There are several instances where someone with a life-threatening infection had fecal transplant save their life!

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1 FECAL TRANSPLANTS: Can Help Colitis, Candida, IBS and More! HEALING LEAKY GUT What is a Fecal Transplant? According to a study published in the journal of Gastroenterology Hepatology, fecal transplants (also known as microbiota transplants) have a 93 percent cure rate in treating Clostridium difficile and may also help heal IBS, colitis and autoimmune disease. There are several instances where someone with a life-threatening infection had fecal transplant save their life! A fecal transplant is a procedure in which fecal matter, or stool, is collected from a pre-qualified healthy donor, mixed with a saline or another solution, strained and then placed into the colon of another patient using a colonoscopy, endoscopy or an enema. Why do such a thing? Well, the intent is to repopulate the receiver s gut with normal, healthy bacteria and microbes that are living in the donor s gut. You can repopulate the gut with good microbes by consuming probiotic-rich foods and taking quality probiotic supplements, but this can take much longer to repopulate the gut. Your average probiotic food or supplement may contain between 1-30 strains of probiotics at billions of units, but healthy stool contains 1,000+ strains of microbes (bacteria, yeast, bacteriophages, etc.) at hundreds of trillions of units. Before you judge and dismiss this procedure, please realize that fecal microbiota transplants (FMTs) are actually backed up by some very compelling early clinical research. While FMTs haven t exactly become mainstream medicine just yet, fecal transplants are providing huge relief to people with a range of painful, even deadly, digestive disorders and symptoms. They are especially useful for people who have recurring intestinal infections caused by the type of intestinal bacteria known as C. difficile, but in the future, they may also provide help for those with IBS, ulcerative colitis, autoimmune disease, chronic fatigue syndrome, celiac disease, obesity, food allergies, rheumatoid arthritis, diabetes and even Parkinson s disease. 01

2 Why Would Someone Need a Fecal Transplant? Why would it be beneficial, or even safe, to transplant stool from one person to another, you might be wondering? It turns out there are trillions of live, beneficial strains of bacteria that live inside of our colons. Poop itself contains over 500 forms of bacteria and potentially 4,000 unique microbes that are found in our gut microbiome. Your microbiome is like a little world, or ecosystem, inside your gut that contains all of the good and bad bacteria that control how your body digests and processes nutrients. It is as unique as a fingerprint and reflects all the damage that your gut has experienced, such as antibiotics, medications, processed foods, parasites, etc. So what if you could take all the wear and tear bacteria that have grown up from misuse and substitute a whole new world for your body to process nutrition and grow new healthy cells from? Essentially this is what FMT is a whole system reboot from the inside-out! According to the Centre for Digestive Diseases in Sydney Australia, to understand the utility of FMT, it is first necessary to appreciate the compositional complexity of the GI microbiota, along with its associated functional implications. There are over 10 trillion bacterial cells in our body 10 times more than the amount of human cells and most of these bacterial cells reside in the GI tract. (1) People who suffer from digestive infections and disorders such as irritable bowel syndrome, Crohn s disease and ulcerative colitis typically have a high amount of harmful bad bacteria living inside of their gut and, unfortunately, a low amount of healthy good bacteria. Either due to a disorder or certain lifestyle factors, like a poor diet and long-term antibiotic use, the good bacteria that are normally present have been killed or suppressed. So, for those people with such a compromised gut, a fecal transplant is worth considering. They essentially benefit from having another person s good bacteria inhabit their own gut and getting their digestive system rebalanced. The best way to take advantage of living bacteria is to transplant them directly from a donor to a receiver while the bacteria is still living this way the healthy microbes take hold in the receiver s gut and reside and repopulate there. You can think of the process almost like someone receiving an organ transplant, or even like an entire immune system transplant! 02

