Sunday, August 14, 2011

Fecal Transplants: Ben's Story

Continuing my adventures in understanding the long hollow tube that is the human GI tract, I've been in correspondence with a blog reader, Ben D., for the past month or so regarding fecal transplants and our similarities in intestinal dysfunction.  We are definitely gut brothers from other mothers, as his symptoms match up incredibly well with my own.  When he told me he would be trying the human probiotic home infusion protocol a few weeks ago, I was very curious to follow his progress.  Ben was wonderfully light-hearted and humorous about the whole thing while providing very useful information regarding his 10-day transplant experience.  Here is his intestinal saga in his own words.  Thanks, Ben!

What's up gutsers? I am coming to the end of 10 days of fecal transplant therapy carried out at home with my doctor's blessing and prescriptions.
I am posting here because I want to answer any questions people have about the procedure, especially if they are considering doing it themselves. So far it has improved my symptoms quite a bit, but has not been a total cure. I think it is going to turn out to have been a very valuable tool in the treatment, and eventual cure of my condition.
Below is a short version of the whole story of my illness. Check it out before asking questions... the answer may be in there.
My name is Ben. I'm 25 and I've been dealing with Post-Infectious IBS-C since January 2010. It started on a trip to India with some diarrhea and then I became constipated for the next two months of the trip. I tried the usual fiber + probiotics and I think they just made things worse. Since nothing was moving, I think they just gathered in my small intestine and gave me a case of SIBO because I ended up with terrible bloating on top of the C.
I had stool and blood tests done, as well as a colonoscopy, while traveling and they all found nothing. The Indian doc diagnosed the P-I IBS-C and gave me Lactulose, a daily laxative. I took that for a while and it helped the constipation, but made the bloating much worse. I eventually got another case of diarrhea, took some antibiotics for the diarrhea, and all the symptoms went away. About a week after the antibiotics, some symptoms returned in a very mild form, but didn't bother me much.
Then in January of this year (strangely enough around the same date that the first flare began in India), after 8 or so months of relative health, the constipation came back. Again I tried more fiber in my diet and probiotics and again this produced the backed-up, SIBO-esque bloating. I had stool and blood tests and an ultrasound that found nothing. I then tried 3 rounds of various antibiotics, because they seemed to help back when I was traveling. None worked this time, so I started working with alternative treatments: Oregano oil, raw garlic, cloves, Wormwood, Black Walnut hulls, Aloe Vera, acupuncture, Chinese herbs, etc. I've also been on the Specific Carbohydrate diet since early April. Some of the alternative treatments helped, and the SC Diet keeps the bloating from being too crazy, but nothing was really moving me in the direction of a cure. I also saw a holistic doctor who had me do a stool test with Diagnos-techs. It found a very light amount of Candida, moderate pathogenic Strep, occult blood, and low SIgA.
I got a recommendation for a tropical medicine doctor in New York (Dr. Kevin Cahill). I saw him and he inspected a scraping of my colonic mucous that revealed an infection with Entamoeba Histolytica. I was relieved to finally have a more clear diagnosis. He gave me Paromomycin, an anti-amoeba drug, and Doxycycline, an antibiotic. I took them, was retested by him, and came up negative for the amoebas. He told me it may take a couple months to heal and feel well again, but after abouta month and a half I only felt worse.
At that point I began to assume that the amoebas and all the antibiotics I had taken had caused some other damage to my whole flora that needed to be addressed. My holistic doctor had mentioned fecal transplant as a possibility and so I began to look for donors. Without intending to actually ask her to donate, I mentioned the procedure to a good friend's girlfriend and her eyes immediately lit up. "Do you want me to shit for you, Ben?!," she excitedly asked.
She told me she was very comfortable gut-wise and went 2-3 times a day consistently, which sounded great to me considering I was dealing with constipation. I started the low-fiber diet part of Borody's protocol right away and got her a stool test kit. Her test came back clear, and after 3 weeks of the low-fiber, I started taking Vancomycin, as recommended by Borody, as well as Nitazoxanide, an anti-protozoal just in case any of the amoebas were left.
The antibiotics made me feel horrendous. They added to the general feeling of unwellness that I had been experiencing for months, made me more constipated, and worsened the depression that this whole experience had created.
On the first day of infusions, I noticed an almost immediate loss of that depression and malaise. It could have been simply the hope involved in trying a new treatment, but it felt like there was a more physical, medical connection. It made me even more sure of the brain-gut connection and the ability of our flora to effect our emotions. I remained constipated for a couple days, but on the morning of the third day, I woke up to an immediate, easy, giant, solid BM. Those easy morning BMs have continued, except for one more bad day on day 5. Tomorrow will be the last infusion and then time will tell how well the new bacteria will colonize my gut.
The bloating after meals remains so I think it is a related but separate issue. Like I said before, it didn't start until a week or so into the constipation flares, after I had eaten lots of fibrous foods and taken probiotics in trying to move things along. If it does not fade with time, I'm definitely going to get tested for SIBO, and then treat that somehow, possibly following up with more transplants to keep things moving well.

20 comments:

Online Roulette said...

Antibiotics will always be the first response to such infections, but when those fail, a fecal transplant could be the next step.

CeceDawn said...

I also just had a fecal transplant, on August 10th. I've been in horrible pain and I'am not sure if it's the transplant getting used to my body, or if the procedure did not work and the c. diff has come back. I hope you are feeling well! Thank you for posting your story.

