Fecal transplant pill replaces antibiotics for serious infections
english.elpais.com
english.elpais.com
Because it doesn't happen to most people, we as a society tend to underestimate how potentially harmful a course of even a mild antibiotic can be - wiping out a portion of the healthy strains and suppressing much of the rest gives other microbes, sometimes incredibly harmful ones, an excellent opportunity to take over. And sometimes, this sticks with you for years and years, and becomes impossible to root out as the organisms adapt to their new place better.
Regrettably, C.Diff is somewhat exceptional in that cure rates of FMT alone are incredible(90%+), while most other microbiome-linked conditions - IBS, Ulcerative Colitis, SIBO, and all kinds of assorted stuff like many cases of chronic fatigue or depression - often get no or very temporary benefit.
My own experience with DIY FMT was that I experienced 1-2 days of complete relief(brainfog, depression, anhedonia, mild diarrhea), and 3-4w of feeling much better, before symptoms returned in almost-full-force. Many other people have had even less luck- most actual successes involve comprehensive antibiotic pretreatment to get rid of existing microbes, and many repeat transplants, before the benefits stick.
Nonetheless, this is a step in a good direction, and will hopefully open doors to further research for other conditions - far, far too many people are forced to deal with severe illness while doctors shrug and funnel everyone into psychiatry for their "psychosomatic symptoms"
I can only imagine that someone must have served them with a lawsuit, because they have taken all of their content and user feedback offline.
Perhaps there are still parts of the site still available if you're willing to dig through the internet archive.
While there's some risk of transmitting dangerous, asymptomatic-in-host pathogens, if you rule out viruses and the worst of bacteria, a healthy person's microbiome is likely to be robust enough to ensure they don't proliferate.
*my observations support this.
I recently had occasion to get some dental work done, pulling a tooth and replacing it with a titanium implant. Part of the prep for that exercise included taking a strong antibiotic before the tooth removal so that the likelihood of bacteria around the gums causing a major infection is minimal.
I haven't seen a doctor for anything for a while and after reading the data sheet for the prescribed antibiotic I was considering backing out of the whole deal since one potential consequence was that the antibiotic could zap all the bacteria except the much more resistant, more persistent C. diff which could then begin raging and possibly cause more problems than I would've had by keeping the tooth.
Several members of my family have careers as medical professionals so I contacted one of them that I trust to be a no-bullshit source of information. They are a nurse with decades of experience. I described the situation and told them that I was considering scratching the tooth implant since I didn't want to chance any health issues related to antibiotic side effects, especially a C Diff infection.
They told me that the likelihood of a bad outcome could be decreased significantly if you follow a simple procedure involving combining probiotics with the antibiotic in the dosing schedule.
It was recommended that I buy a probiotic with a lot of beneficial bacteria from several species (I chose a store brand with 20 billion beneficial bacteria). The dose schedule was easy - One hour before taking each dose of the antibiotic, just take one capsule of the probiotic.
I followed that probiotic one hour before antibiotic dosing schedule and have to say that I am now in a much better place than I was before the dental visits.
For several years after my last doctor visit, where I was prescribed an antibiotic to deal with a persistent sinus infection, I have had progressively worse digestive issues to the point where it was becoming normal for me to have indigestion or reflux severe enough to compel me to take a Tums antacid up to four times a week to deal with the problem. My whole digestive system was out of kilter in ways I won't describe here but it was simply not fun to be me.
Since beginning this probiotic/antibiotic pretreatment to head off post-op infection related to the implant procedure I have seen a near-total reversal of fortune. It has been nearly two months and I have not had a single instance where I felt that I needed an antacid. It felt like flipping a switch. I went from an increasing dependence on antacids before bedtime to a near-total elimination of acid reflux or sour stomach. I hated that I was having trouble eating foods that I loved because those foods had become triggers for acid reflux. Since completing this probiotic/antibiotic schedule I have taken to eating all of those trigger foods and have had no ill effects at all. Truly like finding out that the light at the end of the tunnel really was just another sun-shiney day and not an oncoming locomotive. It is obvious in several ways that other issues downstream from the stomach have also normalized and for the first time in years I feel like the bottom part of the tubulars are working up to spec.