3 Are Safe, and Do They Really Work? By donating healthy stool to another person, the donor is able to give the receiver the ability to replace good bacteria in the gut over time and to reduce harsh and dangerous symptoms that have previously been untreatable. According to the latest research, fecal transplants are up to 98 percent effective! So while it may sound completely strange to transplant poop from one person to another, fecal transplants actually have an extremely high success rate and provide an affordable and natural solution to people who have tried other treatments but still have not found relief. Best of all? To date, no serious side effects of fecal transplants have been reported. This makes FMTs a low-cost, low-risk, highly effective treatment for those willing to try it out. While the research on fecal transplants is somewhat limited, early studies show very high success rates and impressive results in patients who have been suffering for months, or even years. In particular, a 2013 study done by the New England Journal of Medicine (NEJM) compared the effects of traditional antibiotics to fecal transplant procedures. The researchers found such positive improvements in patients receiving FMTs during the study that they actually stopped the study short in order to give all patients receiving the antibiotics fecal transplants instead! The researchers felt that in light of the positive research showing the dramatic improvements in patients symptoms from fecal transplants, it would be unethical to continue giving a group of patients antibiotics alone and withholding FMTs. (2) Those of us who do fecal transplants know how effective they are. The tricky part has been convincing everybody else. Those words came from Dr. Colleen R. Kelly, a gastroenterologist with the Women s Medicine Collaborative in Providence, R.I., in a recent New York Times article. Speaking about the NEJM study, Dr. Kelly said, This is an important paper, and hopefully it will encourage people to change their practice patterns and offer this treatment more. (3) 03

4 Here are the 7 Health Benefits of 1. Can Cure Infections, Including C. Difficile and Possibly Candida Clostridium difficile colitis, also called C. diff, is a very serious infection inside the gut that causes severe cases of diarrhea, vomiting and fever. Sometimes C. diff can be so serious that it can even lead to death. Unfortunately, its incidence has grown over the past decade. The Centers of Disease Control report that about 500,000 people in the U.S. alone were diagnosed with C. diff in 2012, and 14,000 sadly died. Some other sources show that these numbers are likely even higher but that the causes of death are sometimes undiagnosed. (4) The frequent use of antibiotics is most likely the cause of C. diff bacteria over-populating the colon. The NEJM reports that roughly 24 percent of C. diff cases occurred in hospitals, and 40 percent began in nursing homes or community health care settings. (5) Antibiotic use can lead to C. diff infection because antibiotics have the ability to kill normal gut bacteria, which fight infection. If patients are then exposed to C. difficile, which is common in many hospitals (especially among the elderly), a dangerous infection can take hold. The 2013 NEJM study results show overwhelming positive effects of fecal transplants when compared to antibiotics for curing C. diff. In the study, patients were treated with either antibiotics alone, antibiotics in combination with fecal transplants or antibiotics in combination with bowel lavage (a method for flushing out the intestinal tract with liquids). Fifteen out of 16 patients were cured of C. diff after receiving one or two fecal transplant procedures. In comparison, only four of 13 were cured using antibiotics alone, and three of 13 using antibiotics and bowel lavage. The researchers concluded that the infusion of donor feces during the fecal transplants was significantly more effective for the treatment of C. difficile infection than the use of antibiotics. Also important? No serious side effects were reported in the group receiving fecal transplants. This shows serious promise for treating other infections and viruses with FMT, such as Candida, a fungal yeast infection that populates the digestive tract and feeds off of a poor diet high in sugar. 04

5 2. Helps Heal Ulcerative Colitis After conducting an experiment on children and adults with ulcerative colitis (UC), researchers from the Helen DeVos Children s Hospital in Michigan found that fecal enemas were effective and well-tolerated at controlling UC symptoms. (6) Those who suffer from an overgrowth of unhealthy microorganisms in the bowels are often diagnosed with intestinal dysbiosis or colonic dysbiosis, which can develop from intestinal parasites that are hard to completely remove and many sufferers find that they keep on recurring. Colonic dysbiosis contributes to the development of inflammation in the colon of people with UC. Fecal transplants can help eliminate intestinal dysbiosis and,therefore, lessen UC symptoms. In the DeVos Children s Hospital study, when nine children with UC received freshly prepared fecal enemas daily for five days, seven of the nine patients (78 percent) showed positive clinical responses within one week! One month later, six of the nine (67 percent) maintained clinically responsive. Since no serious reactions or side effects were reported, researchers concluded that FMTs can be an effective and low-risk way to help heal UC in children and adults in the future. Other similar studies have showed positive results for those with UC, although researchers still want to see more clinical evidence in order to know how many treatments would be needed to actually cure the disease instead of just improving symptoms like inflammation and diarrhea. (7) 3. Can Treat Chronic Fatigue Syndrome There s now strong evidence showing that in people with chronic fatigue syndrome (CFS), the health of the patient s gut microbiota (flora) is actually very connected to their psychological state of mind. Several studies show that there is a presence of abnormal bacterial gut flora in CFS patients and that this is linked with their cognitive dysfunction and symptoms of exhaustion, stress, sadness, low motivation and trouble sleeping. (8) A 2012 study published in the Journal of the Australasian College of Nutritional and Environmental Medicine reported findings that 70 percent of patients with CSF who had gut bacteria therapy treatments showed significant improvements in 05