Anonymous said...

Hi, could someone post the actual procedure they used at home so that i can understand how it's done? I' am very interested in trying it myself since i'm having the same issues. thanks

Gabriella Kadar said...

There is one fallacy in Ben's protocol: the donor's stool was tested as his was initially tested. But yet a mucosal scraping of Ben's colon revealed amoebas which the previous testing did not.

Years ago a patient reported that she had a bowel movement after every meal. She did not think this was a problem. Subsequently she was diagnosed with amoeba which she'd picked up years before while living in Turkey. After appropriate therapy and follow-up which indicated clearance of the parasite, she had one bowel movement per day.

So, I think we need to be somewhat more cautious about determining safety for this procedure.

Earl Future said...

Yeah. I am aware of that fallacy. I just didn't have the time or money to fly my donor up to NYC and have the same doc do a mucosal scraping on her.

She reported no gut issues and had healthy BMs, so I figured a stool and blood test was enough to convince me that she was alright.

Not perfect, but it's what I could do at the time.

Gabriella Kadar said...

Helicobacter pylori. Did you have the breath test for this? Since gastric mucosal atrophy, plus the formation of intestinal type tissue in the stomach lining occurs due to infection, various symptomatoloty is present in those with chronic infection.

Sometimes it is difficult to eradicate this pathogen since it appears to find safe harbour in the periodontal sulcus. I suspect it also finds a niche in tonsillar crypts.

Earl Future said...

Yeah, I was tested for H Pylori many times and don't really have the symptoms for that. My stuff seems to be more in the small intestine and colon.

Anonymous said...

Try Florastor!

WISPR said...

It 's always nice to see the transfer stool in the news, as in this report, a woman in Tampa, who was suffering from Clostridium difficile.

herbs said...

Good to see this post.....

vitamins said...

Over modern times, we've attached to a couple of testimonies about waste transplants—a real operation where doctors take a contributor chair.

Emily said...

Doesn't this sentence sum it all up?: "The bloating after meals...didn't start until a week or so into the constipation flares, after I had eaten lots of fibrous foods..."

Have you read 'Fiber Menace?' You should adapt a low-fiber lifestyle. Fiber will only exacerbate your symptoms and render your infusions (a good idea, also one mentioned in the book) a waste of time and money. I hope this helps; I have struggled with bloating for years -- I literally always looked pregnant (and I am in good shape and healthy). Beyond aesthetics it caused pain, fatigue, etc, symptoms I am sure you are familiar with. A few days ago I stopped all fiber, and no longer have bloating whatsoever. I am still in the transitional phase of become fully regular. However, with a low-fiber diet, recovery of bacteria in the large intestines, and a subsequent healthy, grass-fed meat/fat/organ/bone broth dominant diet, you (in theory) should recover. I realize that everyone is different, and the extent of damage already done will vary. It is always worth a try, though.

Emily said...

Wow I guess I really missed the boat on this one...by like...6 months. I hope someone, esp. Ben actually reads my post.

Anonymous said...

Ben,

How are you now several month later ?? Did you get long term relief?

Anonymous said...

Hi! Hope to hear how you are doing? Your story of the constipation sounds very similar to mine however I was not travelling. I have done a 5 day course of the fecal transplant but don't know how much better my constipation really is. I am curious if you are "cured" and if you can share any secrets or advice. It would be greatly appreciated!!

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Jacob @ Cash Cow Couple said...

I've been reading up on fecal transplants because of some chronic gut issues of my own and my inability to stay consistent.

Thanks for the great article.

Anonymous said...

Anyone with these issues must try the GAPS Diet. GAPSdiet.com. Stands for 'Gut and Phsycology Syndrome'. Dr Natasha Champbell Mc Bride brings a fresh perspective to Gut issues. Following her protocols will bring long term healing. it's not a quick fix and can take time and considerable effort with food preparation but the results are phenomenal!

Unknown said...

Ben-

I wonder, since your troubles began in India, I wonder if you have considered using the stool of a healthy person from the same region of India, who may have a variety of powerful strains of microbes that have evolved specifically to outcompete the bad bugs you're dealing with? I have a feeling that the science on this topic is going to explode in the next ten years, and there will be all kinds of different lines and varieties to choose from, patent, and profit from. Fortunately they are residing in the colon of someone near you! Very best of luck!

Meggie said...

Several clues in your story tell me you might have low stomach acid. I'm not talking about the kind of acid that gives you heartburn. I mean the kind that gives a person the reputation of having an "iron stomach". If you don't have ulcers, you could try to take some Betaine Hydrochloride with Pepsin. When I started taking them, I only took 1 at a time. A friend told me to start with just one and then keep taking one more about every 15 minutes until it feels warm. Well, that scared me, so I took one capsule only 3 times, and waited. It worked. The next day I still felt like I had a "sour" stomach and had one more. In about 15 I felt better. A few months later my sister came for a visit, and we had breakfast at a restaurant. Well, her bacon or something wasn't done right and by the time we got back home she felt terrible. I persuaded her to take 2 and some water, and she was able to hold it down. In 5 minutes! she felt tons better, and took 2 more a few minutes later and was amazed. She's had so much trouble digesting things, this incident really made an impression on her. I hope my experience helps you. I don't know if lack of stomach acid is your problem, but the acid in your stomach KILLS bacteria, viruses, parasites, etc, if it's healthy. Good luck and blessings!