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Fecal Microbiota Transplant (FMT)

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In Emergency Situations, a Fecal Transplant May Be a Lifesaving Option

October 08, 2012 | 183,564 views
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By Dr. Mercola

Probiotics, i.e. beneficial gut bacteria have been heavily featured in the media lately, and for good reason. Researchers are increasingly realizing just how essential your intestinal microflora really is to your health.

The easiest way to improve the makeup of bacteria in your gut is to include traditionally fermented foods in your diet, but in an emergency situation, a novel procedure called fecal microbiota transplant may be the difference between life and death.

Who Knew a Fecal Transplant Could Be a Life Saving Procedure?

Such was the case with Kaitlin Hunter, a California woman who developed a potentially lethal bacterial infection in her colon after spending a month in the hospital recuperating from a serious car accident.

As reported by CNN Health:1

"In the hospital after her accident, doctors followed standard care and put Hunter on antibiotics to prevent an infection. In spite of the antibiotics – or possibly because of them – Clostrium difficile (C. diff) infected her colon, causing severe stomach pain, diarrhea and vomiting...

It's believed that antibiotics, which kill harmful infection-causing bacteria, also weaken the beneficial, healthy bacteria percolating in the colon. With the colon's defenses down, C. diff grows rampant, releasing a toxin and inflaming the colon.

C. diff infections kill about 14,000 people in the United States every year, according to the Centers for Disease Control and Prevention, and the number and severity of total cases have increased dramatically over the past decade."

A fecal microbiota transplant (FMT) involves taking donor feces (the donor is typically a spouse or relative; in the Kaitlin's case, it was her mother) and transferring it to the patient during a colonoscopy. In this way, the patient receives a transplanted population of healthy bacteria that can combat the overgrowth of pathogenic bacteria.

Recent research has shown the procedure to be very effective against recurrent Clostridium difficile infections. In a study2 published earlier this summer, FMT had a 91 percent primary cure rate, meaning resolution of symptoms without recurrence within 90 days of FMT. The secondary cure rate was 98 percent. Here, resolution of symptoms occurred after one additional course of vanomycin either with or without probiotics and/or a repeat FMT.

Antibiotics Without Probiotics Can Be a Dangerous Proposition

Kaitlin had received nine rounds of antibiotics, so it's no wonder such a dangerous infection could get foothold in her colon. In this particular case, the fecal transplant likely saved her life.

However, I would dissuade you from thinking this procedure is a magical route to fix less than life threatening conditions. Furthermore, it's important to understand that you have the power to prevent such a dangerous condition from occurring in the first place. It would certainly be nice if more doctors understood the importance of reseeding the gut with probiotics during and after a course of antibiotics, to reduce the health risks to their patients. However, as in so many other instances, many doctors still overlook this critical step, and this is where knowledge and self-responsibility comes into play.

Any time you take an antibiotic, it is important to take probiotics to repopulate the beneficial bacteria in your gut that are killed by the antibiotic along with the pathogenic bacteria. And you certainly don't need a doctor's prescription or permission for this.

If you're in a hospital setting, you're not likely to be served fermented foods, but you could have a family member or friend bring some in, or ask your doctor to sign off on a probiotics supplement. Outside a hospital setting, your best bet is to incorporate traditionally fermented foods in your diet, so you're constantly maintaining a healthy bacterial balance.

Other Infections that Can Be Treated with Probiotics

Clostridium difficile infections are very serious, and since the cure rate with beneficial bacteria is so high for this type of infection, it can give you an idea of the power of probiotics for other, far less lethal ailments. For example, another type of infection that is far more common than C. diff. is Candida albicans.

An overgrowth of Candida, a type of yeast, can cause a variety of chronic health problems in both men and women. Under normal circumstances Candida albicans is a harmless part of your skin, intestines, and for women, your vagina. But Candida cells develop rapidly, and if your system is out of balance from eating unhealthy foods, taking certain prescription drugs, or fighting an illness for example, Candida can quickly grow out of control.

Vaginal yeast infections tend to occur when the normal acidity of a woman's vagina changes, allowing the yeast to multiply. It's estimated that up to 75 percent of women have had at least one vaginal yeast infection in their lifetime, which typically is accompanied by intense itching, burning with urination and sometimes a thick, white discharge. Up to 80 million Americans – 70 percent of them women – suffer from yeast-related problems, and if you suffer from yeast infections (especially if they're recurrent) you should also be on the watch for other symptoms of Candida overgrowth, such as:

Chronic fatigue Weight gain
Food allergies Irritable bowel syndrome
Migraines PMS

 

As with all yeast-related problems, the infection occurs because your system has become run down or out of balance, allowing the Candida that already exists in your body to multiply out of control, causing illness. You may also fall into the trap of treating the infection with an over-the-counter anti-fungal cream, and then assuming that when the symptoms disappear the problem is cured. However, these creams only treat the symptoms and do nothing about the underlying yeast overgrowth that caused the problem to begin with.

