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.

Fecal Transplants: The Turd Twister & A Historical Account

I have been voraciously exploring the world of human gut bacteria, fecal transplants, and the like as of late, and I wanted to update all you readers with some information that I've found particularly invaluable.  Well, okay the first bit of info isn't invaluable, per se, but it is pretty funny.  My awesome aunt, a frequent reader of this blog, recently sent me something she dug up as she was preparing for an estate sale.  I don't know if anybody else out there has heard of this.  It's called a "Turd Twister."  I thought it would make a great gag gift, especially for a potential fecal transplant donor.  There are many wonderful shapes that can be produced and presented with this device!  Anyway, the version I received is kind of old school and uses hard cardboard, but for more serious turd twisters, you might want to check out the website for a modern and far more comfortable-looking model.

Next, I wanted to reiterate a point I made in the comments of a previous post in order to further bolster the merits of the "sh*tshake" method.  Here is a comment from "Mike K" on the Freakanomics radio show website:

Forty years ago, we treated antibiotic resistant bacteria in the colon by giving the patient a dose of antibiotic sensitive E. coli in a malted milkshake. The sensitive bacteria would replace the resistant bacteria in a day or so. Our theory, or that of my professor who devised the treatment, was that “wild” or sensitive bacteria are better adapted to the normal colon environment. Antibiotic resistant bacteria can only take over when the sensitive bacteria are killed off by antibiotics, as when a patient has been treated for an infection like diverticulitis. When the antibiotics are stopped, the normal sensitive bacteria will quickly oust the resistant ones which are less adapted for life in a normal colon. All that is necessary is to provide a dose of the normal wild bacteria.

In the County Hospital, we used the same method although we did not have the nicety of cultured sensitive bacteria. We would take a fecal sample from a healthy patient coming in for hernia surgery, for example, and give it to the patient in a milkshake.

Needless to say that none of the patients were ever told the extra ingredient of the milk shake. 

This marks the second time I have heard of a fecal transplant used in such a manner.  The first time was from a retired nurse who basically said the same thing.  What surprised me in both cases is that the amount of "donation" required was minimal enough for the patients to not even realize they were drinking a poo concoction.  Also, one might think that the milk would cause a serious acid dump in the stomach and kill the beneficial bacteria, but this didn't seem to happen.  Must be a strength in numbers thing.  Anyway, this just goes to show that the essence of the fecal transplant's magic is actually pretty simple, and it certainly doesn't require some of the exorbitant costs and methods of implementation that are associated with it.

Next up, I have a very juicy post to share about an adventurous blog reader, Ben, and his recent foray into the fascinating world of home fecal transplants.  
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My Intestinal Saga, Part 10: Final Thoughts (cont'd.)

Okay, let's add some more notes to parts 5 through 9 of of the saga.

Part 5, Monastyrsky and Kwasniewski: The most important lesson I learned from this time period was that the heaviness in my body was directly related to being constipated 24/7, and that there were ways to restore my intestinal motility.  I highly recommend Monastyrsky's book, Fiber Menace, to anybody interested in the ins and outs (pun intended) of digestion and how to maintain a smoothly functioning GI tract, as this is what ultimately opened my eyes.  This book has a combination of the author's deep experience and thorough research, which makes it a very powerful read.  His recommendations are solid and very helpful to most modern people struggling with GI problems.


Part 6, It's All Digestive My Dear Watson: Damn, I wish I could eat all the fat I wanted without having gut issues.  Maybe someday I'll be able to if I ever resolve things completely.  Until then, I have to actually keep fat consumption at moderate to low levels because I get the same symptoms as I described in this post: the bad breath, the muscle tension, the bloating, the insomnia.  All of these things I believe are related to the slow motility of my intestines.  And I discovered this by thoroughly observing my body's response to eating food.  This is a fine art, and it requires an understanding of just how food travels through the body.

I have found through talking with others that the one place many folks get tripped up in evaluating their own bodies' digestive capacity is not knowing their symptoms connect with very specific parts of the GI tract.  For example, I have heard many people complain about "feeling full" after a meal, and they'll often say that their "stomach is full."  Yet, when I see where their hands go to describe this fullness, I realize it is not their stomach that is full at all -- it is actually their lower abdomen that is bloated and uncomfortable.  The stomach, of course, is just below the sternum a little to the left -- not around the belly button.  So this "fullness" is most likely coming from the last part of the small intestines.  This region is probably bloated from some kind of dysfunction and is putting pressure on the GI tract above it, including the stomach -- which gives the sensation of having eaten too much.  Knowing about little things like this can help a person really narrow down and target their specific digestive ailments.


Part 7, The Holy Grail of Probiotics ... Part 8, A Fecal Transplant Story ... Part 9, The Long Journey of Mister Poop: I'm covering all of these parts together because they fall under the same general category: taking someone else's poo and putting it in my body to restore intestinal flora.  There are many things that I would do differently now if I did the procedure again -- possibly antibiotics before the implant; better donor selection; make a more palatable concoction and pinch my nose (!) while drinking.  I'll outline my plan in more detail in an upcoming blog post.  For now, I will say that I have not ruled out this procedure and still have great hope for its use in the near future.

I believe very deeply that this is the ultimate tool in regaining digestive health and it deserves far more attention and research than it is currently getting.  However, word is definitely getting out, and I'm encouraged by some of the latest coverage of the treatment.  Here's a list of very recent and active links that I've found regarding fecal transplants:

Freakanomics Radio: The Power of Poop -- A good primer for potential donors on the merits of the procedure.  And it's entertaining.
Fecal Transplant - I Took the Plunge! -- On the "Healing Well" forum.  Exhaustive 5-part resource on individual experiences and questions regarding the treatment.
Home Fecal Transplants -- A group of people attempting transplants.  Some are beginning to consider doing an oral transplant similar to the one I did.

