronic inflammation, dare I carefully say, a cure. But a Full spectrum fecal transplant could still be superior to these bacterial selections and include beneficial fungi and viruses too, as well as more strains, there are hundreds of strains, the human microbiome contains around 10,000 strains of bacteria and about 1000 species and some ibd patients not only have damage to clostridium but other groups of bacteria as well, although clostridium may be the most important group.


----------



## wildbill_52280

*Faecal microbial transplantation more effective and less costly than antibiotics to treat C-diff infections **JUNE 29, 2020*
by University of Birmingham










						Faecal microbial transplantation more effective and less costly than antibiotics to treat C-diff infections
					

An innovative treatment for patients with Clostridium difficile infection (CDI) which uses transplanted gut bacteria to treat the infection, is a more effective and more cost-efficient treatment than using antibiotics, a new UK study has found.




					medicalxpress.com


----------



## wildbill_52280

*The Microbiome Biotech Landscape: An Analysis of the Pharmaceutical Pipeline*






						The Microbiome Biotech Landscape: An Analysis of the Pharmaceutical Pipeline - Microbiome Times Magazine
					






					www.microbiometimes.com


----------



## AmeliaOgden

nice thread
a lot of useful info


----------



## wildbill_52280

"We have used mice colonized with microbiotas from humans with inflammatory bowel disease to study what happens when these mice receive a microbiota transplant from a set of healthy humans. We find that the mouse gut immune system is changed by microbiota transplants, becoming broadly less inflammatory and protecting mice from colitis. "









						Defined microbiota transplant restores Th17/RORγt+ regulatory T cell balance in mice colonized with inflammatory bowel disease microbiotas
					

Composition of gut microbiota is altered in many human diseases, including inflammatory bowel disease. Some hope that restoring microbiota to a healthy state could help treat such diseases. We have used mice colonized with microbiotas from humans with inflammatory bowel disease to study what...




					www.pnas.org


----------



## wildbill_52280

*A predictive index for health status using species-level gut microbiome profiling*

15 September 2020
"Herein, we introduce the Gut Microbiome Health Index (GMHI), a biologically-interpretable mathematical formula for predicting the likelihood of disease . GMHI is formulated upon 50 microbial species associated with healthy gut ecosystems. GMHI is the most robust and consistent predictor of disease presence (or absence) compared to α-diversity indices. Validation on 679 samples from 9 additional studies results in a balanced accuracy of 73.7% in distinguishing healthy from non-healthy groups."

"As researchers uncover more details regarding which gut commensals may play a significant role in host health and disease, a promising translational application of this knowledge would be towards developing analytical tests or quantitative methods that provide indication of one’s health based upon a gut microbiome snapshot "









						A predictive index for health status using species-level gut microbiome profiling - Nature Communications
					

A biologically-interpretable and robust metric that provides insight into oneâ€™s health status from a gut microbiome sample is an important clinical goal in current human microbiome research. Herein, the authors introduce a species-level index that predicts the likelihood of having a disease.




					www.nature.com


----------



## wildbill_52280

I did a search on clinicaltrials.gov for studies on fecal transplant excluding completed and erroneous listings, and including studies that were currently active in some way, the results were 197 studies that were active as of today. 

clinicaltrials.gov search


----------



## wildbill_52280

82 year old man receives FMT for C diff and his alzheimers improves dramatically over the course of a few weeks, and cognitive tests return to normal after a few months.








						ProgenaBiome Announces Alzheimer’s Patient Recalls Daughter’s Birthday After Undergoing Fecal Transplant - California Newswire
					

VENTURA, Calif. /California Newswire/ -- Dr. Sabine Hazan, founder of ProgenaBiome, a genetic sequencing lab in California, achieved rapid improvement in Alzheimer's disease (AD) symptoms in an 82-year-old male patient following fecal microbiota transplantation (FMT).



					californianewswire.com


----------



## Scipio

wildbill_52280 said:


> I did a search on clinicaltrials.gov for studies on fecal transplant excluding completed and erroneous listings, and including studies that were currently active in some way, the results were 197 studies that were active as of today.
> 
> clinicaltrials.gov search


Impressive, but unfortunately only a small handful of them are looking at Crohn's.  The vast majority are for C. diff and other infections, UC, IBS, and an assortment of random stuff.  I think this reflects the realtive lack of success that FMT has shown in Crohn's feasibility studies up till now.


----------



## wildbill_52280

Scipio said:


> Impressive, but unfortunately only a small handful of them are looking at Crohn's.  The vast majority are for C. diff and other infections, UC, IBS, and an assortment of random stuff.  I think this reflects the realtive lack of success that FMT has shown in Crohn's feasibility studies up till now.



I took another look, and if you go through the search results there are 12 studies on FMT for crohn's, results # 25, 29, 44, 53, 63, 74, 91, 122, 131, 132, 157, 167. This doesn't include the completed studies though, but we don't need more studies we need better studies that improve on the method to increase efficacy rate.

I would list the links to the studies but I'm kind of busy right now!!


----------



## wildbill_52280

It's not even amazing anymore.

Faecal microbiota transplantation halts progression of human new-onset type 1 diabetes in a randomised controlled trial.


			Faecal microbiota transplantation halts progression of human new-onset type 1 diabetes in a randomised controlled trial | Gut


----------



## wildbill_52280

IBD patients who had FMT for C. diff reported more improvements in there IBD then worsening. Microbiome diversity increased on average in all patients, and UC patient's microbiome resembled the donor microbiome more closely after FMT, then crohn's patients. 









						Inflammatory Bowel Disease Outcomes Following Fecal Microbiota Transplantation for Recurrent C. difficile Infection
					

AbstractBackground. Recurrent Clostridioides difficile infection (CDI) in patients with inflammatory bowel disease (IBD) is a clinical challenge. Fecal microbio




					academic.oup.com


----------



## wildbill_52280

> In the first clinical trial of its kind, a small group of patients with pancreatic ductal adenocarcinoma (PDAC) will receive fecal microbial transplants (FMT) to test whether this novel approach might alter the disease's unique tumor microbiome, leaving recalcitrant tumors open to immunotherapy.











						The Role of Fecal Microbial Transplants in Pancreatic Cancer : Oncology Times
					

An abstract is unavailable.




					journals.lww.com


----------



## wildbill_52280

Takeda-partnered Finch Therapeutics grabs $36M and looks to leapfrog the pack in microbiome R&D.