6 symptoms. When 60 patients with CFS underwent either one or two bacterial infusions to introduce healthy bacteria into the rectum and colon, 42 out of 60 patients (or 70 percent) responded positively. (9) Maybe even more impressive is that the patients were contacted years after the experiment was done and 58 percent reported that they still had a significant resolution of symptoms, even after so much time had gone by. Complete resolution of symptoms was maintained in seven of the 12 patients, and five of 12 didn t experience recurrence for approximately one and a half to three years after the treatment. 4. Helps to Control Irritable Bowel Syndrome As you ve probably heard me say plenty of times, our gut microbiota has an enormous impact on our health in general. So we shouldn t be surprised that clinical evidence suggests roles for our microbiome in everything from obesity to autism. Unfortunately, many adults experience poor macrobiotic health because of antibiotic use, a conventional gluten-and-gmo-packed diet, nutrient deficiencies, allergies and toxin exposure, all of which can lead to the formation of common digestive disorders like irritable bowel syndrome (IBS). IBS is usually a chronic problem that is hard to really detect or solve, and it s marked by unpleasant periods of diarrhea and/or constipation. IBS is partially caused by intestinal dysbiosis, an imbalance of normal intestinal flora and partially caused by such factors as antibiotics, psychological and physical stress and certain dietary components. Intestinal dysbiosis can be eliminated or at least reduced by FMT treatment, or when the microflora is treated and repopulated with healthy bacteria from a donor. In a 2012 study undertaken by the Diabetes and Nutritional Sciences Division of King s College London, when 15 patients with IBS were treated with FMT, 86 percent demonstrated improvements and had better response to their current medications afterwards. (10) 5. May Address Food Allergies and Sensitivities According to a report published by the U.S National Library of Medicine, Bacteria which naturally 06

7 live inside our digestive system can help prevent allergies and may become a new source of treatment... Bacteria may have a particular role in altering the immune defenses of the gut lining and preventing some of the food allergen entering the bloodstream. (11) One 2014 animal study run by the University of Chicago looked at how alterations in gut bacteria are associated with food allergies. The study results showed that mice lacking normal gut bacteria had increased allergic responses when they were given peanut extracts, but when the mice had specific groups of healthy bacteria inserted into their guts, they then had reduced allergic responses. (12) The same positive effects are believed to work in humans regarding food allergic reactions, too. While a fecal transplant may not be able to eliminate a food allergy or sensitivity all together, it can help reduce inflammation in the gut and that will indirectly help food intolerances. 6. Can Assist in Healing Autoimmune Diseases Those with autoimmune diseases suffer from abnormal gut bacterial health that makes their own immune system attack itself. In an autoimmune reaction, antibodies and immune cells target the body s own healthy tissues by mistake, signaling the body to attack and causing ongoing inflammation. (13) Because fecal transplants can help repopulate an unhealthy gut with bacteria that are able to re-establish microbiota homeostasis, autoimmune disease patients can experience improvements in inflammatory responses as their bodies learn to properly distinguish real threats from normal cells. In January 2015, the Department of Gastroenterology and Hepatology at Tianjin Medical University in China reported, It is an exciting time in the burgeoning science of FMT application in previously unexpected areas, including metabolic diseases, neuropsychiatric disorders, autoimmune diseases, allergic disorders and tumors. A trial was conducted by the researchers in patients with metabolic syndrome by using FMT to infuse microbiota from healthy donors into the patients. The results showed that patients had increased insulin sensitivity along with increased levels of healthy intestinal microbiota. (14) 7. May Help Maintain Brain Health and Slow Cognitive Decline 07

