Adventures in Holistic Adult and Child Psychiatry

"One only sees what one looks for, one only looks for what one knows." - Goethe

"I did then what I knew how to do. Now that I know better, I do better." - Maya Angelou

From Obesity to Autoimmune Disorders: Potential Applications for Faecal Transplant

 

Today I am going to write about a topic that fascinates me, faecal transplant. It first attracted my attention when I heard an interview on NPR’s Fresh Air with Dr. Jeffrey Gordon, a professor at Washington University in St Louis, who is engaged in a project to catalogue the human biome, the microbial communities that live in or on a human body. These microorganisms consist not only of bacteria, but viruses, protozoa, parasites and worms. At this point relatively little is known about the vast variety of these microflora, about the function and role that they play in disease states and in health.

There are 10 times more microbial cells in the body than human cells. This means that we are ten percent human cells and 90 percent microbial, and there are an estimated 100 times more microbial genes than human genes in the human body. Given these numbers, it makes sense to ask, “Who is running the show here?” We often think of disease states when we think about bacteria and other microbes, but actually these microflora perform vital protective functions, which are essential to the preservation of our health, digestion and immunity. The vast majority of these microorganisms are located in our gut.

Dr. Natasha Campbell McBride’s theory behind the GAPS (Gut and Psychology Syndrome) healing protocol, is based upon the notion that deficient quantities of protective microflora in proportion to harmful species of microflora in the gut, result in a disruption of the integrity of the bowel wall. A damaged bowel allows microorganisms, toxins and food particles to leak into the body causing inflammation in the body and the brain, which cause many psychiatric, auto-immune, and intestinal maladies.  The aim of her treatment protocol is to restore the predominance of healthy flora through diet, detoxification and targeted supplementation. This is a process which requires a great deal of time and commitment in order to implement it successfully and effect a cure.

In contrast to the time and commitment it takes to heal via the GAPS diet, there has been remarkable immediate results with transplantation of feces via enema from a healthy individual to a person suffering from various disease states. The enema introduces healthy microflora into the bowel, most commonly via an enema consisting of saline mixed with stool from a healthy donor. What has been most thoroughly studied is the 95% immediate cure in patients infected with antibiotic resistant strains of Clostridium difficile, a bacteria, which in some individuals causes chronic debilitating severe diarrhea, and which can be lethal.

There have also been reports of cures for some cases of ulcerative colitis, chronic constipation, Parkinson’s disease and various auto-immune conditions such as Multiple Sclerosis, Rheumatoid Arthritis, Diabetes Type 1 and Chronic Fatigue with faecal transplant. Some chronic fatigue patients regain their energy and mental clarity dramatically.

A procedure based on similar principles has been used in veterinary medicine on animals for centuries. Livestock farmers treat indigestion following a change in diet in grazing animals, such as cows, by feeding rumen fluid that has been sucked out of a healthy cow’s stomach to the sick animal.

One of the most fascinating potential uses of faecal transplant is in the treatment of obesity. It has been shown that the gut flora of obese and lean individuals is markedly different. Microflora of obese individuals release nutrients in food that remain undigested in lean individuals. Lean mice who receive transplanted feces from obese mice, cause the lean mice to put on weight!

Tonight when I mentioned to my teenage children what I was writing about, they all deemed it disgusting and did not want to hear about it. I don’t think its gross. We do marrow transplants for people who cannot produce blood cells, we do heart and liver transplants, why not transplants of microorganisms for those of us with deficient or pathologic indigenous gut flora?

The procedure is apparently still in the experimental stage, and there is caution and concern about introducing disease from one individual to another. Right now it is only being done routinely to treat antibiotic resistant Clostridium Difficile. I would be interested in trying it myself to treat my chronic constipation, if it became readily available. GAPS is working for me, better than anything has in the past, but it is a very slow incremental process. This procedure has the potential for immediate vast improvement. That sounds very good. It is minimally invasive, relatively inexpensive, and intuitively makes enormous sense. I believe it holds huge promise, and that we are going to be hearing much more about it in the future.

