University of Minnesota Clostridium difficile study published

Fecal Transplant Treats Serious, Recurrent Intestinal Infection
Excerpt:

Fecal transplants, using stool from a donor, have been successful at treating a serious gut infection, researchers report. The infection is called Clostridium difficile. It causes diarrhea and severe abdominal pain and kills thousands of people worldwide each year, the authors of the small study explained. It's believed that the infection overwhelms the good bacteria required to maintain a healthy intestine. The fecal transplant method was developed to treat people with C. difficile infections, particularly those who have repeat infections. Fecal matter is collected from a donor, purified, mixed with a saline solution and transferred to the patient, usually by colonoscopy. However, not much is known about the long-term stability of fecal transplants, the University of Minnesota researchers pointed out. The study, published in the current issue of the journal Microbiome, included 14 people who had recurring C. difficile infections. Four received fecal transplants. The healthy changes in the patients' intestinal bacterial populations ("microbiome") were sustained for up to 21 weeks after transplant, according to the report.

Comment: Full article of the study in Microbiome (too technical for me!). I am 837 days post Fecal Transplant

4th Century Chinese "Yellow Soup"

Comment: this is not about soup!

NYTimes: When Pills Fail, This, er, Option Provides a Cure
Excerpt:

Transplanting feces from a healthy person into the gut of one who is sick can quickly cure severe intestinal infections caused by a dangerous type of bacteria that antibiotics often cannot control.

A new study finds that such transplants cured 15 of 16 people who had recurring infections with Clostridium difficile bacteria, whereas antibiotics cured only 3 of 13 and 4 of 13 patients in two comparison groups. The treatment appears to work by restoring the gut’s normal balance of bacteria, which fight off C. difficile.

The study is the first to compare the transplants with standard antibiotic therapy. The research, conducted in the Netherlands, was published Wednesday in The New England Journal of Medicine.

Fecal transplants have been used sporadically for years as a last resort to fight this stubborn and debilitating infection, which kills 14,000 people a year in the United States. The infection is usually caused by antibiotics, which can predispose people to C. difficile by killing normal gut bacteria. If patients are then exposed to C. difficile, which is common in many hospitals, it can take hold.

The usual treatment involves more antibiotics, but about 20 percent of patients relapse, and many of them suffer repeated attacks, with severe diarrhea, vomiting and fever.

Researchers say that, worldwide, about 500 people with the infection have had fecal transplantation. It involves diluting stool with a liquid, like salt water, and then pumping it into the intestinal tract via an enema, a colonoscope or a tube run through the nose into the stomach or small intestine.

Stool can contain hundreds or even thousands of types of bacteria, and researchers do not yet know which ones have the curative powers. So for now, feces must be used pretty much intact.

Medical journals have reported high success rates and seemingly miraculous cures in patients who have suffered for months. But until now there was room for doubt, because no controlled experiments had compared the outlandish-sounding remedy with other treatments.

The new research is the first to provide the type of evidence that skeptics have demanded, and proponents say they hope the results will help bring fecal transplants into the medical mainstream, because for some patients nothing else works.

“Those of us who do fecal transplant know how effective it is,” said Dr. Colleen R. Kelly, a gastroenterologist with the Women’s Medicine Collaborative in Providence, R.I., who was not part of the Dutch study. “The tricky part has been convincing everybody else.”

.....

Fecal therapy has often been used to cure gut trouble in cows and horses. Books on traditional Chinese medicine mention giving it to people by mouth to cure diarrhea in the fourth century; one book called it yellow soup.

In 1958, Dr. Ben Eiseman, of the University of Colorado, published a report about using fecal enemas to cure four patients with life-threatening intestinal infections.

Comment: Missionary friend sent the article to me. I find it interesting that the concept goes back to 4th Century China. Glad I did not have to take orally! Also interesting that only 500 have been done. I was # 9 in the Park Nicollet system. About the effectiveness ... yes ... a complete cure. Consider that I was sick for 10 weeks ... thousands of dollars in pills ... 4 days hospitalized. Almost $ 15,000 in costs (although my max out of pocket threshold was $ 5000.). 7 weeks of missed work! (and that's just in 2012! I was sick for about the same amount of time in 2011!) To have a complete cure is amazing to me. I am praising the Lord and thanking my Doctor!

Two methods are mentioned in the article ... tube though the nose into the small intestine and the back door approach. I had the later.

About "yellow soup" ... that's about right .... but more like yellow broth. 1 liter of it.

The "gift" of good gut flora

Introductory Comment: May be TMI (Too Much Information). I blog this for several reasons:

• For my own personal log of my struggle with C-Diff (which frankly has been a trial)
• For anyone else who has suffered with C-Diff and may stumble upon my blog and find this helpful. (For all Cold Fusion Guy posts on C-Diff click here)
• For any friends or family members who may be interested.

Well I did it .. I had the Fecal Flora Transplantation today at Methodist Hospital. My experience with Fecal bacteriotherapy is in this blog post. Wiki has a good article on Gut flora.

• The Doctor: David Stoplman
• The Donor: My son, Roger. Thank you son!
• The Process
  • Donor qualification
    • The donor had to sign various paperwork
    • The donor provided a stool sample (last Saturday) that was tested for 7 different conditions: C-Diff, Hepatitis B, Hepatitis C, HIV, and other pathogens
    • This testing is not covered by insurance and my out of pocket will be $ 250
  • Prep for recipient (me)
    • Consultation with the Dr (last Thursday) and paperwork
    • Free from C-Diff (test confirmed) (see an earlier post)
    • Off drugs (I took my last Vanco Tuesday and my last aspirin on Monday (I take a baby aspirin three times a week)
    • The less than fun colon cleanse : 8 8 oz glasses last night; 7 today (I threw out the last 2-3 oz ... I couldn't take it any more. During this time I camped out by the bathroom. Kathee moved my recliner to right outside the bathroom door. Last night I camped out from 6 pm until 9:30. This morning from 7:00 am until 11 am. This stuff really works! During my "camp out" I read the Scriptures, prayed, and ran to and fro from the bathroom
  • The transplant:
    • The donor provided fresh stool to the hospital this morning. It had to be there by 10:00 a.m. and had to be fresh this am.
    • Methodist's lab processed and filtered it. The outcome was a liter of brownish / yellow fluid.
    • I arrived this afternoon and had the basic Colonoscopy. This is my third time. I had a Sigmoidoscopy when I was 50. I had a Colonoscopy at 60. And now I am 63. At my 2nd exam one polyp that was removed and tested. This time all clear - no polyps. The colon is healthy with no permanent damages from the C-Diff infection
    • The inner aspect of the Colonoscopy was a complete exam of the colon. I watched on TV. The outer (pull-out) sprayed the fecal transplant material throughout my colon.
    • Takes all of 15 minutes.! (Simple) ... followed by
    • 45 minutes in the recovery room.

I am the 9th person in the Park Nicollet system to have the procedure. Nine is my lucky number! 2012 is almost over .... 2013 will be a year of health!

An interesting thing about the scheduling of the procedure:

• I've reached the $ 5,000 out of pocket deductible for my insurance this year.
• They wanted this to be scheduled in January .. would have cost me several thousand dollars.
• I said I really really needed it to be done this month.
• The suggested December 26th. (Wouldn't Christmas have been terrible (prep work)
• But they moved things around and got me in today!

I hadn't eaten in 2 days. Yesterday was apple juice and water up to to the beginning of the prep at 6:00 p.m. Today likewise no food. Kathee made a nice dinner at my request of sloppy joes! Um good!