I just wanted to put that out there for others who may find themselves needing a course of antibiotics. Unfortunately oral antibiotics are the go-to prescription on many doctor visits and several can cause digestive issues since they zap all the gut biota on their way to the exit leaving the user open to infection or colonization by bacteria that are hard to kill, like C Diff, so that the user ends up with part of their biology in worse health than before their visit.
Remember folks, buy a probiotic with a huge number of several species of beneficial bacteria. One hour before taking each dose of the antibiotic, take a probiotic. For each antibiotic pill, take one probiotic pill. I took mine (the pro and the anti) with food and water at each dose, typically a slice of cheese and a tortilla with a large glass of water.
I had such great results that I am still taking the probiotic once daily.
Good luck.
The answer was that it basically comes down to the fact that there is not enough evidence that supplementing probiotics orally does anything beneficial in the grand scheme of things. The amount of evidence that shows they do nothing beneficial or are slightly negative out-weighs the body of evidence showing that they are beneficial.
Obviously, if they work for you then keep doing what you're doing. But if people are wondering why prescribing probiotics isn't the norm, that's why.
Note: my information is around 8ish years old at this point, but I did a quick search before writing this comment and found a metastudy published in 2023 that seems to confirm nothing has changed.
The grandparent post uses the term “probiotic” but then describes what sound like “active cultures”… my reply assumes you also mean “active cultures”.
My understanding is that bacteria consumed are generally seen as “foreign” by the immune system, and are eventually eliminated. This is why there’s no benefit “in the grand scheme of things”.
However, in the “modest scheme of things”, that bacteria may help you digest food your native bacteria can’t… That effect will only continue as long as you continue to consume the cultures.
Figuring out how to create cultures that become “native” is where lot of research focuses now. Transplants using lab-grown samples from the patient’s own strains has been very promising, but this is not practical for any but the most serious health conditions.
This is actually where I am today. I have run out of the probiotics that I bought so I am in the stage where I will find out whether, in my case, there is any long-term change to my digestion that could be tied to the probiotic. I expect that if I see a return to the previous condition over the next few weeks then I can confirm that the effect lasts only as long as the probiotic is taken and wears off with time. I would like to see a permanent correction to the problem from this one period of probiotic treatment but that is unlikely to be the case.
Time will tell.
I had been considering making a visit to a gastroenterologist to see whether I could get on a list to do a transplant with a pooh pill. I am not a person who rushes off to a doctor every time something changes so I have to work hard to get myself into a mindset where it is acceptable. Basically, if I can manage something myself I will take that path and any long-term consequences that result are on me. That is acceptable.
The success of this probiotic supplement in changing the whole process for me to one that is a normal process leaves me with one option - self-management - that I can definitely handle. I just need to know the boundaries as far as how long to do it, the durability of the treatment, etc. It is cheap enough and easy enough that I can accept taking a simple supplement daily forever if I can demonstrate that it eliminates the really undesirable situation that I had to manage with antacids previously. When I started this treatment I had noticed that the condition was deteriorating so that on some nights I needed two Tums to handle the reflux. Like I said, I have not needed a single antacid since beginning this and that is a huge QoL improvement by itself since I can now enjoy all the spicy things that I ate anyway with no consequences, managed only by taking a daily probiotic. It isn't just the reflux. Top to bottom there were issues that have all disappeared now. I see real improvements in every part of the digestive process.
Sample size of one. No long-term data. It works for me, so far. Your mileage may vary. With that said, the whole thing was a recommendation from a family member who has been in nursing for multiple decades. I trust them.
In the case of probiotics, there seem to be few to no downsides, but unclear or unrepeatable upsides. Therefore, many doctors simply chose not to use them.
Overall, this is largely a good attitude. You don’t want medicine to take wild swings at new and fad-like treatments. However, there are often times when they respond far too slowly to information that could help treatment.
I can definitely say without adding all the nasty details that my whole digestive process from top to bottom has improved dramatically, returning to a normal condition during the period where I took the probiotics beginning on the first day of combined probiotic/antibiotic dosing and continuing thru today with no ill effects and nothing but positive results to report. It remains to be seen just how durable the change will be. I have a spreadsheet of all dosing treatments and now I will be updating it as I see and note the effects of stopping the probiotic. Last night was the first night with no probiotic. I'm gonna let the chips fall where they will.
or...for someone like described in the story, about to have their gut wiped?