 

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41 Comments


  1. Amy, 2 months ago Reply

    Hello,
    I’m scheduled to have my doctor do a Fecal Transplant next week but he’s becoming increasingly wary as I have very high IgE levels. My main issue is colitis, chronic but not ulcerative, that became awful after 3 sets of antibiotics over 4 weeks. I have had autoimmune symptoms for a while-burning behind knees (arthritis perhaps?), blocked ears after eating, breathing difficulties, and each got worse in the last month after all the antibiotics. I’m wondering has anyone with colitis and autoimmune, or at least raised IgE levels tried the Transplant? My doctor has never used it for autoimmune so is worried it may make things worse, while I feel it may in fact have the opposite effect. He has warned me of tales os months of bloody diarrea before a painful death (bit dramatic I felt) but I just feel that it may at least ease some of my symptoms if not eradicate them. I’m not looking for medical advice, just stories or even hypotheses. Thanks so much and good luck to everyone on their health journey.


    • Fifi, 2 months ago Reply

      Hi Amy,
      Although I don’t know your whole medical history, my experience of colitis is that the number one step to take is to stop eating any and all cereal grains. This includes all those that contain gluten but also those that are considered ‘gluten free’. The word ‘gluten’ is assumed to have a clear meaning but it is actually a category of proteins that occur in all members of the Poaceae family (also called Graminaceae), including rice, corn, sorghum and millet and oats. So I always remove all these in all forms from the diet of anyone with colitis, ulcerative or otherwise. The fecal transplant option will probably be a great adjunct to the change in diet (oh, and obviously you want all carbs i.e. starchy veg and sugars including fruit to be kept really low too as they all become glucose which feeds the troublesome components of the microbiota of the gut). I have also seen huge benefits from daily ingestion of a good Bone Broth, as it is so full of minerals, glycose-amino-glycans, collagen and other compounds that are involved in healing, and especially the healing of the gut lining. These measures may be sufficient without the fecal transplant, but I can’t see it disrupting things, depending OF COURSE on the state of the donor’s microbiota.
      To me that is the biggest issue, the microbiota of the donor and how one judges this!
      Good luck Amy, can you keep this site posted about what you do and what the progress is like? Ta.
      Fifi


      • Amy, 2 months ago Reply

        Thanks so much for the prompt reply. My donor has been checked for bacteria, parasites etc. I’m doing this all supervised by my doctor who will be performing the transplant. If I go for it, I will definitely keep you updated. Thanks for all the tips!


  2. Fifi, 2 months ago Reply

    Dear Judy,
    Nice to find a fellow GAPS practitioner who also mentions the ketogenic diet for cancer. In my clinic in England I use both of these approaches where appropriate, and also lesser versions of both in the majority of my patients. My number 1 food to avoid, for everyone, is wheat and a close 2nd is all the other cereal grains including rice and corn, so I certainly do not recommend eating any so-called ‘gluten free’ products. In cutting out these particular foods, even when leaving certain patients (those who I discover are simply not ready for a full scale low carb diet) on potatoes and even sugar I have had major improvements in terrible disorders, such as POTS (postural orthostatic tachycardia syndrome) a condition which can blight a person’s life by leading to frequent daily fainting, which is, basically, not unlike having frequent grand map epilepsy! However, I always endeavour to change the diet more fully than this to a complete GAPS diet just as an ongoing norm, and it is, as you say, very powerful. However, getting fecal transplantation in the mix may turn out to be a God send, and I have been thinking about how to do this without waiting for some ‘authority’ to ‘make it available. I just saw a BBC program about allergies, and fecal transplant was mentioned, and shown (partially) on this Horizon program. They simply added filtered water to a small amount of a healthy person’s poo in a dish, mixed it up with a spoon, filtered it twice through muslin cloth, added more water to what was left an filled a bottle to the brim with this liquid, and a lid tightly screwed on so as to exclude any air, ensuring a anaerobic environment, like the gut. This liquid is then applied to the colon via an enema to the patient. It is a very non technical, easy to replicate system. Of course first you have to identify someone you find looks and seems really healthy, then have the difficult and no doubt uncomfortable discussion with them about donating a bit of their poo. I have already had someone ask for mine, but, as their practitioner, I didn’t feel it appropriate to explain that actually I suffer from excess wind, so probably do not have the healthy bowel flora that she deserves, and fortunately she dropped the matter when I demurred.
    So, after all this I think anyone could simply use their own good sense, start up that interesting conversation, and see what comes of it. I think I need to do it myself!
    Thanks for keeping this blog
    Fifi


    • admin, 2 months ago Reply

      Thank you for writing and for this great comment.

