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Fecal Transplants for treatment of Clostridium Difficile, Ulcerative Colitis and other digestive disease
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Fecal Transplants for treatment of Clostridium Difficile, Ulcerative Colitis and other digestive disease


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A summary of information about Fecal Transplants which are used to treat and effectively cure infections of anti-biotic resistant Clostridium Difficile infections of the large intestine. In addition …

A summary of information about Fecal Transplants which are used to treat and effectively cure infections of anti-biotic resistant Clostridium Difficile infections of the large intestine. In addition to helping treat c. diff there have been case studies reporting success for treating Ulcerative Colitis and Crohn's Disease as well. Unfortunately access to this treatment through doctors in the United States is currently limited by FDA restrictions which require doctors to first apply for an Investigational New Drug (IND) permit. This has lead to some patients doing fecal transplants themselves.

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  • 1. Fecal Transplantsfor the treatment of digestivedisease
  • 2. My Story• Diagnosed with Ulcerative Colitis in 1999• Depression, diet and a potential bacterial infection whiletraveling appeared to be contributing factors.• Anti-biotics appeared to help bring about remission morethan once.• Otherwise cancelled surgery days before my date in March2011 when I discovered that fecal transplants had beensuccessfully used for Ulcerative Colitis.• Now over two years after using self-administered fecaltransplants combined with medications and dietarysupplements I am still symptom-free.
  • 3. Problem: Clostridium Difficile• Anti-biotic resistant strains ofClostridium Difficile bacteria isbecoming more of a problem.• Over 14,000 people die in theU.S. from c. diff complications.• Anti-biotics don’t work topermanently treat thiscondition because the bacteriacomes back from spores.• C. diff comes back becauseanti-biotics wiped out the“good” bacteria to prevent itfrom growing out of control.
  • 4. Problem: Chronic Inflamatory Bowel Disease• Over 1.4 million Americans are estimated to suffer fromCrohn’s Disease and Ulcerative Colitis.• worldwide incidence rate of ulcerative colitis varies greatlybetween 0.5–24.5/100,000 persons.• Crohn’s disease varies between 0.1–16/100,000 personsworldwide, with the prevalence rate of IBD reaching up to396/100,000 persons• While the cause is unknown it is usually treated as anautoimmune disease.
  • 5. Impact of Ulcerative Colitis and Crohn’sDisease
  • 6. Impact of Inflammatory Bowel Disease• Overall health care cost of more than $1.7 billion in the U.S.• 700,000 Dr visits• 100,000 hospitalizations, and disability in 119,000 patients.Over the long term, up to 75% of patients with Crohn’sdisease and 25% of those with ulcerative colitis will requiresurgery.3
  • 7. Why Fecal Transplants for c diff• Highly effective for patients with Clostridium Difficile withsuccess rates of 90-100% depending on the study.• Symptoms improve almost immediately often with just onetreatment using a colonoscope or less than a week of self-administered enemas.• Fights bad bacteria with a mix of stronger, more dominant,good bacteria.• Safe, with a healthy donor, there are no published cases of aperson contracting an incurable disease.• Keeps the infection from coming back as it often does withanti-biotics, by restoring a healthy balance of bacteria.
  • 8. Why aren’t Fecal Transplant beingused more often?• FDA regulation as an Investigational New Drug (IND.) Stated purpose is to protectpatients, however the result has been to strongly discourage doctors from doing it.• “Ick” factor and a lack ofunderstanding about how thisworks.• Lack of awareness among doctorsand patients that this is atreatment option.
  • 9. Why Fecal Transplants for UC• Existing treatments often do not continue to work for patientsover an extended period of time.• Anti-inflammatory and immune suppressing drugs havesignificant side effects, including bone density loss, risk ofcancer, liver or kidney damage and elevated risk of secondaryinfections.• 25% of Ulcerative Colitis patients and 75% of Crohn’s Diseasepatients will have surgery to remove some of all of theirintestines.
