Posted 10 July 2012 - 08:12 AM
There are many threads on fecal transplant in these forums.Furthermore, if you go on the internet, you can find various protocols for performing a DIY fecal transplant. There really is not a lot to it.Whether you see a physician or DIY, you still have to decide which orifice you are going to use.You can use an enema bag, in which case you need to dilute the feces with sterile saline (available online at low cost) and filter it through a coffee filter, to remove stuff that would clog the enema line.If you see a GI, she might use a colonoscope, so you can really squirt it into the upper reaches.I have read accounts of some people who failed using the anal route and succeeded only when they went down the throat.The standard upper approach is to use a nasogastric (NG) tube. This strikes me as way to risky for DIY.Many physicians advocate using a PPI (Prilosec) if using the upper route, to neutralize stomach acids that might destroy the previous cargo.A DIY upper route has been recorded by a mother of an autistic child. The mother filled empty gelatin capsules and the child swallowed them. A less aesthetic approach is to drink it down in a (chocolate
) milkshake.The latter seems as if it might lower the possibility of success. The standard, if you are going to mix it, is sterile saline. Mixing it up with other substances could conceivably lower its potency by killing some of the bugs.Whether you are guided by an MD or you DIY, donor screening and selection is of paramount importance. You don't want to get HIV, hepatitis, C. diff., or anything else from your donor. A lot of DIY find it convenient to take feces from a baby's diaper. You don't have to have any embarrassing conversations. But what is most convenient often is not what is best. In this case, some physicians argue that one's gastrointestinal microbiome is not fully developed until age 16 or so. A healthy adult's feces would have more of what an unhealthy adult would need than a healthy infant would have. Nonetheless, I have read accounts of those who were benefited by using baby-diaper feces.It can be tough to find doctors who will perform this procedure. It can be doubly tough to find those who will perform it for IBS, since its benefits for IBS are much less clear than they are for C. diff.I first became aware of this procedure a year ago. Considering all the stuff I've tried in my quest for a cure, fecal transplant, although initially revolting, strikes me as rather time. As long as the donor is healthy, there is the chance of a huge benefit for the tiny cost of a short period of time of perhaps mild discomfort. I find fecal transplant (FT) to be a fascinating comparison to Mark Pimentel's work on SIBO (small intestinal bacterial overgrowth).At the highest level of generality, they share a common explanatory framework: microorganisms. They both say that our problems are not primarily emotional, rather, they are a direct effect of the microorganisms that populate our GI tracts.But when we drill down into the details, the explanations diverge. SIBO says that problems are caused when bacteria, which do belong in the large intestine, colonize the upper intestine. The problem is not that we have the wrong kind of bacteria, but that the bacteria we have are in the wrong place. SIBO, does not generally support the use of probiotics. Probiotics are like atom bombs. They spread everywhere. SIBO prefers snipers. It uses antibiotics or elemental diets to selective destroy small intestinal bacteria. It does not intentionally aim to affect the bacterial content of the large intestine.The practice of FT contrasts markedly with SIBO. The most basic FT treatment is an enema. This has the goal of repopulating the large intestine with a new population of microorganisms. Some physicians argue that this is sufficient, because the large intestinal organisms will migrate up to the cecum and perhaps higher in the small intestine.The goal of FT is a positive one where the goal of SIBO is negative. FT aims to establish new organisms. SIBO aims to remove existing organisms and replace them with an environment that is as near to sterile as is physiologically possible.Some FT physicians have found that success is increased by using the nasogastric route rather than the anal route. They believe that there are many cases where the transplanted organisms do not migrate from the large intestine to the small intestine in sufficient numbers. So, they administer the transplant through the stomach, insuring that the entire length of the small intestine is exposed to the new populations.Most published FT data is not specific to IBS. SIBO research is specific to IBS. The problem is that the experiences of many on this forum does not seem to reflect the data in SIBO journal articles. Very few people have had complete and decisive remissions from SIBO treatments.There is almost no reliable data on FT for IBS. So, those of us who do give it a try a blazing a new path. I have not yet tried FT, but, as I have argued above, cannot think of a good reason why I shouldn't give it a try. I probably was putting myself at much greater risk by trying multiple courses antibiotics and elemental diets.