      Yes the power of diet never ceases to amaze me, and particularly the devastating effects gluten can have on some patients. I have also seen some terrible reactions to corn, but not to rice, though its carbohydrate content can be problematic for many.

      I was under the impression that in England that there are clinics who offer Fecal Transplant for conditions other than anti-biotic resistant Clostridium Difficile, which is the case in this country. And I am aware of the at home do-it-yourself fecal transplant. I heard of a different version involving a blender. I do wish it were more readily available and administered by professionals. It absolutely should be. It’s my understanding that usually one transplant is not sufficient, and that often a series of transplants are required.


      • Fifi, 2 months ago Reply

        Hi again, really nice of you to reply so prompty.
        Between writing my comment and your reply I looked at your article about the saturn return. Wow, we really are on the same wavelength! I am an astrologer too and, like you, I don’t know how it works, but I have no doubt at all that it is ‘real’ as I have seen it a thousand times, in astonishing ways. You write so intelligently and honestly, it is really very refreshing. I rarely mention astrology to anyone as, as you say, there is nothing more derided in our society (well, English society at least, I am not sure where you are) but when it does come up I always find myself having to gently defend this ancient wisdom, but I know that in most cases I am viewed with a bit less respect as a result, which does gall me I must admit.
        I am nearly 53 so interested to see what happens at the next S return. (On the first one I leapt into marriage with a bloke that, two weeks later I had to throw out! It was exactly on the very date of the spot on minute perfect saturn return, though I had not looked at the ephemeris for ages so hadn’t clocked it at the time.)
        Now that I have glanced at a couple of your posts I will read them all and subscribe. If you take a look at my blog you might find some interesting articles there too. Hope so!
        Best wishes ~ Fifi


        • admin, 2 months ago Reply

          It’s so exciting to meet you! We really do have so much in common. I hope someday that we can meet in person. I looked at your blog, and it’s right up my alley. I live in the Boston area, and there is no openness whatsoever in most circles to astrological wisdom. I believe that some day, people will wake up and see the value of astrology, just as they are starting to understand that saturated fat is very healthful. Some of us are just ahead of our time and that can be lonely. Have you noticed how much press the human biome is receiving lately? Dr. Natasha has been talking about this for a very long time. She is way ahead of the curve.
          So, you will have to be on your toes during your next Saturn return, so that you do not overlook something again. I am finding it a challenging time. Aging and mortality feel much more real, and I am definitely feeling myself shift into a new phase, and I am trying to figure out what I want that to look like. I am really happy to meet you, Fifi.


          • Fifi, 2 months ago

            Hi Judy, I am really pleased to have ‘met’ you too, and to have started a sporadic conversation with you. It is so nice to know that there are people dotted around the world who just happen to have been exposed to and embraced or at least acknowledged similar things to me. I love the idea of a psychiatrist discussing the Saturn Return or gut microbes with their patients/clients. I think that if you were in the UK you would be ostracised by your colleagues. The problem with the NHS (our national health service) is that every practitioner ends up taking virtually the same approach as every other practitioner, as the medico-legal pressures on them are such that they have to be able to defend whatever they do in the terms that others of their profession would do the same thing. So of course, they all do the same. So patients can not find practitioners that do anything that deviates from whatever the norm for that discipline is. In psychiatry the results are abominable. And while we have an almost religious belief in the populace at large of the value and importance of the NHS I think it needs dismantling and reforming in a new model, with a different medico-legal framework too. Then patients could seek out and find practitioners who do things differently without being ‘struck off’ / lose their licence to practice, which is what happens currently. And private practice is a far less secure place for any practitioner than within the NHS. I don’t know of any private psychiatrists actually. Maybe there are some but not round here, and even if there were they would still be very restricted as to how they practiced. No such thing as freedom it seems! But well done you, it looks as though you have found the sweet spot and clearly have superb results.
            Are you listening to the Evolution Of Medicine Summit that is on all this week? I have heard all of yesterday’s (day 1) interviews. They were ok, but not earth shattering. Leo Galland probably had the clearest concept and terminology so far. I’ll try to catch some of today’s speakers.
            Heaps of goodwill to you!
            Fifi


          • admin, 2 months ago

            Hi Fifi,
            I was interested to hear your impressions of the NHS. It’s a pity that its like that. The idea of universal health care is so appealing, but what you describe is not. I was not aware of the Evolution of Medicine Summit. I will have to investigate.