How Are Things Now?  

I am currently fairly stable in my gut as long as I follow certain rules that seem to work for me:

1) Low fiber diet: in addition to meat, butter, cheese, etc., I eat white rice or peeled potatoes for my starches and occasional bowls of homemade ice cream (with unrefined sugar).

2) No gluten: this without a doubt keeps my GI tract stable and happy.

3) Magnesium supplementation: prevents hard stools better than anything else I've tried.

4) Pancreatic enzymes: these appear to aid the digestion of foods in my stomach, particularly starches.

5) Moderate to low protein and fat: if I don't gorge on meat and fat (as much as I want to), things remain stable.

6) Two meals a day: this gives my digestive tract time to rest and be free of symptoms, and it appears to allow me to sleep through most of the night without intestinal disturbances.

7) Chewing fennel seeds: three or four times a day I'll grab a pinch of fennel seeds and chew them like gum.  I extract as much of the beneficial oils as possible before spitting out the fiber (when there is no taste left).  Really helps with expelling trapped gas and relaxing the gut.

When following these guidelines consistently, I find that my bloating is very minimal, my muscles have very little tension, and my mind is clear and focused.  Overall, I just have more energy.

This Is (Not) the End, My Friend

Well, here we are at the finish of my intestinal saga -- at least for now.  There will certainly be more updates in the future as I continue to discover more and more about my condition.  I still have a great amount of curiosity in exploring the mystery that is my GI tract, and only time will tell what kinds of crazy treatments I might stumble upon.  One thing all of you out there in blogger land can be sure of is this: you will hear about it.  Thanks for reading -- and happy digesting!
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My Intestinal Saga, Part 9: The Long Journey of Mister Poop

Having decided that the best way to treat the entirety of my GI tract with a fecal transplant was through the oral route rather than rectally, I pondered just how in the heck I would get myself to consume my friend's sh*t -- I mean, it can't taste good, right?  Hmm.  Probably not.  Then there was the problem of administering the concoction.  I didn't have a nasojejunal tube and sedatives, as Borody's clinic does, so I would certainly have to just toss it down the hatch and pinch my nose.  One woman I was in contact with -- a retired nurse -- said that fecal bacteriotherapy used to be around in her day (the 60s) as a last resort therapy for ailing patients, and it often worked (interestingly enough without antibiotic or colon lavage preparation procedures).  How did they administer the therapy back then?  Milk + poo.  A sh*t-shake.  I thought this would be an easy and perhaps even pleasant way to go.  Heck, I might even have a burger and fries with it.

So, on day three of my adventure in feces shenanigans, I popped open the yogurt container with my donor's deposit inside.  Stinky!  (Duh.)  I mixed a bit of the stool with water and strained it into a mason jar.  I had some goat milk on hand and stirred it in.  The mad scientist was at it again, and nobody could stop him.  I looked at the whitish-brown beverage in front of me.  For a second I thought about sweetening it or something, but I had already begun to feel my body and mind rejecting the idea of consuming the liquid, so it was now or never.  Just do the damn thing before doubt takes over.  Glass to lips, in it went.  Oh, dear God!  It was the most acrid taste I've ever experienced in my entire life.  My gag reflex kicked in and almost kept me from swallowing, but somehow I managed to get it down.  Gurgle!  Gulp! ...  Holy sh*t.  I just ate sh*t.  The horrible taste remained, so I immediately began rinsing my mouth and smearing toothpaste all over my gums.  I must have rinsed for 20 minutes.  During this time, I realized I could have probably at least pinched my nose while I drank the poo drink.  Oh well.

And so the millions of bacteria were now in my stomach doing God knows what.  The long journey of mister poop had begun!  Thankfully, I had no need to vomit.  In fact, besides the objectionable taste, it was a downright quick and painless experience.  I wondered how this would turn out.  Would I have diarrhea or a food-poisoning kind of episode?  Only time would tell.  Surprisingly, that evening, as I laid down to go to bed, I had a feeling that I hadn't had since I ate very little food for several years and did yoga and meditation every day.  It was a feeling of complete and total comfort in my gut -- my body felt 100% relaxed.  I think it worked!  I fell asleep quickly and woke in the morning feeling refreshed and energetic.  I remember playing guitar and singing that day -- my voice was smoother than it had ever been.  I presumed this was due to my stomach not being bloated and stiff, so I could finally breathe fully again.  Amazing!

The afternoon rolled around and I felt a strong urge to sh*t.  When I did, it happened very quickly and without difficulty -- definitely something new for me, since I was usually the opposite.  It was a soft, well-formed stool and, hot damn, it smelled just like my friend's poo!  The poo cocktail must have survived the acid bath of the stomach and traveled the entire length of the intestinal tract.  The question was, would these feelings remain?  Unfortunately, they didn't.  That evening, I had trouble sleeping again and woke the next morning to another difficult bowel movement.  "Well," I thought, "maybe it will take some time for the bacteria to fully establish."  I was certainly done drinking sh*t-shakes, so I decided to stop the experiment.  Everything returned to "business as usual" in my intestines, and I decided that most impressive conclusion of this experiment was that nothing changed, good or bad.

Up next, Part 10 of "My Intestinal Saga" -- final thoughts ... 

