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FECAL TRANSPLANTS: A Guide

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/fecal-transplant-instructions/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..
 
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.
 
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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.
 

Lady Organic

Moderator
Staff member
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.
 
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.
 
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.
 
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.
 
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.
 
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
 
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
 
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.
 
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
 
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Lady Organic

Moderator
Staff member
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

Moderator
Staff member
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.
 
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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.
 
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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.
 
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
 
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
 
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.uk/asset-library/documents/products/data-sheets/data card modulen ibd.pdf
 

Lady Organic

Moderator
Staff member
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.
 
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.
 
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
 
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.
 
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.
 
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.
 
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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..
 
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=U8bgKGvZJV0C&printsec=frontcover&dq=prolongation+of+life+optimistic+studies&hl=en&sa=X&ved=0CB0Q6AEwAGoVChMIitHbtNLsxgIVSJqACh2F6gpB#v=onepage&q=prolongation 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-burkitts-f-word-diet/?utm_source=rss&utm_medium=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.
 
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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.
 
''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.
 
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.
 
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.
 
Last edited:

Lady Organic

Moderator
Staff member
''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.
 
''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.
 
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?
 
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.
 
wilbill - I just bought some Myarisan, thanks for the tip! I bet it will help reduce my intestinal permeability.
 
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.
 
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.
 
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!!
 
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.
 
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
 
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
 
''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.
 
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
 
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.
 
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.
 
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/Abstract/publishahead/Metagenomic_Analysis_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
 
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.
 
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.
 
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!!
 
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.
 
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.
 

Lady Organic

Moderator
Staff member
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...
 
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

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
 
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.
 

Lady Organic

Moderator
Staff member
''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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''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.
 

Lady Organic

Moderator
Staff member
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.
 
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.
 
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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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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