  3. TTMacDonald, 1 year ago Reply

    Introducing healthy flora is not a new concept, but there is a ‘disgusting’ connotation to feces in general, and the associated means of delivery. Could the healthy stool be cultured, added to saline and then administered to help alleviate the ‘disgusting’ perception?


    • admin, 1 year ago Reply

      That is the method. I believe the stool is put in a blender with saline and then administered as an enema. I am not sure that is less “disgusting”.


  4. Dan Hegerich, 1 year ago Reply

    Dr. Judy,

    You are on the path to restoring health through the laws of nature. We have been duped and conditioned to believe that anything natural is unhealthy and dangerous. That is because corporations find nature a competitor to their unnatural products. They have put on a huge marketing campaign to deceive the people that nature is the problem and they have the solution. Thus we have been domesticated becoming commodities in their profit game of capitalism at the expense of peoples wellbeing.

    The logic you speak of is not only academic sense but also primal instinct! I would also like to see studies done on post cancer patients from medical treatments in order to rehabilitate them properly.

    Dan Hegerich
    Six time Cancer Survivor
    Optimal Life Coach and Holistic Health Consultant


    • admin, 1 year ago Reply

      Thanks for writing. I have seen up close and personally the devastating effect that cancer treatments have had on friends and family. For some cancers the ketogenic diet shows promise, but there is little awareness about it in the conventional cancer treatment centers, and hard to get funding for research because there is no profit to be made. Our for profit health care system creates so many problems and delivers poor misguided care that is very expensive. It’s great that you are able to make use of your own experiences to be of service to others.


  5. Mavis, 1 year ago Reply

    I’m sure you’re likely to get a number of new hits now that Michael Pollan has written his article in The New York Time Magazine, touching on many of these points. Congratulations on being ahead of the curve.


    • admin, 1 year ago Reply

      Thank you for writing. I did not see Pollan’s piece in the Times, I will look for it. How did you find this older post?


  6. Albie Cilliers, 1 year ago Reply

    Hi Dr Judy

    I just found your website searching for possible reports of Type 1 diabetics being cured by fecal transplants. This specific topic has grabbed my attention the last few weeks as well and me too are facinated by the possibilities. My 10 year son was recently diagnosed with Type 1 DM so you can imagine how much research I have done the last few months on the topic and also diet and nutrition !

    Anyway, while reading your post, I was wondering if you are aware of the recent report about synthetic ‘poop” being used to cure 2 patients. This should go a long way to get people around the “uncomfortable” issue of the topic. I have written a post about it myself if you are interested.
    http://sastocks.wordpress.com/2013/01/10/our-human-microbiome/

    Kind regards


    • judytsafrirmd, 1 year ago Reply

      Thank so much for writing. I tried to post a reply on your blog, but think that I may have been unsuccessful. I enjoyed reading your blog post and totally agree with you that making use of the human microbiome is the next frontier of medicine. I thought the information about the ear wax transplant fascinating. So far I only heard about transplanting gut flora. It is also amazing about the synthetic poop.


  7. Grace, 2 years ago Reply

    Hi Judy!

    I loved reading your article! I first heard about fecal transplants from a friend of mine whose relative tried it. She had chronic diarrhea for years and says that she hasn’t had a case of it since the transplant! She can now eat most everything with ease.

    I’ve been having some digestive issues myself. I have not been diagnosed with any major gastrointestinal disorder, no chronic diarrhea or constipation, but i do have unbalanced gut flora, candida overgrowth problems, leaky gut, and many food sensitivities. I have been following the GAPS diet now for about 3 months and have noticed improvement, but yes, it does require a lot of patience and dedication. The die-off symptoms are not fun.