						Takeda-partnered Finch Therapeutics grabs $36M and looks to leapfrog the pack in microbiome R&D
					

Close to a year after Seres declared that it had jumped back on track after a troubling setback with its lead microbiome drug for Clostridium difficile infections, a dark horse in the pack is challenging it for the lead in the emerging field. Four months after merging with Crestovo, Finch




					endpts.com


----------



## wildbill_52280

FMT was given to 10 patients who didn't respond to cancer immunotherapy, 3 of them became responsive to therapy after FMT. 





						Science | AAAS
					






					science.sciencemag.org


----------



## wildbill_52280

*Danone North America Announces 2020-2021 Gut Microbiome, Yogurt and Probiotics Fellowship Grant*
For the 9th year, $50,000 will be granted to graduate students exploring the critical role of the gut microbiome, yogurt and probiotics in human health.









						Danone North America Announces 2020-2021 Gut Microbiome, Yogurt and Probiotics Fellowship Grant
					

/PRNewswire/ -- Danone North America announces it will award two graduate students $25,000 each for the 9th year in a row. As the name indicates, the grant is...




					www.prnewswire.com


----------



## wildbill_52280

*Turning microbiome research into a force for health*
A diverse group of researchers is working to turn new discoveries about the trillions of microbes in the body into treatments for a range of diseases.

Zach Winn | MIT News Office
Publication Date: January 5, 2021

 “In almost every disease context that’s been investigated, we’ve found different types of microbial communities, divergent between healthy and sick patients,” says professor of biological engineering Eric Alm. “The promise [of these findings] is that some of those differences are going to be causal, and intervening to change the microbiome is going to help treat some of these diseases.” 









						Turning microbiome research into a force for health
					

MIT has been home to fundamental research into the microbiome, and MIT-affiliated researchers are at the forefront of the drive to create microbiome-based therapeutics.




					news.mit.edu


----------



## lukesjr

thanks for posting


----------



## wildbill_52280

10 patients with U.C. were given a single FMT to induce remission without drugs, with 10 patients in the control group to compare. Mayo score was decreased more in the FMT group at week 4 and 8 but not at 6 months. Microbiome diversity improved in fmt patients. Monotherapy with a single fresh FMT is an effective and safe strategy to induce long-term remission without drugs in patients with active UC.








						Long-term efficacy and safety of monotherapy with a single fresh fecal microbiota transplant for recurrent active ulcerative colitis: a prospective randomized pilot study - PubMed
					

Monotherapy with a single fresh FMT is an effective and safe strategy to induce long-term remission without drugs in patients with active UC and may be an alternative induction therapy for recurrent UC or even primary UC.




					pubmed.ncbi.nlm.nih.gov
				




My thoughts are there weren't much details about the methodology of FMT in this abstract, there was no improvement in the firmicutes which could the most important for IBD, but its always nice to have more evidence of FMT even though this wasn't much of an advancement on the procedure.


----------



## lukesjr

I think they should try and eradicate someone's micribiome first then reinstall a new one with fat. Just reset it all.


----------



## wildbill_52280

lukesjr said:


> I think they should try and eradicate someone's micribiome first then reinstall a new one with fat. Just reset it all.


 That might not be the best idea because many strains of bacteria that we have inherited from our mothers are very well suited for us. I have references for this but not on hand. might be better just to have a higher dose of donor microbiome and some FMT studies show fiber can help the new organisms take a permanent hold in the FMT patient.


----------



## lukesjr

I only say that because there was that one case of a cancer patient who had his immune system/microbiome wiped out by the cancer treatment which also fixed his crohns.  Now, there is likely way more going on, but I thought it would be an interesting combo.


----------



## wildbill_52280

"In the study, the fecal transplants, which were obtained from patients with advanced melanoma who had responded to pembrolizumab, were analyzed to ensure that no infectious agents would be transmitted. After treatment with saline and other solutions, the fecal transplants were delivered to the colons of patients through colonoscopies, and each patient also received pembrolizumab.

After these treatments, 6 out of 15 patients who had not originally responded to pembrolizumab or nivolumab responded with either tumor reduction or long-term disease stabilization. "









						Fecal Microbiome Transplant Converts Melanoma Immunotherapy Non-Responders into Responders
					

Scienists say ultimate goal is to replace fecal microbiota transplant with pills containing a cocktail of immune therapy-boosting microbes.




					www.genengnews.com
				









						Fecal Transplant Turns Cancer Immunotherapy Non-Responders into Responders
					

Changing the bacteria in the gut can help patients with advanced melanoma respond to immunotherapy, according to a Pitt-UPMC study published in Science.




					www.pittwire.pitt.edu


----------



## wildbill_52280

*$3M Grant Awarded to Orthopedics Researcher to Study the Role of the Gut Microbiome on Osteoarthritis*
Michael Zuscik, PhD, says the research could lead to the first disease-modifying treatment for patients with osteoarthritis.




Valerie Gleaton | 

	
	
		
		
	


	




 April 2, 2021










						$3M Grant Awarded to Orthopedics Researcher to Study the Role of the Gut Microbiome on Osteoarthritis
					

Orthopedics researcher Michael Zuscik, PhD, received a $3.175-million grant from the NIH to analyze the link between the gut microbiome and osteoarthritis.




					news.cuanschutz.edu


----------



## wildbill_52280

NEWS RELEASE 6-APR-2021
*Gut microbiome plays role in autism*
AMERICAN SOCIETY FOR MICROBIOLOGY








						Gut microbiome plays role in autism
					

A new study has demonstrated that autism spectrum disorder is related to changes in the gut microbiome. The findings are published this week in mSystems, an open-access journal of the American Society for Microbiology.



					www.eurekalert.org


----------



## wildbill_52280

*"The Microbiome Gains Momentum in Cancer Immunotherapy*
 Once an object of skepticism, microbiome-augmented cancer immunotherapy is being advanced by companies such as Synlogic, Vedanta Biosciences, and Persephone Biosciences

Vedanta Biosciences develops drugs made from defined bacterial consortia. One of these drugs, a cancer drug called VE800, addresses a challenge that may commonly occur with microbiome-engaging cancer immunotherapeutics. The problem is variability in microbiome signatures. Vedanta’s CEO, Bernat Olle, PhD, says that with cancer, there is no “night and day type of signature” like that seen with Clostridium difficile infections. Olle suggests that overcoming this problem will require big data sets, big sample sizes, and multiomic analyses. 

By Julianna LeMieux, PhD May 3, 2021"









						The Microbiome Gains Momentum in Cancer Immunotherapy
					

Once an object of skepticism, microbiome-augmented cancer immunotherapy is being advanced by companies such as Synlogic, Vedanta Biosciences, and Persephone Biosciences.




					www.genengnews.com


----------



## wildbill_52280

*2,000-year-old human feces explain why we now suffer from more chronic diseases




			From the study of these fecal samples, Aleksandar Kostic, Marsha Wibowo and their team reconstructed 498 microbial genomes, of which 181 show strong evidence of being ancient and of human intestinal origin. The researchers found that 61 of these genomes had not been described before.
		