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My Intestinal Saga, Part 8: A Fecal Transplant Story

I've done a lot of crazy things in my life.  I dropped a college scholarship to go live on an isolated homestead with a mountain man named Peter Bigfoot.  I lived in my car in frigid cold temperatures in the foothills of the Chiricahua Mountains, waking up in the middle of the night to high speed winds rocking my vehicle and groups of 50 illegal immigrants passing by; border patrol agents would flash their lights in my windows hours later.  I did several survival trips into the wilderness with little or no gear, sleeping on the cold hard ground and eating cactus, lily bulbs, any creature I could get my hands on -- lizards, rodents, grasshoppers, scorpions.  I went for years as a low-calorie, highly-active vegetarian, working as a wilderness guide for troubled youth for weeks at a time and hiking many miles on nothing but lentils and ash cakes.  I jumped into dumpsters to retrieve ripe avocados and flour tortillas to avoid buying food from our country's faulty factory-farm system.  I ate rotten meat because I thought it would improve my health based on the recommendations of a guy who calls himself Aajonus.  Oh, and I worked in a retail store at the mall once.

My friend and yours ... Fleet Eneman!

But all of that pales in comparison to the gastrointestinal exploration I was about to embark on.  Bathroom door closed behind me, a sealed yogurt container in front of me.  I popped the lid.  Smelled like sh*t.  Looked like sh*t.  It was definitely sh*t.  My friend had left it for me that morning, a gift -- "the good sh*t," we had earlier joked.  It was helpful to have a sense of humor around such an odd and awkward circumstance.  But with the backing of an MD and an ND, hours and hours of research, and the home infusion protocol in hand, I was confident in this circumstance.  I decided to skip the antibiotics in the protocol because I wanted to avoid them if I could, and I wondered if things would work without this step.  I also didn't do a colon lavage or bother to get any saline solution for mixing.  I wanted to see what would happen if I just did the damn thing with no preparation.

So this was it.  Now or never.  My friend's turd was my medicine.  I scooped out some poo with a spoon and mixed it in a separate container with a little water until I had a brown slurry.  I then poured the slurry through a strainer into another container.  This watery sh*t shake was then streamed into a small fleet enema bottle, after which the I screwed on the probe-like lid.  The concoction was prepared.  The mad scientist in me became excited for the unknown results of what I was about to do.  I got in enema position.  Then in it went, where the sun don't shine.  Squirt.  I held it, got up, cleaned up, and left the bathroom that cold winter morning with somebody else's crap in my colon.

I went about my day as usual, preparing some breakfast and sitting down to eat.  "Hmm.  No difference so far."  About two hours later, I felt the urge to "drop the kids off at the pool."  To my surprise, what came out wasn't my usual brew -- it smelled and looked exactly like my friend's sh*t.  And it came out much easier than was usual for me.  Okay, so obviously my donor's bacteria had multiplied and formed stool in my colon.  But would that last?  To my disappointment, I had my usual hard stools that evening.  The next morning I did the protocol again with the same result.  Again the following morning.  Damn.  Something isn't right.  I realized I might not be getting the bacteria far enough up the colon to make a difference.  In Borody's clinic they often implant the feces deep in the colon through a colonoscopy instrument -- all I had was a little squirt bottle.  Add in the fact that my bowel problems appeared to be more in my small intestine near my ileocecal valve, and I decided I needed to treat more than just the first few bends of my colon.  Knowing it wasn't possible at home to replicate the clinical procedure, I began pondering another route to get deeper into the GI tract.  Borody had employed another method of fecal transplant which involved a "nasojejunal tube."  This instrument was basically a complicated way of getting the feces into the small bowel through the nasal passage and stomach.  Well I wasn't about to snort some sh*t.  But crazy as it sounds, I was strongly considering drinking a sh*t shake.

Part 9 of "My Intestinal Saga" coming soon ... 
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My Intestinal Saga, Part 7: The Holy Grail of Probiotics

At the end of my rope after years of irritating intestinal symptoms, I decided there had to be something out there that was a silver bullet -- something that would end my problems for good and allow me to live my life free of abdominal discomfort and 3 A.M. insomnia.  Manipulating my pattern of eating only helped mildly and did not work as a long term fix.  I was on a maintenance plan of suboptimal health, and I was tired of it -- ready to try anything.

Me and my dog.  Note the sh*t-eating grins.

One sunny winter day, on a hike with my dog in the mountains of southern Utah, I was pondering what else I could try that I hadn't already.  My thoughts were abruptly interrupted by a grotesque munching sound: Chomp, squish, blurg!  It was my little black lab enjoying some fresh cow dung.  I'd seen her do this countless times in her puppy years, and I always figured she was getting a healthy dose of beneficial bacteria with every squishy bite -- perhaps to stimulate her immune system or to settle her stomach.  In a sense, my pup was happily choking down natural probiotics in that slurry of cow excrement.  As I witnessed this phenomenon for the umpteenth time, a light bulb went off in my head: "That bovine poo must be absolutely teeming with hundreds of species of millions of bacteria -- probably in greater diversity than could ever be produced in a laboratory.  I wonder if there are any accounts of humans eating feces for health as some animals appear to.  And, if so, could this be something that would help me?"  Not the weirdest thought I've ever had, but certainly up there on the list.  