    My question is if you think the fecal transplant would be a good procedure for someone like me who isn’t experiencing any extreme symptoms, but still has unbalanced flora. My thought is that it couldn’t hurt. But what is your opinion?

    Grace


    • judytsafrirmd, 2 years ago Reply

      Hi Grace, thanks for writing and I am glad you enjoyed the post. I truly wish that faecal transplant was more widely and readily available. As far as I can tell, it is only offered for cases of intractable cases of Clostridium Difficil, but I suspect that it has much wider applicability. I don’t think you would be likely to be able to have the procedure even if you wanted to have it. It is not available to people with the symptoms you describe. I think it’s a pity, because my guess is that it would be very effective. But of course, there is not much motive to do research about it, because there is little profit to be made. There are no expensive drugs to be developed. You can research a home version. I know I read about it.


  8. Gianna, 2 years ago Reply

    hello…you’re the go to gal when I get info on fecal transplants now :-)

    thought I’d share in case you hadn’t seen it:

    Gut Microbiota Transplantation May Prevent Development of Diabetes and Fatty Liver Disease
    http://www.sciencedaily.com/releases/2012/04/120419091026.htm

    best to you!


    • judytsafrirmd, 2 years ago Reply

      Thank you, Gianna. This is fascinating. Thank you for thinking of me!


  9. Kevin Krenitsky M.D., 2 years ago Reply

    Anyone with any intestinal ailment besides an active infection or Inflammatory Bowel Disease should ask a good alternative practitioner about daily coffee enema’s. Once routine care and a part of the Merc manual they are very helpful and therapeutic especially for those with constipation. Also they are very detoxyfying to the liver.

    Ask Dr Nick Gonsales in NYC wo uses these regulary for all his patients sick and well..


    • judytsafrirmd, 2 years ago Reply

      Hi Dr. Krenitsky.
      Thanks so much for taking the time to write. In the GAPS practitioners training in September, Dr. Natasha spent close to an hour talking in detail about the health benefits of coffee enemas for adults. (They should not be given to children) She was very much impressed with their value.


  10. Gianna, 2 years ago Reply

    Hi…maybe you’ve seen this…couldn’t help but think of you!

    “Fecal Transplants: The Straight Poop
    Journalist and author Maryn McKenna talks about fecal transplants, which have proven to be exceptionally effective at restoring a healthy intestinal microbiome and curing C. diff infections, but which remain in regulatory limbo.”

    http://www.scientificamerican.com/podcast/episode.cfm?id=fecal-transplants-the-straight-poop-12-01-31

    I’ve not listened to it yet as I am traveling…have saved it for later.


    • judytsafrirmd, 2 years ago Reply

      Gianna,
      Thank you for alerting me to this. I will definitely listen! I am so happy that this issue is getting more press.


  11. Alexandra, 2 years ago Reply

    I wonder if some infants will be best candidates, fresh supply of microorganisms from their parents, no antibiotics or drugs yet; nor poor diet, nor parasites…
    It seems a good cheap “first course of action” rather than last and it is frustrating it is not truly available yet.


    • judytsafrirmd, 2 years ago Reply

      Hi Alexandra. Thanks for writing. It makes sense what you say about infants being unspoiled. I like that word. And I totally agree about it being frustrating that the procedure is not readily available. I would be eager to try it myself. I also have patients who are so ill, and I believe it would reduce their suffering quickly, and not in the slow incremental way my recommendations help. That being said, it would likely be necessary to take good care of yourself in terms of nutrition and lifestyle after the procedure, lest the benefit be lost.


      • Gianna, 2 years ago Reply

        ah…according to Natasha McBride, author of GAPS diet, infants inherit the quality of gut microbes from their parents. That’s why small children do well on GAPS to straighten out the poor gut health they are born with.


        • judytsafrirmd, 2 years ago Reply

          Absolutely!


  12. Ruth @ Ruth's Real Food, 2 years ago Reply

    I find this fascinating too. I wonder if it will ever become mainstream.


    • judytsafrirmd, 2 years ago Reply

      Hi Ruth. Thanks for writing. The whole thing makes so much intuitive sense to me.