  • 10. Why Fecal Transplants for UlcerativeColitis and Crohn’s Disease?• Bacterial imbalance or presence of bacteria that releaseinflammatory toxins may be the root cause of inflammation.• This seems possible since stomach ulcers were linked to hpylori bacteria within the last 20 years.• Traveler’s diarrhea from bacterial infections and also c diff areknown to be caused by bacterial infections and cause similarsymptoms.• While a specific bacteria has not been identified yet,researchers are still mapping the human biome.
  • 11. Success of Fecal Transplants• “Treatment of Ulcerative Colitis using Fecal Bacteriotherapy”published article in which Dr. Borody’s 6 patients who achievedprolonged remission as long as 13 years without continuedtreatment with drugs, he suggests it could be considered a “cure”• Self-reported patient stories including myself continue to mount.• However other patient reports have not been so promising.• Success of Fecal Transplants is complicated by several other factorsinvolved in healing the illness.– Depression / anxiety Irritable Bowel Syndrome– Damage to the intestinal walls from chronic inflammation– Possible food intolerance or allergies
  • 12. More challenges for fecal transplants• Effective treatment could involve addressing several different factors to ensurethat an optimal bacterial balance is established and all pathogenic bacteria areeliminated or rendered harmless.• Immune-suppressing drugs may be necessary so that the immune system doesnot attack new, helpful bacteria and to treat existing inflammation.• This may include pre-treating with a course ofanti-biotics before fecal transplants.• Drugs to calm muscle spasms and diarrhea.• If used for Crohn’s Disease, a top down method(nasal gastric tube or swallowing capsules) mightbe more effective since bacterial might have ahard time making their way through the illealcecal valve.
  • 13. Keys to success for fecal transplants• Find a healthy donor.– Younger to middle aged adult with “normal” bowel habits for theirwhole life would be ideal.– Infants may not have fully developed fecal flora just yet.– Older people in their 60s and older might be a higher risk for having cdiff and there intestinal flora might be diminishing as they age.– Free of risk factors for disease
  • 14. Keys to successful Fecal Transplants• Have a knowledgeable supportive doctor and/or at least onementor who has successfully done this before to help guideyou and let you know what to expect.• There may be some ups and downs in terms of symptoms aspart of the process of fecal transplants working.
  • 15. Key to successful Fecal Transplants• Use over-the-counter anti-diarrhea and anti-gas drugs to treatsymptoms from the fecal transplants and help in retaining theenemas.• Anti-depressants, anti-anxiety drugs or other herbal ormedicinal treatments for IBS to limit urgency and diarrheafrom muscle spasms.• Drugs like Bupropion could have anti-inflammatory effectstoo.
  • 16. Keys to Successful Fecal Transplants• Provide added nutrition to help the body heal using proteinshakes.– Other supplements like L-Glutamine can be helpful. High amounts ofthis are found in most over-the-counter body builder’s protein shakesincluding Muscle Milk.– Pre-digested meal replacement shakes can help calm a flare ininflammation by helping “rest” the bowels. Another one specificallymade for the treatment of digestive disease is Absorb Plus.
  • 17. Keys to Successful Fecal Transplants• Be prepared to continue through some ups and downs.– A flare of symptoms is possible, followed by continued mini-flares asthe “good” bacteria continue to kill off remaining “bad” bacteria.– Fever, bloating and diarrhea may be part of the process of the newbacteria becoming established.• Keep your foot on the gas: continue your combination ofdrugs and supplements for weeks and even several monthspast the time when you have stopped doing the enemas.
  • 18. Keys to Successful Fecal Transplants• Continue to control inflammation and immune response bycontinuing to take existing medications until some time aftersignificant improvement or full remission.– This is because bacteria could continue to come back from sporesembedded in the intestinal walls.– Also limiting diarrhea and inflammation will further help the newlytransplants bacteria to help you heal.
  • 19. More Resources• My website: with articles,videos and more detail on my own experience– My book: Fecal Transplants Cured Ulcerative Colitis For Me•– Contact the site owner for access to a Facebook discussion group•– Website for Centre for Digestive Diseases in Australia with Dr. Borody•– Great source of information and active discussions amongst patients.•– Another large patient discussion forum