I voraciously researched the internet for anything relating to humans and feces consumption that wasn't connected to some odd fetish or mental disease.  My first lead came from a humorous website, called "The Straight Dope."  This website answers questions people have about random, often shocking subjects.  A woman had written in to ask whether or not coprophagia -- sh*t eating -- was dangerous for humans.  The website authors, who actually appeared to be quite intelligent despite the mocking and sarcastic nature of the site, dug into some research to answer her question the best they could.  What they found, in a scientific journal, Perspectives in Biology and Medicine, was this:

... consumption of fresh, warm camel feces has been recommended by Bedouins as a remedy for bacterial dysentery; its efficacy (probably attributable to the antibiotic subtilisin from Bacillus subtilis) was confirmed by German soldiers in Africa during World War II.

Fascinating!  A bacterial remedy for a bacterial illness.  So, did I go out and eat cow dung after reading this?  As tempting as it was to a crazy, fringe health dude like myself, I decided to do some more research first.  After coming across other counterintuitive silver bullets in reversing disease, such as helminthic (worm) therapy, and coming full circle reading about Aajonus Vonderplanitz (God, I love that name) and his recommendations to eat animal crap, I finally stumbled upon what appeared to be a scientifically-validated therapy for gut issues, called "fecal bacteriotherapy" or "fecal transplant."  In a paper, called "Bacteriotherapy Using Fecal Flora: Toying With Human Motions," Austrailian gastroenterologist, Thomas Borody, outlined the historical and scientific precedence for a procedure he developed to treat severe digestive diseases.  What was this procedure?  Basically, he was implanting the feces of healthy people into sick people -- orally or rectally -- and achieving amazing results, not the least of which was a long term remission of crohn's disease.  Holy sh*t.

I found out that Borody offered this procedure in his clinic in Australia.  Well, I wasn't about to fly to Australia and pay thousands of dollars to eat feces when I could probably do it just as well at home.  (Wow.  That would be a funny sentence to quote out of context.)  Sure enough, I found a "human probiotic home infusion protocol" (nice euphemism) that I could use in collaboration with a doctor and a donor.  This protocol described how to go about doing an enema with a poo mixture.  To my surprise, my doctor had already heard of the therapy, and I quickly found a donor in a friend of mine who was healthy and free of bowel problems (or so I thought after interviewing him -- more on that later).  After having my friend, who I was about to become incredibly intimate with, tested for all the bad bugs and viruses that could be transferred in human feces -- and once more consulting with my M.D. -- I was ready to take the leap.

Part 8 of "My Intestinal Saga" -- it gets even better -- up next ...
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My Intestinal Saga, Part 6: It's All Digestive, My Dear Watson

On Kwasniewski's Optimal Diet, I felt the strongest I had felt since I was a high school athlete working out at the gym 6 days a week.  My body composition was extremely desirable to me.  I felt solid and seemed to build muscle very easily.  Eating gobs and gobs of fat along with just enough protein, I was never unsatisfied with meals.  The satiety factor of this dietary pattern was incredible, and I happily stuck to it for close to a year even though I had odd muscle tension throughout my body and would toss and turn in my sleep, sometimes waking up for three hours around 3:00 A.M.  My breath also was absolutely horrible, as my girlfriend at the time made perfectly clear to me.  There were so many things right with the Optimal Diet and, yet, so many things were wrong.  I had the body and strength that I wanted, but, good Lord, was I slothful at times.

Me on the Optimal Diet

During the Optimal Diet, I began to tweak my mealtimes to see whether or not my symptoms were fully attributed to the digestion and absorption of my food.  I experimented with one meal a day, which was easy to do and get adequate calories from since the foods I was eating were so low in fiber and very calorically dense.  As I had expected, my symptoms suddenly became isolated to certain times, depending on when I ate.

First, an hour after eating, my chest would usually begin hurting and feeling tender and then subside over another hour.  Also during this time, I would often get a headache and a bit of lower abdominal discomfort along with a unique "pins and needles" feeling in my chest/upper abdomen.  About 8-10 hours after the large meal, in addition to bloating, I'd feel heaviness come over me in the form of shoulder, abdominal, and -- oddly enough -- left calf tension.  From my studies of human digestion, I knew this is when the food would have been traveling through my small intestine (food typically empties from the stomach in 3 hours).  So I thought maybe something was wrong with that part of my GI tract, but had no clue what it could be.  Sometimes the abdominal tension (which felt like a rock) would be so bad that it would "push up" my stomach, and I'd actually have to vomit.  Taking the experiment further, I learned that if I fasted for a day, I would feel absolutely amazing the entire next day.  Upon eating again, I'd experience some "tender chest" pain, but no "pins and needles," headache or lower abdominal discomfort.  I realized after eating the next day and then feeling those symptoms coming on that they were actually happening 24 hours after my last meal.  I came to call these the "24 hour symptoms" as a result of this discovery.  The "8-10 hour symptoms" consistently happened the same time after mealtime.

So I had my answer.  My detective work paid off.  It was all digestive.  It wasn't "all in my head" as some of my close friends and family suggested.  It wasn't due to poor posture or not exercising enough.  It wasn't because I was some kind of hypochondriac.  It was because I had friggin' digestive problems.

Abdominal/Pelvic CT scan

At this point, some of you may be thinking, "Ryan, why the heck didn't you just go to a doctor to diagnose all of this?"  Well, I did.  I saw quite a few M.D.'s, Naturopaths, and body workers, and they all provided some pieces of the puzzle, but I never got a definitive answer from any of them.  I was subjected to various tests, as well -- barium swallow abdominal/pelvic CT scan, gall bladder ultrasound, and stool/blood analyses of all kinds -- and nothing informed me that I had specific digestive problems.  Yet, here I was with direct experiential proof that all of my symptoms were, in fact, digestive.    