  13. Betsy MacMichael, 2 years ago Reply

    I wonder about how one defines “a healthy individual” (the prospective donor of faeces) in this context. Is it based upon their weight? Their type and frequency of defecation? how often and from what they are sick? I consider my digestion pretty healthy, but it varies from day to day some, dependent upon diet, and other factors. Interesting article.


    • judytsafrirmd, 2 years ago Reply

      Hi Betsy. Thanks for writing and your thought provoking comment. I am not sure what they do mean by healthy, but what I assume would be someone of normal weight, without auto-immune issues, with regular digestion and bowel movements most of the time, and who usually feels energetic and well. But that is a guess. Your question caused me think about what that meant. Thanks.


    • Turnip, 1 year ago Reply

      Well Betsey there is a big study underway called the Human Bionome Project. Bigger than the Human Genome Project. The data from this study is being managed by NIH. Basically researchers from around the world have signed up for this. The study is to determine what strains of good bacteria healthy humans have throughout their bodies. They first had to agreed on what is a healthy human. Can you image that discussion? They then had to decide what parts of the body they would sample from. Then within those various areas which strains of bacteria they would run complete dna analysis. Last I heard they were still tyring to decide which strains to focus on. This is not easy since we have so many strains all over. One strain of bacteria has a much more complex dna code than an entire human being’s dna. I am sure they will be picking a lot of these strains to break down and it will take some time. Hopefully they will have the new Intel processors developed for dna sequencing that were to come out this year which will bring the cost down to only 1k for running a dna for a human which is amazing since they last processor could do it for about 200K. This also means many researchers now can afford to run dna tests on lots more humans and other stuff. This study is what stellar researchers are watching since all roads for so many illnesses lead to healthy bacteria. Once they can figure out what strains we actually should have for health then they can actually make a probiotic that will work and maybe by pass an enema transplant. Right now they sell tons of probiotics with all sorts of strains based on best guess. Hopefully this study will also provide us info on how much we need to of these strains. Right now they are just guess with probiotics.


      • admin, 1 year ago Reply

        Thanks for taking the time to write this informative useful comment. I am aware of the Human Biome project and think its very very exciting, and truly the leading edge of where medical understanding will head in the future. I believe that its going to result in a huge leap in understanding when we know more about the human biome.


  14. Gianna, 2 years ago Reply

    I agree, this is fascinating, I too have been following such news. I’m glad that even though chronically ill I’ve found GAPS and can do that. I have learned to be wary of radical procedures and this strikes me as one.

    That said, perhaps we’ll find that it is completely safe, and yes, I think that would be great, as you’re quite right, GAPS is difficult and it takes a long time, both. Not everyone finds the inner strength and faith to do it.


    • judytsafrirmd, 2 years ago Reply

      Hi Gianna.
      Thanks for writing. I am totally not a procedures enthusiastic person usually. Its just that this particular procedure, administered via enema, using the flora from a healthy donor, does not seem to me in any way radical. It feels very natural. As I mentioned in my post, analogous procedures have a traditional safe history in veterinary medicine.
      If a person were to have this procedure, be cured, and then return to the Standard American diet, stress filled life style, antibiotics and hormone exposure, and toxic environment, it seems likely that there would a regression to the previous state.
      It will be really interesting to watch what the future holds in terms of this treatment.
      And, yes, I agree, that it is the rare person in this culture who is able to follow the GAPS protocol.


      • Gianna, 2 years ago Reply

        those are all good points, yes…
        I guess it seems radical to put another persons waste…that’s all…if there is anything not healthy…but they do that every day with blood!!


        • judytsafrirmd, 2 years ago Reply

          You are right, and terrible diseases can be transmitted via blood transfusions as well. So caution and experience are totally needed.


  15. Lysa, 2 years ago Reply

    Dr. Judy this is a very interesting topic!! I have never heard of this!!

    Yes it does sound a bit disgusting but who ever thought we’d be injecting botulism into our faces and butt fat into our lips!!
    I have been slowly implementing the Gaps diet into my own lifestyle, and I prefer trying Gaps before trying this!!! Thanks for the post!!


    • judytsafrirmd, 2 years ago Reply

      That is a totally interesting analogy about the botulism. Very appropos! It’s funny, I don’t feel disgusted by the idea of fecal transplant. It seems very natural to me. But I think my reaction in not typical.


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