The document discusses the use of fecal transplants as a treatment for digestive diseases, particularly ulcerative colitis and clostridium difficile infections. It highlights the effectiveness and safety of fecal transplants compared to traditional antibiotics, while also addressing the challenges and barriers to their adoption in clinical practice. The author shares their personal success story with fecal transplants, along with insights on the necessary conditions for successful treatment.

1. Fecal Transplants
for the treatment of digestive
disease

2. My Story
• Diagnosed with Ulcerative Colitis in 1999
• Depression, diet and a potential bacterial infection while
traveling appeared to be contributing factors.
• Anti-biotics appeared to help bring about remission more
than once.
• Otherwise cancelled surgery days before my date in March
2011 when I discovered that fecal transplants had been
successfully used for Ulcerative Colitis.
• Now over two years after using self-administered fecal
transplants combined with medications and dietary
supplements I am still symptom-free.

3. Problem: Clostridium Difficile
• Anti-biotic resistant strains of
Clostridium Difficile bacteria is
becoming more of a problem.
• Over 14,000 people die in the
U.S. from c. diff complications.
• Anti-biotics don’t work to
permanently treat this
condition because the bacteria
comes back from spores.
• C. diff comes back because
anti-biotics wiped out the
“good” bacteria to prevent it
from growing out of control.

4. Problem: Chronic Inflamatory Bowel Disease
• Over 1.4 million Americans are estimated to suffer from
Crohn’s Disease and Ulcerative Colitis.
• worldwide incidence rate of ulcerative colitis varies greatly
between 0.5–24.5/100,000 persons.
• Crohn’s disease varies between 0.1–16/100,000 persons
worldwide, with the prevalence rate of IBD reaching up to
396/100,000 persons
• While the cause is unknown it is usually treated as an
autoimmune disease.

5. Impact of Ulcerative Colitis and Crohn’s
Disease

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’s
disease and 25% of those with ulcerative colitis will require
surgery.3

7. Why Fecal Transplants for c diff
• Highly effective for patients with Clostridium Difficile with
success rates of 90-100% depending on the study.
• Symptoms improve almost immediately often with just one
treatment 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 a
person contracting an incurable disease.
• Keeps the infection from coming back as it often does with
anti-biotics, by restoring a healthy balance of bacteria.

8. Why aren’t Fecal Transplant being
used more often?
• FDA regulation as an Investigational New Drug (IND.) Stated purpose is to protect
patients, however the result has been to strongly discourage doctors from doing it.
• “Ick” factor and a lack of
understanding about how this
works.
• Lack of awareness among doctors
and patients that this is a
treatment option.

9. Why Fecal Transplants for UC
• Existing treatments often do not continue to work for patients
over an extended period of time.
• Anti-inflammatory and immune suppressing drugs have
significant side effects, including bone density loss, risk of
cancer, liver or kidney damage and elevated risk of secondary
infections.
• 25% of Ulcerative Colitis patients and 75% of Crohn’s Disease
patients will have surgery to remove some of all of their
intestines.

10. Why Fecal Transplants for Ulcerative
Colitis and Crohn’s Disease?
• Bacterial imbalance or presence of bacteria that release
inflammatory toxins may be the root cause of inflammation.
• This seems possible since stomach ulcers were linked to h
pylori bacteria within the last 20 years.
• Traveler’s diarrhea from bacterial infections and also c diff are
known to be caused by bacterial infections and cause similar
symptoms.
• 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 achieved
prolonged remission as long as 13 years without continued
treatment 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 factors
involved 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 ensure
that an optimal bacterial balance is established and all pathogenic bacteria are
eliminated or rendered harmless.
• Immune-suppressing drugs may be necessary so that the immune system does
not attack new, helpful bacteria and to treat existing inflammation.
• This may include pre-treating with a course of
anti-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) might
be more effective since bacterial might have a
hard time making their way through the illeal
cecal valve.

13. Keys to success for fecal transplants
• Find a healthy donor.
– Younger to middle aged adult with “normal” bowel habits for their
whole 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 c
diff 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 one
mentor who has successfully done this before to help guide
you and let you know what to expect.
• There may be some ups and downs in terms of symptoms as
part of the process of fecal transplants working.

15. Key to successful Fecal Transplants
• Use over-the-counter anti-diarrhea and anti-gas drugs to treat
symptoms from the fecal transplants and help in retaining the
enemas.
• Anti-depressants, anti-anxiety drugs or other herbal or
medicinal treatments for IBS to limit urgency and diarrhea
from muscle spasms.
• Drugs like Bupropion could have anti-inflammatory effects
too.

16. Keys to Successful Fecal Transplants
• Provide added nutrition to help the body heal using protein
shakes.
– Other supplements like L-Glutamine can be helpful. High amounts of
this are found in most over-the-counter body builder’s protein shakes
including Muscle Milk.
– Pre-digested meal replacement shakes can help calm a flare in
inflammation by helping “rest” the bowels. Another one specifically
made 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 as
the “good” bacteria continue to kill off remaining “bad” bacteria.
– Fever, bloating and diarrhea may be part of the process of the new
bacteria becoming established.
• Keep your foot on the gas: continue your combination of
drugs and supplements for weeks and even several months
past the time when you have stopped doing the enemas.

18. Keys to Successful Fecal Transplants
• Continue to control inflammation and immune response by
continuing to take existing medications until some time after
significant improvement or full remission.
– This is because bacteria could continue to come back from spores
embedded in the intestinal walls.
– Also limiting diarrhea and inflammation will further help the newly
transplants bacteria to help you heal.

19. More Resources
• My website: http://www.FecalTransplant.org with articles,
videos and more detail on my own experience
– My book: Fecal Transplants Cured Ulcerative Colitis For Me
• PowerofPoo.blogspot.com
– Contact the site owner for access to a Facebook discussion group
• http://www.cdd.com.au
– Website for Centre for Digestive Diseases in Australia with Dr. Borody
• IHaveUC.com
– Great source of information and active discussions amongst patients.
• HealingWell.com
– Another large patient discussion forum