Click to expand...

*


> Marsha wibowo explains that today’s gut microbiome is much less diverse than the old one. “Approximately 40% of the genomes that we recovered from the samples were previously undescribed species. This reduction is associated with chronic diseases such as obesity and metabolic syndrome ”. According to Wibowo, the causality between the lack of specific microbes and these diseases has been suggested by different studies in humans that show, for example, how “the transplantation of fecal microbiota from healthy donors to individuals with metabolic syndrome can improve the sensitivity to insulin”.



*








						2,000-year-old human feces explain why we now suffer from more chronic diseases
					

Marsha Wibowo, a doctoral student at Harvard Medical School.Joslin Diabetes CenterMarsha wibowo, a doctoral student at Harvard Medical School, and




					pledgetimes.com
				



*


----------



## westernbuddy

That was very Interesting that 2000 year old study.

Lots of people always say eat fruit veg eat greens.

But like that just said even fruit and veg are sprayed with chemical.

I don't think we will all be going back eating fresh organic diverse wild food.

Science will have to advance fix the food, actually I think when they fit a lot of gut health problems lifespan will increase and space travel will be starting.

Science will need to fix all of our chemical food, make it taste good but not with chemicals that will cause disease.

When they learn the right stuff to feed the gut this will come.

There is a lot of excitement to come, wish it would speed up.


----------



## Crabi

wildbill_52280 said:


