10 FMT treatments completed

[edamame]

I have done 10 treatments of microbiota transplants in the last 2 weeks. Unfortunately there have been no improvements in my symptoms (rosacea, psoriasis, lower back pain, fatigue). I suspect FMT works better for infections and some UC patients, but not for inflammation in the ileum and up. With the two methods I have tried (enema and capsules) the donor solution could not reach the inflamed area, but whether that would make any difference is unknown.

 

[Scipio]

I suspect FMT works better for infections and some UC patients, but not for inflammation in the ileum and up.

That's pretty much what most of the research so far has shown. C. diff is doable by FMT. UC is tougher but still shows significant response. Crohn's, especially ileal Crohn's, is tougher still.

I'm not giving up hope on FMT for Crohn's. but it's clear we have a lot to learn still. And it's not going to be easy.

 

[wild_one353]

I read a study that showed crohns tends to have the least diversity in the microbiome so that's at least one possible explanation why its so resistant to FMT compared to U.C. and C.diff.

Typically crohn's can take 30-80 FMT enemas to get remission, while some cases of oral FMT in crohn's show one dose can be effective, but this was also in china and there is a possibility their donors have awesome diverse microbiomes compared to U.S.A. , but that's one theory I've considered.

Did you ask your donor to follow a high fiber diet? also avoiding emulsifiers and preservatives could help too. are you aware the stool bacteria will die when exposed to too much oxygen? all this info can help your success in FMT. Good luck!

 

[Scipio]

I read a study that showed crohns tends to have the least diversity in the microbiome so that's at least one possible explanation why its so resistant to FMT compared to U.C. and C.diff.

Another explanation is that UC and C.diff are located in the colon whereas the majority of Crohn's cases have the disease located primarily farther upstream in the small bowel - where it is harder to establish new bacterial engraftment by enema.

 

[edamame]

Another explanation is that UC and C.diff are located in the colon whereas the majority of Crohn's cases have the disease located primarily farther upstream in the small bowel - where it is harder to establish new bacterial engraftment by enema.

Yeah, that's pretty much what I believe now. During the course of the treatments I have discussed with the doctor but it was simply infeasible for donor solution to directly contact the ileum or any inflamed parts besides the colon. The only way to do this is through a nasogastric tube, but they are not doing it right now. I still think MAP or a combination of certain microbes cause the inflammation though.

Also, since IBD is a perfect condition for pharmaceuticals to sustain profitable business model, I doubt we ever get a cure...

 

[Scipio]

Also, since IBD is a perfect condition for pharmaceuticals to sustain profitable business model, I doubt we ever get a cure...

I doubt this is true. The pharmaceutical companies are certainly not charities or nonprofits, but they do compete with each other fiercely. They would not pass up the chance to beat their competitors to a cure if one were feasible.

Hepatitis C had the same business model of expensive, long-term treatments for an incurable disease going for it. But after a lot of research the drug companies developed several very effective anti-viral medications that actually cure Hep-C. Their approach was to then simply to turn around and charge outrageous prices for the cure.

So they'll cure Crohn's if they can, but the cure will certainly not be cheap.

 

[edamame]

I did a colonoscopy a month after FMT and the doctor said there was a slight improvement compared to the last time I did it (beginning of this year), but personally I have not seen any effects up to this day.