How to Harness Your Gut Bacteria for Better Health

Do you suffer from gas and bloating? Constipation or diarrhea? Fatigue? Headaches? Sugar cravings? All of these are signs that unhealthy bacteria of one type or another have taken over too much real estate in your gut, which is actually quite common considering how vulnerable your gut bacteria are to environmental insults. It's important to realize that your lifestyle can and does influence your gut flora on a daily basis. Therefore, to protect your microflora, you'll want to avoid:

  • Antibiotics
  • Chlorinated water
  • Antibacterial soap
  • Agricultural chemicals
  • Pollution

Poor diet is another enemy to healthy gut bacteria. Sugar is enemy number one, as it actually nourishes the bad or pathogenic bacteria, yeast, and fungi in your gut. Hence, dramatically limiting or eliminating sugar and fructose is an essential step to optimize your gut health. Processed foods also promote bad bacteria – partly due to the high fructose content in most processed foods, but also because of the processing, which essentially "kills" the food.

One of the major side benefits of eating a healthy diet like the one described in my nutrition plan is that it helps your beneficial gut bacteria to flourish. A critical part of a healthful diet is fermented foods, as they will actively "reseed" your body with good bacteria, and can do so far more effectively and inexpensively than a probiotic supplement. It's unusual to find a probiotic supplement containing more than 10 billion colony-forming units.

But when my team tested fermented vegetables produced by probiotic starter cultures, they had 10 trillion colony-forming units of bacteria. Literally, one serving of vegetables was equal to an entire bottle of a high potency probiotic! So clearly, you're far better off using fermented foods. Again, when choosing fermented foods, steer clear of pasteurized versions, as pasteurization will destroy many of the naturally-occurring probiotics. Examples of traditionally fermented foods include:

  • Fermented vegetables
  • Lassi (an Indian yoghurt drink, traditionally enjoyed before dinner)
  • Fermented milk, such as kefir (like fermented vegetables, a quart of unpasteurized kefir also has far more active bacteria than you can get from a probiotic supplement)
  • Natto (fermented soy)

Learn to Make Your Own Fermented Vegetables

Fermented vegetables are my favorite as they're both easy to make, and one of the tastiest types of fermented food. To learn how to inexpensively make your own, review the following interview with Caroline Barringer, a Nutritional Therapy Practitioner (NTP) and an expert in the preparation of the foods prescribed in Dr. Natasha Campbell-McBride's Gut and Psychology Syndrome (GAPS) Nutritional Program. In addition to the wealth of information shared in this interview, I highly recommend getting the book Gut and Psychology Syndrome, which provides all the necessary details for Dr. McBride's GAPS protocol.

Although you can use the native bacteria on cabbage and other vegetables, it is typically easier to get consistent results by using a starter culture. Caroline prepares hundreds of quarts of fermented vegetables a week and has found that she gets great results by using three to four high quality probiotic capsules to jump start the fermentation process. If you're not quite ready to make your own, Caroline also prepares the vegetables commercially. I used hers for a month before I started making my own batches. You can find her products on www.CulturedVegetables.net or www.CulturedNutrition.com.

Download Interview Transcript

How to Reduce Chances of "Healing Crisis"

There is one precaution that needs to be discussed here, and that is the potential for a so-called "healing crisis," provoked by the massive die-off of pathogenic bacteria, viruses, fungi, and other harmful pathogens by the reintroduction of massive quantities of probiotics. It can significantly worsen whatever health problem you're experiencing, before you get better.

The reason for this is because when the probiotics kill off the pathogens, those pathogenic microbes release toxins. These toxins are what's causing your problem to begin with; be it depression, panic attacks, rheumatoid arthritis, multiple sclerosis, or any other symptom. When a large amount of toxin is suddenly released, your symptoms will also suddenly increase. So, if you've never had fermented foods before, you need to introduce them very gradually.

Dr. Campbell-McBride recommends starting off with just ONE TEASPOON of fermented vegetable, such as sauerkraut, with ONE of your meals, and then wait for a couple of days to see how you react. If it's manageable, you can have another helping, and gradually increase your portion. If you feel worse, stop. Let the side effects subside, and then have just a tiny amount again. Some may even need to start with just a teaspoon of the juice ferment to start. Then move on to two teaspoons per day, and so on.

It's important to realize that besides containing massive amounts of beneficial bacteria, fermented foods also contain many active enzymes, which act as extremely potent detoxifiers. As Dr. Cambell-McBride explains:

"Healing goes through two steps forward, one step back, two steps forward, and one step back. But you will find that the next layer is smaller. The die off and the detox will not last as long as the previous one... We live in a toxic world, and many of us have accumulated layers and layers of toxicity in our bodies. The body will clean them out, but you will find that each layer will last shorter and not be as severe... Eventually, you will come to complete, radiant health. You will feel 100 percent healthy, no matter how ill you were before."

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