> *FECAL TRANSPLANTS and how they could cure IBD.
> 
> While this guide discusses home-based fecal transplants, the opinion of Crohnsforum.com is that they should be done under the supervision of a trained clinician as fecal transplants are potentially dangerous. ALWAYS discuss any potential treatment with your doctor.* - Forum Admin
> 
> 
> 
> Fecal Microbiota Transplants(FMT) have induced sustained drug free remissions in both forms of Inflammatory Bowel Disease(IBD) and may have cured some cases of IBD in small trials, according to Gastroenterologist Doctor Thomas J. Borody MD, Ph.d. Details of these reports are listed in section 1.
> 
> There are 14 F.D.A clinical trials planned for the use of fecal transplant in both forms of IBD. In this post you will find out everything about them. Fecal transplants restore missing bacteria in IBD patients by obtaining them from healthy donors stool, mixing a stool sample with saline solution in a blender and giving it to the patient as an enema. This procedure has been performed successfully at home, but if your decide to do it, be sure to read the papers in the post below for expert instruction, don't just jump into it, donors need to be absolutely healthy. http://www.cghjournal.org/article/S1542-3565(10)00069-8/fulltext
> 
> Latest studies in IBD show reduced diversity of healthy bacteria that regulate the inflammatory response when compared to groups of healthy people without IBD. Therefore, it is believed by some scientists that the restoration of the bacteria in IBD patients will correct the abnormal inflammatory response. So far we have some good scientific evidence this may be the case, but it will take time to prove this theory with absolute certainty. With official reports of UC and Crohn's patients maintaining a drug free remissions for as long as 25 and 13 years, this provides some compelling supportive evidence that they may have been cured by FMT.
> 
> Other ways of performing a fecal transplant are orally through a nasogastric/duodenal/jujenal tube or pill form which is currently in development. So far the studies have shown when donors are well screened with blood tests and meet health criteria, this is generally a safe treatment.
> 
> 
> *My experiences with Fecal Transplants: *In this thread i have posts which detail my experiances with FMT, I was trying to find a way to make a FMT pill which proved pretty difficult. I tried FMT 4x with 3 different donors, only one FMT led to improvements, such as gaining 10 pounds in 10 weeks, improved bowel movements, lowered anxiety, but the majority of my other symptoms remain so I will have to find a new donor and try it again, but I'm convinced doing this again will likely reduce the severity of my disease even more.
> 
> ----Receive updates and notifications from this thread by subscribing via the upper right menu labeled THREAD TOOLS.----
> 
> *Outline
> 1. History of Fecal Transplant in IBD: Its success so far
> 2. Clinical Studies Currently in progress
> 3. Testimonies.
> 4. General Information
> 5. How to select a Donor
> 6. How to perform a Fecal Transplant*
> 
> 
> ------------------------------------
> 
> *1. History of Fecal Transplants in IBD: Its Success So Far.
> 
> 
> Dr. Borody Background*
> These studies were done by a doctor in Australia, Thomas J. Borody who is trained in Gastroenterology in addition to other education and experience in scientific research.
> 
> Educational/Career background on Doctor Borody.
> BSc (MED) (HONS)(Bachelor of Science), MBBS (HONS)(Bachelor of medicine, Bachelor of Surgery), MD(Doctor of Medicine), PhD(Doctor of Philosophy), FRACP(Fellow of the Royal Australasian College of Physicians), FACG (Fellow of the American College of Gastroenterology), FACP (A Fellow in the American College of Physicians), AGAF (American Gastroenterology Association Fellow)
> 
> Link to his website where this information was derived-
> http://www.cdd.com.au/pages/clinical_staff.html
> 
> Here is a link to the U.S. National Library of Medicine /National Institute of Health where a search on his name will show some of his published contributions to various Medical/Scientific journals, search results on this database reveal 74 references to his name which illustrate more documentation of his professional experience. These references date from as recent as 2013 to as far back 1979, spanning about 34 years.
> http://www.ncbi.nlm.nih.gov/pubmed/?term=borody+t
> 
> 
> 
> *Fecal Transplant Studies on IBD* -
> 
> *1989* – Doctor Borody first used fecal transplants in 55 patients with a wide range of Gastrointestinal disorders ranging from constipation, diarrhea of unknown cause, Crohn’s disease and ulcerative colitis. 20 were considered cured. 9 were improved and 26 were unchanged. At least one of the cured patients were cured of Crohn’s disease and one of ulcerative colitis. This is an early study so it was unknown how many times a transplant may have to be done to get any results.
> 
> http://www.cdd.com.au/pdf/publications/All Publications/1989-Bowel-flora alteration a potential cure for inflammatory bowel disease and irritable bowel syndrome, Med J Aust, vol 150, issue 10 p604.pdf
> 
> 
> *2003*- Doctor T.J Borody tried this therapy on 6 patients with ulcerative colitis, that elimated all signs of disease symptoms without drugs ranging from 1-13 years after therapy. These patients are considered to be potentially cured since there is no sign of disease, no longer need medication beyond 2 years and they remain disease free to this day. This study was published in the journal of clinical gastroenterology.
> http://prdupl02.ynet.co.il/ForumFiles_2/28701499.pdf
> 
> *2011*- The same researcher Dr borody reported results in a group of patients with Crohn’s disease and all patients obtained remission without drugs. These were severe cases that didn’t respond to any medication before doing the fecal transplant. The results and details of this study were presented at the American College of Gastroenterology’s (ACG) 76th Annual Scientific meeting in Washington, DC in November of 2011. Here is the Official news release from the American college of gastroenterology-
> http://d2j7fjepcxuj0a.cloudfront.ne...2011acg_fecal-transplant-cdiff_FINAL_1025.pdf
> 
> references for the 2011 fecal transplant study on crohn’s
> Some reports of the ACG meeting in 2011 on various news websites
> http://www.medicalnewstoday.com/releases/236885.php
> http://www.sciencedaily.com/releases/2011/10/111031114945.htm
> 
> *2013*
> July- 14 year old boy with crohns achieves remission with FMT -http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3742951/?report=classic
> 
> September- Early results from the mcmaster study, news segment-
> http://www.ctvnews.ca/health/experi...tionize-treatment-of-bowel-diseases-1.1445800
> 
> November - man with severe crohn's disease achieves complete remission without drugs and with only one fecal transplant delivered orally.
> http://www.ncbi.nlm.nih.gov/pubmed/24222969?dopt=Abstract
> 
> November- patient with crohn's responds to fecal transplant
> http://www.ncbi.nlm.nih.gov/pubmed/24239403
> FULL TEXT
> http://ecco-jcc.oxfordjournals.org/content/8/3/256
> 
> 
> 
> *2014*
> 
> March- Woman remains in remission for 13 years after recieving an oral fecal transplant for Crohns disease, she may have been cured. http://www.abc.net.au/news/2014-03-18/sydney-doctor-claims-poo-transplants-curing-diseases/5329836
> 
> additional source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3868025/
> http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3868025/figure/F2/
> 
> May-Mcmaster Ulcerative Colitis Study.
> Mixed results, some bad responses while some very good responses to FMT.
> http://www.medscape.com/viewarticle/824930
> 
> August - Beth Israel deaconess Medical center Crohn's Disease,
> After 4 weeks of follow-up, 55% had clinical response; 36% were in clinical remission.
> http://www.healio.com/gastroenterology/inflammatory-bowel-disease/news/online/{13d3a6cd-6dde-4871-b904-21770537217d}/fecal-microbiota-transplant-improved-symptoms-in-patients-with-crohns-disease
> 
> *2015*
> 
> January-Crohn's- 23 out of 30 patients achieve remission with one oral administration of Fecal Transplant.
> http://www.ncbi.nlm.nih.gov/pubmed/25168749
> 
> March-Crohn's-
> http://journals.lww.com/ibdjournal/...icrobial_Transplant_Effect_on_Clinical.7.aspx
> 
> 
> 
> *Fecal Transplant History of use for C. Difficle Infection.*
> 
> Here are some reports about the latest study on Fecal Transplants  outperforming standard Antibiotic therapy for C. Diff.-
> http://www.cbsnews.com/8301-204_162...cs-for-curing-diarrhea-caused-by-c-difficile/
> 
> Here is a link to the actual study published in the New England journal of medicine 2013
> http://www.nejm.org/doi/full/10.1056/NEJMoa1205037#t=abstract
> 
> EXCERPT from the study-
> “The study was stopped after an interim analysis. Of 16 patients in the infusion group, 13 (81%) had resolution of C. difficile–associated diarrhea after the first infusion. The 3 remaining patients received a second infusion with feces from a different donor, with resolution in 2 patients. Resolution of C. difficile infection occurred in 4 of 13 patients (31%) receiving vancomycin alone and in 3 of 13 patients (23%) receiving vancomycin with bowel lavage (P<0.001 for both comparisons with the infusion group). No significant differences in adverse events among the three study groups were observed except for mild diarrhea and abdominal cramping in the infusion group(fecal transplant) on the infusion day.
> 
> 
> 
> 
> 
> 
> 
> Here is a quote by University of Minnesota Doctor and Researcher Alex Khoruts
> some info on him- http://www.med.umn.edu/gi/faculty/khoruts/
> 
> "Those of us who've been doing this procedure(fecal transplant) for some time didn't need any more convincing, but the large medical community needs to go through these steps," Dr. Alexander Khoruts, a gastroenterologist at the University of Minnesota in Minneapolis who was not involved in the new study, told Nature. "It's an unusual situation where we have more than 50 years of worldwide experience and more than 500 published cases, and only this far along does a randomized trial appear.”
> 
> link to quote- http://www.cbsnews.com/8301-204_162...cs-for-curing-diarrhea-caused-by-c-difficile/
> 
> 
> 
> 
> *2. CLINICAL STUDIES: Currently In Progress*
