C-difficile is currently the most common hospital acquired infection—affecting half a million Americans every year. While one out of five patients fail to respond after the initial round of antibiotics, repeated doses of antibiotics remain the standard of care in most hospitals.
But new research, that is finally catching up with antiquity (“yellow soup” discovered by Chinese Dr. GE Hong more than 1700 years ago), may hold the cure. Yellow soup was a broth involving dried or fermented feces from a healthy person. Taken by mouth, the healthy bacteria in the stool would then inhabit the gut of the sick person and bring about a cure.
Whoever invented the capsule—I applaud you.
Before you “poo-poo” this treatment as insanity—the science is real and FMT (Fecal Microbiota Transplant) –where you take a stool sample from a healthy person and infuse it into the colon of a C-diff patient and the infection is eliminated (often within one day)–is also real. Please do your own research.
Three years ago, a friend asked me to help him with some serious health issues. He was doing much better and had really worked hard to heal his gut. And then he got C-diff. Twice. I had no idea it could be deadly. He had contracted it before and it almost killed him. That’s when I started looking for treatments and how I learned about FMT.
Fortunately for him, he didn’t get to that point. Instead, he took an intense (five days), naturally diverse, whole food probiotic (400 Billion CFU) to replace beneficial gut bacteria lost after repeated doses of antibiotics. With bacteria in general, and C-diff in particular, the treatment is to inoculate the gut with a diversity of beneficial strains to “re-seed” the area before the resurgence of bad bacteria occurs.
One way to prevent bacterial infection is to make sure you have adequate stomach acid. Studies have shown that those who take proton pump inhibitors for gastric suppression and those who take Histamine 2 blockers have an increased risk for recurrent C-diff infections. It makes sense if you understand the human body and its self-preservation mechanisms.
It’s not that C-diff is hard to treat. The problem is the extremely high rate of recurrence. Mainstream medical treatment involves antibiotics like Vancomycin—but this only has a 30-80% success rate. In the early 2000’s, a new hyper virulent strain of C-diff emerged from Quebec. In 2013, the Centers for Disease Control and Prevention placed C-diff into its top category—Urgent. C-difficile kills thousands of patients every year and by some accounts, is replacing MRSA as the most common hospital acquired bacterial infection.
Changes in our diet for the last 40 years–like pesticides in our food, diets low in fiber and high in sugar, and overuse of antibiotics are creating inflammation in our gut microbiome. Changes in our lifestyles–like increase in C-section births, decrease in breastfeeding, and dependence upon gut destroying drugs, are creating chronic disease at levels previously unheard of–because we lack good bacteria inoculated into us by vaginal birth and breast milk–destroyed by acid blockers, vaccine adjuvants, and antibiotics.
Bacteria have co-evolved with us for tens of thousands of years. Our body contains 10 times as many bacterial cells as our own cells and those bacteria are responsible for controlling multiple functions inside us. They control metabolism, and what nutrients get absorbed–they make Vitamin K2, and control the permeability of our gut wall, control our immune system, and level of inflammation. Inflammation is the root cause of all disease, and so many people with chronic inflammation get better when they fix their gut.
FMT when administered via enema or colonoscopy is 85% effective at eliminating C-diff because C-diff tends to occur at the junction where the small and large intestines meet in the “cecum” of the colon. The ileoceal valve is a sphincter muscle that connects the two. Valves in the body work to restrict movement of fluids in one direction only—in this case to limit the reflux of colonic contents back into the small intestine. (The esophageal valve works the same to prevent acid reflux from the stomach to the esophagus.)
The cecum plays an important role in the digestive system by assisting in the formation of feces. Partially digested food, known as “chyme” passes through the small intestine where it is digested and most of its nutrients are absorbed. Approximately 2 liters of fluid a day pass through the ileocecal valve to the colon. This is the only spot in the entire gut where Vitamin B12 is absorbed. Once the chyme enters the cecum at the beginning of the large intestine, it is mixed with bacteria by contractions in the walls of the cecum—before being pushed upward into the ascending colon. This is why you want to administer FMT via colonoscopy at the cecum—so you can position beneficial bacteria from the healthy stool specimen to compete with the C-diff to seed the colon and prevent recurrence.
Infectious Disease Specialists can deliver the stool via a nasogastric tube to the site of infection, but the efficiency rate goes down to 75-80%. And yes, there is a pill you can swallow, but it is 70% effective. According to Carolyn Edelstein, Executive Director of Open Biome, the first public stool bank (listed below)—the current Standard of Care calls for high dose antibiotics up to 48 hours before FMT. FMT is still considered an “investigational drug” and patients must be in clinical trials to gain access. However, because FMT was so overwhelmingly successful for those patients who failed to respond to standard therapies, the FDA has “enforcement discretion” that allows clinicians to provide FMT for clinical patients. The first randomized control trial was actually stopped early because the researchers and their medical review board decided it was unethical to withhold lifesaving FMT treatment from the control group receiving standard of care. Imagine that.
And according to Dr. Mark Hyman, FMT for C-diff is just the beginning. “People don’t think that their gut flora relates to obesity or type 2 diabetes. You can literally transplant fecal matter from a thin person to a diabetic person and reverse their diabetes. You can take fecal matter from a normal kid and put it in an autistic kid and there will be behavior changes.” (Reference below)
Everything new is well forgotten old. Many functional medicine and holistic doctors focus first on healing the gut. Most believe that healing the gut is the next frontier in medicine. In just the last decade or two, genetic sequencing technologies have become more sophisticated and cheaper. New tests to analyze Microbial Organic Acid (MOAT) or Comprehensive Stool Panels provide information to show us where we lack bacterial diversity to heal. Analyzing the poop of isolated societies is allowing us to see the damage of years of industrial western lifestyle choices on our gut, and empowering us to make changes.
Dr. Hong would be proud.