8 At this time, more clinical evidence is still needed to prove that FMT treatments can help improve symptoms of cognitive disorders such as multiple sclerosis, Parkinson s disease and autism. However, researchers are hopeful that fecal transplants will help prevent or treat brain disorders due to the strong relationship between gut health and brain health. The gut and brain have a steady ability to communicate via the nervous system, hormones and the immune system. Some of the gut microbiome can even release neurotransmitters, just like our own neurons do, speaking to the brain in its own language via the vagus nerve. Scientists know that patients with these brain conditions suffer from abnormal GI microbiota, and so it s believed that improved gut health will work to signal messages to the brain that may turn off causes of cognitive decline, memory loss associated with getting older, mood disorders such as depression or learning disabilities like ADHD. (15, 16) 08

9 How a Fecal Transplant Works As of 2013, the FDA allows only qualified physicians who have been trained in this procedure to perform fecal transplants. It s not recommended to try doing one on your own at home (although some people still do). Currently, physicians can perform FMT procedures for recurrent C. difficile infections only, with signed consent from patients and carefully tested donor stool. But in the near future this may be changing Fecal transplants are performed in clinics, which is the recommended approach at this time, or in someone s own home. The process involves diluting the donor s stool with a liquid, usually saline, and then pumping it into the intestinal tract of the receiver via an enema, a colonoscope or a tube that is run through the patient s nose into their stomach or small intestine. For curing C. diff infection, usually one or two treatments is enough to show significant results. However, for chronic digestive disorders, treatments over several months are usually needed, or at least for two weeks. Most people experience positive relief from disorders after two to three months of doing FMTs almost daily, for this is at least how long it takes for the healthy bacteria to repopulate in the gut. The most common way of doing a FMT is to collect stool from a donor in a cup at a medical clinic, then for a doctor to put the stool into a french catheter and easily inject it into the colon of the receiver. The living microbes within the stool then take hold in the gut of the receiver and populate the microbiome with beneficial bacteria that can kill infection. While its best to do the procedure right away in order to ensure all the healthy bacteria are still living, it can also be done with a stool solution that has been frozen and thawed. As of now, bowel lavage, or gut flush, is not always included as part of a FMT protocol. The reasoning behind first doing a bowel lavage is to enhance FMT success by flushing out residual feces, antibiotics, harmful bacteria, toxins and spores from the gut prior to the administration of the donated flora. Bowel lavage can help enhance the potential for FMT to provide a fresh start in repopulating the colonic habitat of the recipient s gut, but it isn t always necessary. 9

10 Where Do Fecal Transplant Donations Come From? The benefits of a fecal transplant will depend on the health of the bacteria present within the donor s stool. A donor should always be in good health and should have no medical history of digestive disorders or intestinal infections. One benefit of having a FMT done at a clinic is that the clinic will always tests the donor s stool to make sure healthy bacteria are present in high levels. They will usually also tests the donor s blood in order to reveal any unknown diseases or infections, such as sexually transmitted diseases or hepatitis. As of now, most people use stool from donors that are family members. However, in the future, we may see larger projects that will involve collecting and banking or freezing donor stool samples for further studies and anonymous transplants. For example, the University of Minnesota Fairview Medical Center has a small standardized laboratory process of banking frozen fecal material. When patients treated for C. diff infection with fresh donor material were compared to patients treated with the standardized frozen material, there were no significant differences in infection clearance for fresh versus frozen samples. The Centre for Digestive Diseases in Sydney, Australia also performs the majority of their FMT procedures with standardized frozen and fresh donor fecal samples that are anonymous. (17) Are New? While it s only become an accepted practice recently in the U.S., the idea of performing a poop transplant is actually not new at all. Similar practices have been done for hundreds of years, going back to fourth century China, where these techniques were known as yellow soup. In many areas around the world, it s also been a customary practice to give newborn babies a small amount of their mother s fecal matter in order to boost the baby s immune system by populating its gut with healthy living bacteria. FMTs have also been used with animals for many years as part of veterinary medicine. Few people are aware that fecal transplants have actually been performed either by doctors or by patients themselves in the U.S. since the 1950s. FMTs have increased in popularity over the past decade or so, especially with more research coming out that shows their proven benefits, but they still have a small following; Estimates indicate that only about 500 patients have FMTs performed by physicians each year. 10