> 
> 
> These studies were found on www.clinicaltrials.gov. To verify their existence, enter the identifier code into the website search engine.
> 
> -----------------------------------------
> Pediatric Inflammatory Bowel Disease(Ulcerative colitis)
> Helen DeVos Childrens Hospital (HDVCH)
> Grand Rapids, Michigan, United States, 49503
> ClinicalTrials.gov Identifier: NCT01560819
> Estimated Primary Completion Date: May 2013
> 
> recently released study results April 4, 2013-
> http://www.sciencedaily.com/releases/2013/04/130405112859.htm
> 
> excerpt-
> “Results showed that, 78 percent subjects achieved clinical response within one week while 67 percent subjects maintained clinical response at one month after FMT. Thirty-three percent subjects did not show any symptoms of ulcerative colitis after FMT. Patient's clinical disease activity (PUCAI score) significantly improved after FMT compared to the baseline. No serious adverse events were noted. “Patients often face a tough choice between various medications that have significant side effects. Allowing the disease to progress can lead to surgical removal of their colon," said Dr. Kunde. "Our study showed that fecal enemas were feasible and well-tolerated by children with ulcerative colitis. Adverse events were mild to moderate, acceptable, self-limited, and manageable by patients."
> 
> 
> ----------------------------------------------------------
> Ulcerative Colitis
> University of Washington
> Seattle, Washington, United States, 98103
> ClinicalTrials.gov Identifier: NCT01742754
> Estimated Study completion Date:               April         2013
> ------------------------------------------------------------------------
> Ulcerative colitis
> Academic Medical Center
> Amsterdam, Netherlands, 1100DD
> ClinicalTrials.gov Identifier: NCT01650038
> Estimated study Completion Date:                December 2013
> ------------------------------------------------------------------------
> Ulcerative Colitis
> Hamilton Health Sciences / McMaster University
> Hamilton, Ontario, Canada, L8N 3Z5
> ClinicalTrials.gov Identifier: NCT01545908
> Estimated Primary Completion Date:    March    2014
> 
> -----------------------------------------------------------------------
> Crohn's Disease
> Beth Israel Deaconess Medical Center
> Boston, Massachusetts, United States, 02215
> ClinicalTrials.gov Identifier: NCT01847170
> Estimated Enrollment:    20
> Study Start Date:    May 2013
> Estimated Study Completion Date:    April 2014
> -------------------------------------------------------------------------
> Crohn’s disease and Ulcerative colitis
> Seattle Children's Hospital
> Seattle, Washington, United States, 98105
> ClinicalTrials.gov Identifier: NCT01757964
> Estimated Primary Completion Date:            December 2014
> --------------------------------------------------------------------------
> Crohn’s Disease
> Medical Center for Digestive Diseases, The Second Affiliated Hospital of Nanjing Medical University
> Nanjing, Jiangsu, China, 210011
> ClinicalTrials.gov Identifier: NCT01793831
> Estimated Study Completion date:               December 2014
> --------------------------------------------------------------------------
> Ulcerative Colitis
> Medical Center for Digestive Diseases, The Second Affiliated Hospital of Nanjing Medical University
> Nanjing, Jiangsu, China, 210011
> ClinicalTrials.gov Identifier: NCT01790061
> Estimated Study Completion Date:               December 2014
> --------------------------------------------------------------------------
> Ulcerative Colitis
> University of Chicago Medicine    Recruiting
> Chicago, Illinois, United States, 60637
> ClinicalTrials.gov Identifier: NCT02058524
> Estimated Enrollment:    20
> Study Start Date:    June 2013
> Estimated Primary Completion Date:      June 2015
> ------------------------------------------------------------------
> Ulcerative Colitis
> University of South Wales
> ClinicalTrials.gov Identifier: NCT01896635
> Estimated Enrollment:    80
> Study Start Date:    September 2013
> Estimated Study Completion Date:    September 2016
> 
> -------------------------------------------------------------------------
> Ulcerative Colitis
> Texas Children's Hospital/Baylor college of medicine
> ClinicalTrials.gov Identifier: NCT01947101
> Estimated Enrollment:    10
> Study Start Date:    December 2013
> Estimated Study Completion Date:    December 2016
> 
> ---------------------------------------------------------------------------
> 
> Crohn's Disease
> Gastroenterology department, Saint Antoine Hospital
> Paris, France, 75571
> ClinicalTrials.gov Identifier: NCT02097797
> Estimated Enrollment:    18
> Study Start Date:    March 2014
> Estimated Study Completion Date:    February 2016
> ------------------------------------------------------
> IBD both forms
> Department of General Surgery, Jinling hosptal,Medical School of Nanjing University    Nanjing, Jiangsu, China, 210002
> ClinicalTrials.gov Identifier: NCT02016469
> Estimated Enrollment:    30
> Study Start Date:    December 2013
> Estimated Study Completion Date:    February 2016
> 
> --------------------------------------------
> 
> --------------------------------
> IBD both forms
> Wolfson Medical Center, Holon, Israel.
> ClinicalTrials.gov Identifier: NCT02033408
> Estimated Enrollment:    20
> Study Start Date:    January 2014
> Estimated Study Completion Date:    January 2016
> 
> ------------------------------------------------
> Seattle Children's Hospital, David Suskind.
> ClinicalTrials.gov Identifier:NCT02272868
> Estimated Enrollment:    32
> Study Start Date:    October 2014
> Estimated Study Completion Date:    October 2016
> *3. TESTIMONIES.
> -*
> 
> _*Testimony #1*_
> 
> This is the best testimony I have found so far because it is so detailed. This is a guy who used his son and his wife as donors. You don’t have to watch the entire videos, you can skip to the parts I have defined in the summary to verify the story. You will notice in the last video that the energy in his voice changes and his speaking ability improves a bit and his mood seems slightly improved, which are signs his health has is improving due to the fecal transplants.
> 
> 
> Video #1 –
> 
> 
> 
> video length- 33 minutes
> 
> Summary of video/skip to these parts-
> 2:52- 30 years old, Married for 8 years, Bachelors degree in Business Adminstration, Self Employed, Works in financial services industry, Healthy most of life. Has had ulcerative colitis for about 5 years.
> 7:20- Took antibiotics for 2 years for staph infections on legs, he suspects the antibiotics had something to do with his development of IBD as symptoms appeared while on antibiotics.
> 9:50 - Description of  initial onset of disease.
> 14:30-19:00 Describes symptoms before doing the fecal transplant which include Fistula, fissures, hemmorhoids. Starting transplants on meds @ 40 mg prednisone recently at 80mg. explains all the medications he has tried during the course of his disease for IBD.
> 26:00 when and how he heard about fecal transplants
> 
> 
> Video day#3-
> 
> 
> 
> Summary
> 1:25  bowel movement frequency reduced from 20X per day to around 2x per day, in about 5 days
> 
> 
> Video Day #20
> 
> 
> 
> 2:50 almost entirely off of medication at this point. he’s generally still doing very well bowel wise and feeling pretty good.
> 6:00  encourages people to try it, considers it a miracle for him and his condition.
> 
> 
> Latest update April 30th, 2013-
> 
> 
> 
> 
> 0:00-3:30 gained 30 pounds since starting fecal transplants, eats a normal diet now and most symptoms are gone without medication.
> 3:30-7:32- tips on how to perform the transplant
> 
> 
> 
> 
> *Testimony #2*-
> 
> His screen name is Dr. Briggs and he is a university physics professor who is trained as a scientist and who has done the treatment successfully at home using his wife as a donor.
> link to the forum discussion where this testimony was found- http://www.healingwell.com/community/default.aspx?f=38&m=2541306&p=4
> 
> summary- he has had ulcerative colitis for 12 years, then later was diagnosed with crohn’s disease. He suspects that a course of antibiotics had something to with him developing IBD.
> symptoms before starting the Fecal transplant were 3 bm’s per day, previously he has had up to 20 per day. after the transplants he averaged 2 bms a day and he was able to eat foods that used to cause his symptoms to worsen, this indicates a major change occurred in his ability to digest food.
> 
> A few quotes from his fecal transplant experience-
> posted on 11/27/2012
> Dr Briggs-
> “So, things are going very well. To recap - I was diagnosed with UC about 12 years ago, and spent time on sulfasalazine and prednisone with no benefit (15-20 bloody very loose stools a day), then eventually Remicade after developing a fistula. I was on the Remicade for a little over 7 years, which partially controlled things (5-7 loose stools a day, no bleeding as long as I got infusions every ~11 weeks).
> I am now off all medications, and doing great. Two well-formed stools a day.”
> 
> Posted 2/28/2013 1:14 PM
> 
> Dr briggs- “Sorry for not responding sooner (a lot sooner) - with my UC seeming to be completely gone, I'm getting caught up in other things, so I have to remind myself to occasionally check out this thread.
> Potatoes are often not well digested if you have a compromised GI system, they have lots of complex starches in them. I can eat them now without problems, but before the transplants they gave me issues - and early on after the transplants when I ate potatoes they would give me a very mushy stool afterwards (I have continued healing since the transplants, and now tolerate everything very well it seems - except wheat). “
> 
> 
> 
> 
> *Testimony# 3 *
> 
> Here is another testimony from a women with the screenname bustersmom, she avoided a colectomy by doing a fecal transplant at home using her husband as a donor-
> link-http://www.crohnsforum.com/showthread.php?t=15548&highlight=bacteriotherapy
> 
> post# 139
> I have Crohn's disease and was on Flagyl and Cipro for over two weeks and got three abscesses. I figured i had nothing to lose by trying the transplant. I waited three weeks after finishing the antibiotics and was in bad shape. abscesses were terrible. I did the transplant daily for a while and the abscesses, Two which were large, Began to shrink every day. After a month they were gone, and made NO fistula! I haven't had one bit of trouble down there since. I believe the transplants work. I don't know if it works all through the colon, but it worked on me in my lower colon and i was a complete mess. Bree
