Those who develop Clostridium difficile along with their Inflammatory Bowel Disease may have a harder time treating it with Vancomycin.

A review study of 101 patients who had an Inflammatory Bowel Disease of one kind or another found that Clostridium difficile was more likely to occur in those treated with the antibiotic vancomycin compared to those treated with another antibiotic, metronidazole or a combination of both. Vancomycin goes by the brand name Vancocin while metronidazole is also known as Flagyl.

The review study showed a recurrence rate of almost 40%(39.4%) in those who took vancomycin compared to 14.5% in those who took metronidazole & 13.3% in those who took a combination of both. No obvious differences were found between patients & the vast majority(89%) were on immunosupressive drugs of some sort. Steroid use does seem to play a role as reinfection rates were approximately twice as high, 32% vs 15.7%,  for those receiving a steroidal treatment. Continue reading “Clostridium difficile Recurrence Higher For IBD Patients Treated With Vancomycin” »

Slate.com is doing a story on fecal transplantation:

“Then [Ruth] met Lawrence Brandt, a gastroenterologist at the Montefiore Medical Center in the Bronx who believed he had developed a procedure to cure people of recurrent c. diff infections: fecal transplant. Brandt has been inserting feces into his patients for a decade now and claims to be solving their problems nearly 100 percent of the time. If his method really works—and he’s not the only doctor who believes that it does—then we may have found a viable, if weird, solution to a serious problem. C. diff infects 250,000 Americans each year and killed more than 20,000 from 1999 to 2004.”

At least the idea might be getting a little bit more mainstream. Maybe some day not only will we have blood banks, but “poo banks” teaming with healthy probiotics flora. Luckily there is already a “sciency name” to mask the “sinister truth” of the procedure: Human Probiotic Infusion. “Hey bob, where you going?” – “Oh, just doin’ my part, heading down to the Human Probiotic Infusion bank”.

If you want to get in contact with Dr. Brandt here is his information:

Advanced Endoscopy Center
5500 Broadway Suite A
Bronx, NY 10463
Phone: (866) 633-8255
Fax: (718) 548-8900

I am sure your mind must be pondering, “that title doesn’t mean what I think it means”, well actually it means exactly what you’re probably thinking. The first time I heard about fecal transplantation was when my girlfriend discussed it after seeing an episode of Grey’s Anatomy. I thought it was a joke, no way they would really do that. Thanks to the internet and research, it turns out it is indeed not a joke, but an actual procedure that has helped many people.

Fecal transplantation is simply taking stool from a donor who has a healthy, functional digestive system and implanting it into the affected patient. A poo slurry is created with saline, stool & in some cases added fiber. This is done with a blender(you probably won’t want to make smoothies in this thing afterward). Implantation can be done in different ways, such as via enema, colonoscopy or naso-jejunal tube. This is repeated for 5 – 10 days.

The idea behind fecal transplantation is that the sufferer with the disease is suffering from a bacterial/microbial imbalance in their digestive system. There are literally thousand and thousands of different types of microbes and bacteria in our bodies. If you are missing certain types then you will have an imbalance that will either cause problems with digesting food or allow harmful invaders to setup shop in your digestive system. Since you won’t have the good bacteria available to fight off the infection, this can cause long-term problems. This is the case with Clostridium difficile, a bacteria that is extremely hard to get rid of with normal antibiotics or by the immune system. Also in some cases Crohn’s Disease may be the bodies response to invading bacteria, but since it has trouble penetrating the gut to attack the bacteria, it instead inflicts damage on the gut itself.

One thing that is interesting is that many people who had a a history of taking antibiotics seemed more likely to see improvement after transplantation. Antibiotics are known to wipe out your bacterial flora. When I was little I went through many ear infections which involved many doses of antibiotics. I am wondering if this might play some part in my Irritable Bowel Syndrome. A lot of this is theory, but the facts are that fecal transplantation is real and has had beneficial results for many people.

Prof. Thomas Borody has been pioneering this technique in Australia at the Centre for Digestive Diseases. There hasn’t been much effort taking place in the United States, though there are some Gastro doctors who may be willing to entertain the idea. There have been suggestions that the University of Chicago has been holding focus groups regarding fecal transplants & possibly seeking a grant to do further research. There is nothing on their website right now confirming this though.

If you are in the US or UK or you’re not a character on a Grey’s Anatomy episode, you might try doing this on your own. Some enterprising individuals have taken up doing the job of doing it on their own by recruiting stool from their spouse or family. Some have had surprisingly good results as far as combating Crohn’s or Irritable Bowel Syndrome symptoms. Here is a very informative discussion from the HealingWell.com forums with experiences from people who have done the procedure themselves.

Have you done fecal transplantation? Are you a doctor researching it? Comment or e-mail and tell me your story.

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