I felt defeated, worn out -- ready to be done with these problems that plagued me over the years.  I knew I was having GI problems, and I had tried the herbs, enzymes, HCL, etc., etc., and the only thing that worked was to either eat nothing or eat less.  And to do that meant I would be back at an unhealthy weight, feeling weak and hungry.  Wonderful.  I was stuck with this sh*t.  But I wasn't ready to give up.  In fact, I was entirely prepared to do whatever it took to get well again.  Onward into the fascinating world of *drumroll* fecal bacteriotherapy.  Say what?!  Yes, this is where it gets interesting, folks.

Part 7 coming up next.  Warning: May not be suitable for the squeamish!

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My Intestinal Saga, Part 5: Monastyrsky and Kwasniewski

After my introduction to the man known as "The Bear," I followed the zero-carb "path" and ate nothing but rare-cooked steaks, liver once in a while, bites of butter, and occasional eggs.  To my surprise, I remained at a stable weight during this extreme dietary experiment.  I also had energy to go on long walks, infrequent runs, and swim for hours whenever I could find a body of water large enough.  Despite all of this energy, though, I was still bogged down by the same heaviness that I had felt since I began eating lots of meat again.  The only thing that seemed to alleviate it was eating one meal a day in the evening, after which I would feel the heaviness but it would be gone by morning.  The other problem I had -- hard stools -- was still plaguing me, as well.

In the meantime, I was still reading a lot of zero-carb material on the internet, trying to sort things out.  One man, Jeff, started his own forum dedicated to proving that human beings thrive when there are no sugars and starches in the diet.  He also made it a point to exhibit that, no matter how many calories he ate on a zero-carb diet, he would not gain or lose weight.  At one point he was as high as 4,500 calories a day, literally drinking more than a quart of heavy cream each day.  He also was out to show that exercise is completely different while avoiding carbs and eating an extremely high-fat diet, and his daily and weekly logs displayed how many miles he'd ran and how he felt for days afterwards.  One thing that struck me was that he claimed to not feel sore at all after running over 20 miles in a day -- this coming from a guy that was not, by any means, a runner before the experiment.  I was certainly impressed by all of this and similar reports from others, so I kept on with zero-carb hoping that I would adjust as other folks had.

I never adjusted, and I was starting to get frustrated.  Spending time on forums, I couldn't find anyone that shared a similar predicament aside from a handful of folks.  I had a few "gut buddies" who related to much of what I had going on, and we would all communicate what seemed to be working and what wasn't.  We each individually tried manipulating our eating patterns and supplementing digestive aids like enzymes, herbs, probiotics, and all of those things that are typically recommended to people with the catch-all health problem known as "irritable bowel syndrome."  While some approaches appeared to have benefit, by and large nothing did the trick.  In the end, we still had the same symptoms.  Seeking to deepen my understanding of what was going on, I returned to studying the human digestive tract.  I payed careful attention to where I was feeling what and how the symptoms could be related to certain organs and functions within my GI tract.  Much of the information I came across was pretty dry and lacked experience.  I needed to find someone who had resolved his or her digestive problems experientially and could help me along.  The problem was that every digestion expert out there seemed to recommend fiber as the Holy Grail of gut reparation.  I was already skeptical of this method of improving intestinal problems because 1) it hadn't worked for me and 2) fiber appeared to be completely unnecessary in digestive functions anyway -- lots of folks I was in contact with weren't having any problem with a zero-fiber diet.  But why the heck was I having problems?  Enter Konstantin Monastyrsky, author of a book called Fiber Menace.

I caught wind of Mr. Monastyrsky's gut manifesto on a forum I frequented.  Reading excerpts from his book, I knew this was the guy to learn from.  His story was very similar to mine -- a vegetarian who developed digestive problems and then realized that things needed to change.  Fiber only seemed to make his problems worse, and so Monastyrsky looked at other means of getting well again, delving into medical texts and other research to find out more about human physiology.  Like me, he was a health detective, and he labeled this approach to wellness "Forensic Nutrition." In Fiber Menace, Monastyrsky laid out the fundamentals of what got him better and built a strong case against many of the mainstream health mantras of our time, such as the supposed "dangers" of a low-carb diet and the necessity of drinking eight glasses of water a day.  I found his viewpoints fascinating and quickly devoured his book.  Shortly thereafter, I tried out some of his supplement recommendations, which included a non-habit-forming laxative (a form of vitmain C) and probiotic bacteria with small amounts of soluble fibers to feed them.  These were things I'd tried before, but for some reason I always ran into problems with.  But when I tried Monastyrsky's supplement regimen, I was free of hard stools for the first time in several months.  Astoundingly, the heaviness in my body went away, and I felt lighter and tension free like I hadn't in a very long time -- probably since I had been eating very little food as a vegetarian.

Dr. Jan Kwasniewski

After a close to a year of eating zero carbohydrates, I began to feel like it was time to eat like a somewhat normal human being again.  I wanted to add some starches back into my diet, but not so much as to disturb the "keto-adaptation" (a term coined by The Bear) I had worked hard to achieve.  I still wanted my body to use fat for fuel, as this felt like very efficient energy and I had certainly grown used to it.  So I went with what I felt was a good dietary transition and began the "Optimal Diet" -- a way of eating developed by a Polish doctor, Jan Kwasniewski.  This diet was all about the ratio of protein, fats and carbohydrates and keeping them in balance to achieve optimal health.  The ratio to be followed was 1 : 2.5-3.5 : 0.5 -- protein : fat : carbohydrates.  What that meant was that I would literally be eating sticks of butter and drinking heavy cream.  And I did gladly.  I love fat.  Always have.  Always will.  So it was easy to eat the Optimal Diet -- however, the heaviness seemed to return as I began eating more consistently and the supplements I was on slowly started to lose their effectiveness.  Crap.  Could I ever win?