> 
> 
> Testimony#4
> 
> "Last Fall I went to Sydney Australia on a vacation and while I was there I looked into their programs and research. I found FMT. Fecal Microbiota Transplantation. I was grossed out and said oh hell no. Still, the more I studied and read the more it seemed worth a try. So, I called my doctor here and asked if I could be in one of the clinical studies. Unfortunately there wasn't one here. Only in Portland Oregon. He happened to know the doctor running the study though and offered me another way to treat myself at home. My husbands stool was tested for HIV, Hep A B and C, C Diff, and he passed all the tests with flying colors. So, we bought a retention nozzle, enema bag, tons of Zip lock freezer bags, went through training with our nurses so he could help me complete the series of enemas and my flora was checked and measured by my doctor every other week 7 days after each treatment. I was really sore down there from all the surgeries so instead of 7 days of back to back enemas we changed it to once every other week for 2 months.
> I felt it was my last hope and I wanted to try something because nothing else seemed to work and I just wanted to become a guinea pig if I could. 4 months after my (home treatment) I went in for a scope, except some scarring from the past issues I had no inflammation, no diarrhea, no pain, and had started to work out again. I have felt better this past year than I have since I was 26. I have my life back! I have not been on any meds for 6 mos and after my scope today I was told I was in complete remission. (They still don't know how long it may last or if it will.) Right now I feel normal, no pain, no D and I have energy again!"
> 
> source-
> http://www.crohnsforum.com/showthread.php?t=48939
> 
> *4. GENERAL INFO*
> Here are some general videos explaining how this treatment has potential for IBD and many other diseases. Various environmental toxins and even antibiotics are suspected to be involved in damaging intestinal bacteria, which may contribute to developing these conditions.
> 
> 
> 
> *Video Interview of Professor Lawrence J. Brandt. *
> Here are some credentials/education: Chief Emeritus of Gastroenterology and Professor of Medicine and Surgery at the Albert Einstein College of Medicine. He also has been performing studies on fecal transplants in C difficile in the U.S. since about 1999. C difficile is very similar to Inflammatory Bowel disease which the mains symptoms are chronic diarrhea and often include colonic inflammation just like inflammatory bowel disease.
> 
> Link to verify Professor Brandt’s credentials http://www.einstein.yu.edu/departme...gy-liver-diseases/faculty/profile.asp?id=2519
> 
> 
> 
> Part 1-
> 
> 
> 
> -talks about his experience studying fecal transplants for C. Difficile Infection.
> 
> Part 2- http://www.youtube.com/watch?v=ot7e9bQO2U8
> -his opinion on fecal transplant overall safety, and its potential for other diseases.
> 
> Part 3- http://www.youtube.com/watch?NR=1&feature=endscreen&v=u8eNvAVfc0M
> SUMMARY-
> 1:10  history of fecal transplant in veterinary medicine
> 2:18 different routes of administration of Fecal transplant
> 3:00 self/home administration of fecal transplant
> 4:00 more on the future and potential of Fecal Transplant
> 5:38 mentions pill form as the final future method of administration in the future for fecal transplant.
> 
> 
> here is an article published on February 13, 2013 by Lawrence J. Brandt and another professional which was published in current opinion in gastroenterolology
> 
> Fecal Microbiota Transplantation: Past, Present and Future
> Olga C. Aroniadis, Lawrence J. Brandt
> Curr Opin Gastroenterol. 2013;29(1):79-84.
> link to article-
> http://www.medscape.com/viewarticle/776501_1
> 
> 
> *Video, By Cara Louise Santa Maria* - Science educator, Masters
> Degree in Neuroscience
> link-  http://www.youtube.com/watch?feature=endscreen&NR=1&v=kLB5Pasjjis
> 
> 
> 
> Here is a very well written article On FMT by  KSS , a member of this website. there are testimonies of people who have tried Fecal transplant in this article.
> http://diyehr.com/analysis-of-crohn...e-peer-to-peer-observational-treatment-study/
> 
> 
> Article for TIME magazine in June 2012 about microbiome research-
> http://healthland.time.com/2012/06/14/the-good-bugs-how-the-germs-in-your-body-keep-you-healthy/
> 
> 
> http://commonfund.nih.gov/hmp/overview
> 
> 
> Dr. Martin Blaser has studied the role of bacteria in human disease for over 30 years. He is the director of the Human Microbiome Program at NYU. His new book was just published and discusses the new evidence suggesting antibiotics have contributing to rising rates of diseases like Crohn's by killing off good microbes. - http://martinblaser.com/
> 
> http://www.npr.org/2014/04/14/302899093/modern-medicine-may-not-be-doing-your-microbiome-any-favors
> 
> http://www.amazon.com/gp/product/08...iveASIN=0805098100&linkCode=as2&tag=yoadsu-20
> 
> --------------------------------------------
> 
> *5. How to Select a Donor*
> 
> Overall, as long as the Donor is in good health, there is very little risk with doing a fecal transplant. Even in some of the documents below they reported bypassing blood tests and health screening for some patients who chose a donor that was a family member that they knew and trusted, buts it probably best to take precautions.  All the criteria for selecting a healthy donor and directions for what blood tests they need were obtained from these two papers, one of which was written by doctor Borody and other professionals in the field.
> 
> 
> 
> Requirements:
> NO ANTIBIOTICS IN LAST 6 MONTHS, OR EVER IS BEST.
> 
> NO Gastrointestinal COMPLAINTS LIKE FREQUENT DIARHEA OR CONSTIPATION/excessively firm stool that is hard to pass, blood, No Mucus  in stool  or intestinal pain. You should have a generally regular stool frequency of 1-2 bowel movements per day.
> 
> 
> Absence of metabolic syndrome- http://en.wikipedia.org/wiki/Metabolic_syndrome
> Symptoms and features are:
> -Fasting hyperglycemia — diabetes mellitus type 2 or impaired fasting glucose, impaired glucose tolerance, or insulin resistance
> -High blood pressure
> -Central obesity (also known as visceral, male-pattern or apple-shaped adiposity), overweight with fat deposits mainly around the waist
> -Decreased HDL cholesterol
> -Elevated triglycerides
> Associated diseases and signs are: hyperuricemia, fatty liver (especially in concurrent obesity) progressing to NAFLD, polycystic ovarian syndrome (in women), and acanthosis nigricans.
> 
> No autoimmune conditions- list of conditions-
> link- http://womenshealth.gov/publications/our-publications/fact-sheet/autoimmune-diseases.cfm#d
> 
> No allergic diseases - asthma, atopic dermatitis (eczema), allergic rhinitis (hay fever), food allergies
> 
> 
> 
> Required Blood Tests for donors- full blood count, liver function,
> Negative viral screening for HIV 1 and 2,  Hepatitis a, b, c. cytomegalovirus, Epstein Barr Virus, Syphilis.
> 
> 
> 
> Some studies have bypassed donor screening only in cases where close family members have been selected as donors.
> 
> None of the Testimonys I listed in sections #4 of this paper mentioned taking the suggested  precautions to follow the donor selection criteria, as most were able to get help from family members who they were confident were healthy. I plan on taking full precautions no matter how healthy my donor is, or whether they are a family member or not. I also have additional criteria that go beyond the advice listed here.
> 
> The papers below is where i found most of this information. It is not required that you read these papers with the web links listed below, but if you would like to look them up to verify they exist, feel free to do that.
> 
> Article 1
> Details on page 3-
> http://www.2ndchance.info/inflambowel-Hamilton2011.pdf
> 
> Article 2
> Details on page 479-
> http://www.cdd.com.au/pdf/publications/paper12.pdf
> 
> 
> 
> 
> Recommended diet for donors- this will encourage all the good bacteria in your intestine to grow and make it a more potent medicine.
> High fiber foods, like whole grain oats and wheat
> Berries.
> eat at least one apple per day.
> veggies.
> if you smoke, reduce your smoking as much as possible.
> 
> Things to avoid- anything with aspartame or saccharin in it, excessive meat. excessive amounts of processed food in packaging as it may contain preservatives that inhibit bacterial growth.
> over consumption of meat-  beyond 8 ounces in a day would be excessive.
> 
> other tips-
> if you become sick or get food poisoning while  doing the transplants you will have to stop until you become better.
> 
> --------------------------
> *6. How To perform a Fecal Transplant*
> 
> _chapter a work in progress_
> 
> 
> RECTAL METHOD/BY ENEMA
> I have not included yet any details on how the transplant is done in any precise way, but typically it is done by making a solution of  saline (.9% sodium chloride solution/aka salt water) mixed with stool in a blender and giving it as an enema to retain in the body for 6-8 hours or as long as your body can hold it. I will add more very soon but i think it's all here if you want to figure out the details for yourself, otherwise i will soon give some better instructions to make it easy for people to try themselves. There are some details on page 5 and 6 of this paper by doctor borody.
> http://www.cdd.com.au/pdf/publications/paper12.pdf
> 
> how to make saline solution at home-Quick instructions- mix one gallon of distilled water with 4 teaspoons of salt(preferablly pharma grade neti pot salt) in a pot and stir on low heat so salt easily dissolves. this will make a gallon of saline solution.
> 
> .9% sodium chloride w/v solution is expressed as a mass concentration weight/volume solution. in other words, it is telling us how much mass of a certain substance is dissolved within a volume of a fluid.  in this case, 100 milliliters of a fluid. and in this case sodium chloride aka salt. So there is .9 grams(just shy of one full gram) of salt dissolved in every 100 milliliters of h20 aka water.
> 
> _more to come..._