11 How to Do a Fecal Transplant at Home While it s best to have a fecal transplant done in a clinic with a trained professional, you can attempt to do one yourself if you re embarrassed about the procedure or you ve already had one done and feel comfortable trying on your own. If you are going to attempt an FMT yourself, make sure to find a healthy donor and always have their stool and blood tested. You also want to avoid using stool from a donor that has recently stayed in the hospital, a nursing home or who has traveled overseas to areas where infections and viruses are common, such as Africa or parts of Asia. You can access more information about having donor tests done according to the Infections Disease Society of America and other governing organization s recommendations. More FAQs can also be found here, as you will want to familiarize yourself with all of them before performing the procedure on your own for the first time. 11

12 Here is how to do a fecal transplant at home: Prepare by purchasing the necessary materials, including: - An enema bag that you will hang up on a hook on the wall (prepare this ahead of time) - A kitchen funnel or syringe - Either zipper storage bags or a blender to prepare the sample - Either a saline mixture or distilled water - Lubricant - Throw-away gloves - Clean up materials like tissues, paper towels and disinfectant wipes - A plastic trash bag to dispose of the materials afterwards - A diagram of the colon that you ve familiarized yourself with but will want to keep on hand - A timer - (Optional) A comfortable rug and pillow Beforehand: - Prepare the space where you ll perform the transplant. Set up a heavy duty adhesive hook on the wall at a height that will allow for the tube to reach your body easily but not too low that gravity won t help the sample flow out. Some people prefer doing this in the bathtub or on the bathroom floor. - Do not eat anything for 24 hours beforehand in order to clear out your intestines other than having some liquids like water or herbal tea. Also try eating a low-fiber diet for several weeks before or a diet low in FODMAPs. If this is the first time you re having a fecal transplant done, make sure to clear out your intestines before by not eating and also by using a laxative during the 24 hours prior. This will flush out harmful bacteria and is a very important step. - Decide if you will use saline or distilled water. Different people prefer different options, with some people reacting to saline better than distilled water and vice versa. Saline may be more difficult to hold in, so you might want to try both options. Do not use the kind of saline solution sold for enemas. Instead, make your own saline with distilled water and additive-free sea salt. The ratio is one teaspoon of salt for every one liter/quart distilled water. Distilled water can usually be found at regular drug stores. 12

13 Instructions: 1. Take a laxative 24 hours before and make sure to go to the bathroom. 2. Collect your stool sample from your pre-qualified donor and make sure it appears healthy (not abnormally colored or shaped). 3. Keep your sample at room temperature and use it within two hours unless you re planning on freezing it. If you are going to freeze some of the sample, separate it into portions, put it into a storage container and put it in the freezer as soon as possible. 4. Heat distilled water so that it s warm but not too hot. Then make your saline solution by combining ¼ teaspoon sea salt to one cup distilled water. Make sure not to use regular table salt that has additives. You can also use saline that you ve purchased from a drug store or been given by a physician. 5. Put the sample either into a blender or zipper storage bag and lightly mush/blend with some water to make it a thin consistency (like that of paint). Try not to make it too thick or too thin since neither will work as well. 6. Make sure your enema nozzle switch is shut and then pour the sample into your enema bag using a kitchen strainer or a funnel. Hang your enema bag up on hook and prepare yourself by rubbing on lubricant. 7. Lie down on your left side. If you d like, you can prop up your rear on a cushion. Lift up your right leg and slowly insert the enema nozzle. A little discomfort is normal but do not continue if it is painful. It can help to dilate the entry with a finger before insertion. Open the enema nozzle switch and if don t feel the sample flowing, try to adjust yourself by sitting up and shaking the enema bag. 8. While this is going on, squeeze your butt tight to hold in the sample as much as you can. Lie on your left side for 10 minutes if possible after inserting the sample and then another 10 minutes on your back, followed by 10 minutes on your right side (30 minutes total). 9. Massage the sample in by stroking your colon and try to hold it in for at least six hours if you can. If some comes out, that s okay, but if the consistency was right you should be able to hold it in for several hours. That s it. Like anything else, if you choose to do it again such as if you have a chronic digestive disorder, when you ll want to do this daily for two to three months the process will get easier. If FMT doesn t appear to work, remember to give it time to fairly judge (up to three months). You can also shift to a different donor in the future if you determine it wasn t as effective as you d hoped. 13