Part 6 of "My Intestinal Saga" coming soon ...
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My Intestinal Saga, Part 4: Gurus and Rotten Meat

Rotting meat in mason jars.

So there I was.  It was late summer 2006.  The sweltering Tucson sun beat down on the city relentlessly.  White tail doves could be heard flapping and cooing on rooftops and power lines, and the cicadas' symphony was in full swing.  I sat inside, bathing in the cool air of the swamp cooler, a plate of raw ground beef sitting in front of me.  I took a bite.  It went down easy.  I took another and my body screamed for more and more -- so I fed it.  I followed the meat with a few spoonfuls of raw, "unheated," honey and some raw butter.  I was satisfied like I hadn't felt in years.  And it was all thanks to a man by the odd name of Aajonus Vonderplanitz and his book, The Recipe For Living Without Disease.  In this book, Vonderplanitz outlined the key to optimal health and vitality through food, and it enthralled me.  Raw meat, unheated honey, raw dairy, raw vegetable juices -- these were the ingredients to becoming well again, and I had no problem eating all I wanted and enjoying the heck out of it.  My family and friends were somewhat worried about me at his point.  Salmonella, E. Coli, and countless other bacteria existed in raw food products -- how would this negatively affect my health, particularly my already stressed out gut?  Surely I would get food poisoning at the very least.  And straight butter?  Heart attack city!  Well, after several weeks of the eating all of the foods suggested by the quirky Aajonus, I was happy to report that I had absolutely no problems.  In fact, I had more energy than I could remember feeling in my whole life.  Then I thought, "Hmm.  I wonder if I could feel even healthier?"

Aajonus Vonderplanitz believed if raw meat was healthy, then rotten or "high" meat is probably even healthier.  The Inuit traditionally enjoyed rotted flesh as part of their diet, and so did many cultures around the world.  I was insanely curious about this.  Would it feel good in my body?  Or would I get really sick?  So I began making "high" meat -- filling mason jars with sliced up beef and airing them out every few days.  Oddly enough, the rotten smell that developed over a few weeks began to please my senses.  It smelled good, it looked good -- I couldn't wait to eat it.  Then the day came when it was ready.  So I took a jar filled with rotting, slimy meat outside, opened it, and reached in for my first taste of this supposed health elixir.  I loved it.  Weird, I know.  It just tasted way good for some reason.  Although the little white beads on the meat that had developed over the weeks somewhat disturbed me.  Were these some kind of worm eggs or something?  Was I ingesting parasites?  Well, even if I was, Mr. Vonderplanitz assured me in his book that they would merely detox my body and consume my unneeded intestinal wastes.  Win-win for me and my little worm buddies.  They get to eat and I get better!  Oh lord, I have done some interesting things in my life, and this one is up there on the list.

Again, much to my surprise, the most shocking thing that happened was -- well, that nothing happened.  I remained healthy and feeling quite good overall on my raw and rotten diet.  After a few months of this "primal diet," I encountered something even more alluring in my continual research: the raw paleo diet.  I joined a forum where there were a handful of folks experimenting with this diet -- consisting of nothing but raw meat and fat -- and experiencing great results.  (Apparently these folks still exist.)  Their stance on eating mostly organ meats made a lot of sense to me, as this was where the most nutrients exist, and if my goal was optimal health, well then I wanted all the nutrients I could get, gosh darn it!  I began the raw paleo diet with enthusiasm, picking up raw liver and raw beef fat from the butcher at a local organic foods store.  Damn, did that stuff taste good to me.  I swear, at the time, the liver tasted like chocolate and the beef fat tasted like ice cream.  Soon I was gorging on kidneys, spleens, tongues, and any other raw offal I could get my grubby little hands on.

Pretty soon I realized that zero-carb, raw paleo was the way to go (naturally, right?).  I felt great -- well, for the most part.  My back pain was pretty much gone at this point, but I seemed to have developed hard stools from the sudden transition to zero carbs + zero fiber.  Not only that, but I began to see fat chunks in my stool, which, at first I thought were gall stones until, ahem, closer inspection.  There also was this "heavy" feeling in my body at times, like I was walking underwater.  Also, another problem --chest pain -- came about when I started to try to eat only one large meal a day, as some folks on the raw paleo forum were suggesting as the optimal eating pattern.  It would sort of come and go and actually wasn't too bad ... until I tried to do some push-ups -- ouch.  I thought I was having a heart attack.  I calmed myself and decided that maybe it was just some kind of strain.  It hurt horribly for two days.