I can say this if my test comes back crohns, PLEASE PUT ME INTO THIS TEST PROGRAM or let me know how i ask a doc about this?


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## wildbill_52280

This article is from last year, but its cool and its about the microbiome and mental health.





						Science | AAAS
					






					www.sciencemag.org


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## wildbill_52280

*A Microbiome Therapeutic May Contain the One or the Many*
Two companies—Federation Bio and 4D pharma—pursue very different strategies when they deploy their disease-fighting bacterial strains

By Julianna LeMieux, PhD 

June 30, 2021


*



			The more, the merrier
		
Click to expand...

*


> Federation Bio takes a “go big or go home” approach to microbiome drug development by building extraordinarily large and diverse communities of bacteria. Why does Federation Bio plan to pack many bacterial strains into its drugs, while other companies use a small group of bacteria or even just one?
> 
> It’s a “philosophical difference,” Conley declares. Bacteria live in a dense ecosystem with other bacteria. Based on that, Federation Bio believes that using bacteria to establish the ecosystem, in addition to the drug of action, will allow the bacteria to durably engraft and perform their functions more efficiently. This, Conley says, would be more challenging with a single strain. In her view, it is possible to find a single, magic strain, but putting such a strain into an imbalanced microbiome—an environment that is in a state of dysbiosis—would be “like putting a fish into a tree and expecting it to thrive.”











						A Microbiome Therapeutic May Contain the One or the Many
					

Two companies—Federation Bio and 4D pharma—pursue very different strategies when they deploy their disease-fighting bacterial strains.




					www.genengnews.com


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## lukesjr

thanks


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## Spooky1

Nice to know they are still plugging away at this.  Thanks, Bill.