The Bear

During my raw paleo stint, I was also floating around the Active Low-Carber forum and talking with some zero-carb folks on there.  (You can probably still look up my posts; just search for my username, "rk900.")  We were a ragtag bunch of wandering souls.  There were people who swore that the only thing that kept their weight stable was absolutely no carbs -- not even too many eggs or liver.  Others were on the paleo bandwagon.  Still others were curious about the diet, but were not bought in due to fears of losing their cherished carbohydrates.  I felt proud to be one of the few who was practicing full-on paleo zero-carb, just as primitive humans had done for millions of years before me (or so I thought).  Then, all of the sudden a post appeared: "The real human diet is a totally carnivorous one."  The author of the post was a man simply known as "The Bear."  It began:

I have been eating the natural human dietary regime for over 47 years now. I do not eat anything whatsoever from vegetable sources. The only things veggie I use are spices. My diet is usually 60% fat and 40% protein by calories. I used to eat 80/20 when younger and about twice as much quantity of meat also, but that seems too much energy at my age, which is 71- even though I am very active. I think the body actually becomes more efficient with energy as you age, but I have no way of proving it true. Otherwise, my body today is very like it was at the age of 30. I figure most of what we call 'aging' is due to insulin damage to the collagen and other body structures. No carbs = no insulin. I don't heal quite as fast when injured as I did as a youngster, however. But I have few wrinkles, and my skin is still strong and elastic.

The guru had arrived.  Responses came pouring in.  The Bear had answers for everything.  His healthy 47 years of experience with the zero-carb "regime" proved that modern humans could live well on such a diet without problems.  There was a very strong divide on the forum: some loved him and others thought he was full of crap.  One guy even started a dedicated blog on the "Zero Carb Path."  The Bear validated everything I believed at the time, and I followed guru's advice on eating and living well.  I still had the aforementioned problems with my gut, but decided that I felt better than any other time in my life, so I continued on "the path."


The saga continues in Part 5, coming soon.
  

My Intestinal Saga, Part 3: Making Connections

With the realization that my back pain was somehow related to what I was eating, I began connecting some dots.  Less food + Simple food = Less back pain.  More food + Varied foods = More back pain.  But what the heck did food have to do with muscle pain?  Why would my lower right back hurt so incredibly much based upon my dietary choices?  Why did I feel so much lighter and tension-free when I ate less or fasted?  I began researching the human body and its inner workings to find out why my pain was so localized to this one place on my body.  It turned out that, in the lower left abdomen where the junction of the small intestine and large intestine, there exists something called the ileocecal valve.  This little valve controls when undigested food exits the small intestine and begins the journey into stool formation in the large intestine.  Hmm.  Did this area have something to do with my back pain?  I pressed on my abdomen where the ileocecal valve was located.  It was tender.  Not only that, but I felt the pain from my back transfer to this spot when applying pressure.  It was an epiphany for sure.  I thought, "Wait just a gosh-darn minute here!  Does this mean my pain is actually intestinal, not muscular or skeletal?"  Apparently it was.  Fascinating!

My entire school of thought shifted.  No longer was I wholly committed to a purely external yoga or massage-manipulated path to healing.  I believed I had found the root cause of the pain and tension I was experiencing, and now I only had to figure out how to manage this internal problem.  Easier said than done.  For several months I experimented with herbs, digestive supplements of all kinds, probiotics -- the whole gamut of intestinal warfare.  Nasty herbs for any parasites that might be still hanging out.  Enzymes to aid the breaking down of food.  Good bacteria to repopulate my sad, miserable gut.  All these things, along with continued yoga and the like -- yet, aside from simply eating nothing at all, I experienced little or no improvement.  What hadn't I changed?  Was there anything else I could do?  Or would I have to live with this inconvenient pain the rest of my life?

Finally, the cognitive dissonance had to come to an end.  I was underweight.  I was fatigued.  I had little zest for life.  I asked myself a difficult but honest question: Was I unhealthy because I was a low-calorie vegetarian?  It was time.  I was ready to take a good, hard look at this mostly philosophically-driven food choice -- one that I had always thought could only make me healthier.  That's what all the books I was reading at the time were telling me.  Everything in my mind up to this point had said "yes" to a vegetarian diet.  All these years, however, my body had been crying out a resounding "NO!"  Time to eat some meat.  And, while I'm at it, why not eat nothing but meat for a while?  Oh, how I loved extremes at that time in my life.  So on I ventured into the world of zero-carb, "The Bear," and a sudden fondness for the Inuit.  More digestive lessons were soon to come.

Part 4 of "My Intestinal Saga" up next.

My Intestinal Saga, Part 2: Lower Back Pain

Following the parasite party in my gut, I had a few months of sulfurous burps that just would not go away.  I was the weakest I'd ever been in my life.  If my memory serves me correctly, this was the start of years of funky stools (the description of which I'll spare all of you readers out there unless you personally inquire), as well as a sudden increase in the lower back pain I'd had since high school.  One day, maybe a year after the gut bug debacle, I was shoveling dirt in a garden when all of the sudden I tweaked my back into immobility.  This lasted 3 days.  It was incredibly painful and a huge wake-up call for me -- something about what I was doing for my health wasn't working.  Rather than blame it on being weak and malnourished from vegetarianism and parasites, I turned to purely external physical solutions, such as yoga, acupuncture, chiropractic, massage, and body posture practices.  I focused on keeping my spine aligned and balancing the use of my muscles.  To a certain extent, this worked quite well and kept me somewhat capable physically, although I honestly could not imagine having to do yoga or pay attention to my posture the rest of my life -- it seemed unsustainable.  And why was it that primitive peoples -- who I had begun to study in depth -- appeared to be so light and tension-free in their bodies without needing to do daily maintenance practices such as yoga?  Also, working around kids a lot in summer camps I noticed how they naturally had absolutely perfect posture without any kind of attention to it.  I decided it was my goal to experience this natural freedom from tension.  Yet all that seemed to work was doing yoga three times a day and paying careful attention to my body posture.  There had to be a better way.

In the summer of 2005, I began work with a wilderness therapy program, called The ANASAZI Foundation, and was spending weeks in the backcountry with troubled youth.  Not learning my lesson from the experience with Vince Pinto in the Chiricahuas, I was confident that I could drink from streams without purifying the water.  I was so convinced psychologically that I was the healthiest, most resilient dude of anyone I knew that I believed I could withstand whatever nature threw at me.  I was wrong.  Again.  Three more parasitic episodes over a couple of months and I finally started purifying my water like a logical person would.  I no longer felt invincible and really started to question some of the crazy things I was doing, such as constant yoga and a vegetarian diet.

During my time at ANASAZI, I also realized something profound about my back pain: it would subside to almost no pain at all while I was in the wilderness.  At first, I thought this might be the product of living a more natural lifestyle and walking the earth as humans had done for millions of years before me.  Over time, however, I began to realize that there was something about the food I was eating in the backcountry -- both in amount and type -- that appeared to lessen the pain.  Lentils, rice, and ash cakes in small amounts were my staples in the field.  When I came back to civilization, I'd load up on loaves of bread, peanut butter, salad and tons of yogurt.  So I tried an experiment: eat how I ate in the field while I was at home in the city.  The results were the same: far less back pain and an overall feeling of being lighter in my body.  I thought I had found an answer.  I remained underweight and felt dizzy upon standing, had sunken eyes and a lack of energy, but without back pain, I felt 1,000 times better.  It seemed that more pure food -- and less amounts of it -- was the key to regaining my health.  Or was it?

Part 3 of "My Intestinal Saga" up next ..

My Intestinal Saga, Part 1: Dabbling in Parasites

Wow.  It's been a really long time since I've posted a blog entry.  I'd like to have some extravagant reason as to why, but the truth of the matter is that I've simply been inspired in other directions for the past several months.  My own physical health progress has been at a standstill this whole time until quite recently.  As some of you may know, I have had long-standing digestive problems that possibly came about after many episodes of backcountry parasitic infections beginning almost 8 years ago (which also was the time I began experimenting with vegetarianism).  My digestive problems usually manifest in the form of a slowed down transit time, hard stools and bloating, along with infrequent sharp pains in my intestines (my apologies if anybody is disturbed by my blunt description).  These symptoms have greatly affected my body and my mental state in negative ways: poor sleep, sudden fatigue, coming and going depression, muscle tension, pain, and the like.  When I began eating well again and adding certain supplements to my diet, I was able to lessen or eliminate many of these issues.  I thought I would delve a little deeper into my health history and describe what kinds of changes I made along the way get well again, dietary or otherwise, with the intention of possibly guiding some of you folks out there in blogger land to better health and also receiving feedback from anybody who wants to offer me some other directions I might be able to take to further improve my situation.

Hmm.  Where to begin?  I guess I should probably go back as far as I can remember, and that would be my childhood years.  The major body disturbances I recall from this time, let's say around age 8 and for several years after, were TMJ syndrome and frequent headaches.  I would grind my teeth at night and wake up with a sore jaw quite often.  The headaches seemed to arise at random moments throughout the day, but I remember them being excruciating.  Besides that, as far as I know, everything ran smoothly (if you know what I mean).  It's debatable whether or not the aforementioned problems were from digestion, but later -- in the midst of my health transformation, around age 23 --  I would discover some connections that surprised me.  More on that later. (See the three part post on my own personal health profile for more on my physical transformation and dietary history.)

Now on to high school.  This was when I first started to notice bloating in my lower abdomen.  I've been an avid athlete all my life and high school was the most active time of my life.  Lifting weights 6 days a week; running 3 miles every other day; swimming laps and doing sprints; and practicing on baseball and soccer teams on top of all of that.  Pretty active, right?  Well despite all of that, I still had this perceptible "belly" on me.  At the time, I attributed it to fat, but I'm fairly certain now that it was just bloating -- I was pretty ripped in every other regard.  So what caused the bloating?  I don't know for certain.  My educated guess based upon later experimentation is that it was brought up by some kind of milk and/or gluten intolerance.  Another primary physical issue of that time in my life was lower back pain.  This was why I absolutely abhorred doing any kind of physical labor that involved bending over and lifting.  Again, I now believe I have answers as to why that was happening.  We'll get to these epiphanies in the chronological order that I discovered them.

Okay, post high school -- my time of spiritual journeying and reconnecting with nature.  Here's where the "fun" begins.  Parasites.  Wonderfully horrible parasites.  My first episode happened after going on a survival trip with my friend and mentor, Vince Pinto (who owns and operates a nature school, called Raven's Way Wild Journeys).  We hiked into a stream in the Chiricahua Mountains of southeastern Arizona with minimal gear, including a complete lack of water purification.  Vince drank from this stream on several occasions with no problem, so I was confident that I would do just fine, as well.  Along the stream, there were cow patties literally every couple of feet.  This meant that the water was likely contaminated.  Welcome to the wild, wild West, where cattle have more rights in nature than humans.  Cow excrement aside, Vince and I found a pristine place up stream which we assumed would be safe to drink.  36 hours later, instead of camping in the desert, I was camped beside a toilet.  Giardia.  Vince, on the other hand, was fine.  Unlike him, I was underweight and underfed at the time, so I attribute my susceptibility to the little buggers -- and his resistance to them -- to that.

Part 2 of "My Intestinal Saga" coming soon.

If, for some odd reason, you are absolutely enamored with how cute and cuddly the giardia microbe above is, you can get your very own plush doll at Giant Microbes.