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## wildbill_52280

> *Vedanta Biosciences Completes $68 Million Series D Financing*
> Jul 21, 2021
> _Proceeds expected to be used primarily to support a Phase 3 trial of lead candidate VE303 in Clostridioides difficile infection (CDI) and a Phase 2 trial of VE202 in inflammatory bowel disease (IBD)
> Topline data from Phase 2 trial of VE303 in CDI are anticipated in Q3 2021
> Plans to initiate Phase 2 trial of VE202 for treatment of mild to moderate ulcerative colitis in H2 2021_











						Vedanta Biosciences Completes $68 Million Series D Financing :: Vedanta Biosciences, Inc.
					






					www.vedantabio.com


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## westernbuddy

Appears the infliximab inventors have invested in it Janssen, Has there been any trial done in Crohn's do you know? from what i can see appears there has not yet as to date. But they have sevral big pharma investors and govt backing them.

https://www.zenopa.com/news/8017701...w-ibd-drug-candidate-from-vedanta-biosciences


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## wildbill_52280

This isn't good news for their product to treat Ulcerative Colitis, but its nice to know what is happening.


*Seres Therapeutics’ microbiome therapy flops against placebo as shares go into freefall*
by Ben Adams|
Jul 22, 2021 7:30am


"Shares in the microbiome biotech fell more than 52% to $9.90 in early, premarket trading Thursday morning, from a prior close of $20.73. The fall was precipitated by data from a phase 2 trial which saw the company's ulcerative colitis (UC) candidate SER-287 flop against placebo in improving clinical remission rates, its primary endpoint.

“Given the lack of a clinical efficacy signal identified in ECO-RESET, the company has decided to close the open label and maintenance portions of the study,” the biotech said in a statement.

The company will, however, push on with a similar bacteria-derived therapy in its SER-301 program, which is currently in a phase 1b study aiming to reduce intestinal inflammation and improve epithelial barrier integrity in adults with mild-to-moderate UC. Questions will however be asked over how much faith can be put in its whole business plan, given how much of its pipeline rests on a similar approach."









						Seres Therapeutics' microbiome therapy flops against placebo as shares go into freefall
					

There’s been precious little good news for Seres Therapeutics of late, and the woe continues today as it records another trial failure.  | There’s been precious little good news for Seres Therapeutics of late, and the woe continues today as it records another trial failure. Shares in the...




					www.fiercebiotech.com


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## Spooky1

Wow, that's a bit sad.  But i think the Australians are doing well with trials still, aren't they?  I sincerely hope that all is not lost in this study area for us with UC and Crohns.  thanks for the update.


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## Scipio

Seres is the company that Nestle poured big money into - hoping to turn FMT into a legit therapeutic.   Too bad it's not working out.


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## wildbill_52280

My thoughts: Well scientists have been saying that c diff is a natural resident of the human microbiome, and what makes it virulent is damage to other bacteria that keep its populations from growing out of proportion, so this finding seems to agree with that understanding. Antibiotics being the #1 cause of c diff as far as i recall, due to their ability to disturb the microbiome, in a similar way to how antibiotics might cause IBD too.

*C Diff  Eradication Not Necessary for Clinical Cure of Recurrent Infections With Fecal Transplant*
Tara Haelle

July 26, 2021

It's not necessary to completely eradicate all _Clostridioides difficile_ to successfully treat recurrent _C difficile_ infections with fecal microbiota transplant (FMT), according to a study presented online July 12 at the European Congress of Clinical Microbiology & Infectious Diseases.
_C difficile_ colonization persisted for 3 weeks after FMT in about one quarter of patients, but it's not clear whether this is a persistent infection, a newly acquired infection, or partial persistence of a mixed infection, said Elisabeth Terveer, MD, a medical microbiologist at Leiden University Medical Center, Leiden, the Netherlands. Additionally, "82% of patients with detectable _C diff_ do not relapse, so it's absolutely not necessary for a cure," she said.









						C Diff Eradication Not Necessary for Clinical Cure
					

The findings support existing guidance not to test for presence of C difficile after treatment if the patient is asymptomatic.



					www.medscape.com


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## wildbill_52280

> FMT has been validated in randomized controlled trials (RCTs) as a treatment for recurrent Clostridioides difficile infection (rCDI) with a success rate of ~90%, surpassing that of conventional antibiotic treatment (Kao et al. 2017; van Nood et al. 2013). FMT efficacies in inducing remission in IBD patients with ulcerative colitis have generally been lower (24–32% versus 5–9% for placebo), but surpassed those reported in phase III clinical trials for several biological agents (golimumab and vedolizumab) (Danne, Rolhion, and Sokol 2021).





			https://www.medrxiv.org/content/10.1101/2021.08.18.21262200v1.full.pdf


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## wildbill_52280

Here is a recent study for oral FMT for Ulcerative Colitis, it seems like a good demonstration of the potential for FMT and its a randomized double blinded, placebo controlled study.

15 patients got FMT, 20 patients got placebo.
At week 8, 53% in the fmt group were in remission, vs 15% in the placebo group.
2 patients in the fmt group reported worsening, and 1 patient in the placebo group.

Lyophilised oral faecal microbiota transplantation for ulcerative colitis (LOTUS): a randomised, double-blind, placebo-controlled trial


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## wildbill_52280

Just to show you another way in which Fecal transplants are still being pursued, I just searched clinicaltrials.gov for posted Fecal Transplant studies starting January 1, 2017 - December 8, 2021 and there were 311 results for all types of medical conditions. 

clinicaltrials.gov


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## Spooky1

But i wish they'd just relent and treat us all this way.  That study looks quite promising.  All these promises, and how long have we been waiting.  Thanks for the updates though.


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## wildbill_52280

*The Invisible Organ Shaping Our Lives: Milestones in Human Microbiota Research*
A survey of over 300 years of microbiome research.
By: Alessio Fasano and Susie Flaherty










						The Invisible Organ Shaping Our Lives: Milestones in Human Microbiota Research - The MIT Press Reader
					

A survey of over 300 years of microbiome research.




					thereader.mitpress.mit.edu


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## wildbill_52280

Front. Cell. Infect. Microbiol., 19 October 2021 | https://doi.org/10.3389/fcimb.2021.759435
*Fecal Microbiota Transplantation Relieves Gastrointestinal and Autism Symptoms by Improving the Gut Microbiota in an Open-Label Study*









						Fecal Microbiota Transplantation Relieves Gastrointestinal and Autism Symptoms by Improving the Gut Microbiota in an Open-Label Study
					

Autism spectrum disorder (ASD) is a severe brain development disorder that is characterized by deficits in social communication and restricted, repetitive and stereotyped behaviors. Accumulating evidence has suggested that gut microbiota disorders play important roles in gastrointestinal...




					www.frontiersin.org


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