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FMT Side Effects

We are witnessing a paradigm shift in therapeutics.  Previously, bacteria were thought of only as potential pathogens, whereas now we appreciate that a diverse community of bacteria is crucial to the health of the host. We are now learning that to restore such diversity once it has been interrupted can result in miraculous cure. The future of microbiotic therapy is bright.”  The last few sentences of the abstract of the November / December 2015 issue of the Journal of Clinical Gastroenterology (Fecal Microbiota Transplant: Respice, Adspice, Prospice).  

In case you weren’t aware, GUT HEALTH is the single most important factor in overall health, and nothing is bigger right now in the Gut Health arena than FMT (Fecal Microbiota Transplant).  If you are dealing with CHRONIC INFLAMMATORY DEGENERATIVE DISEASES, AUTOIMMUNE ISSUES, an inability to LOSE WEIGHT, or even CHRONIC PAIN, it would behoove you to at least take a look at this method of treatment.

FMT is exactly like it sounds — the transplant of a HEALTHY MICROBIOTA into someone whose Gut Flora have been compromised — via their ‘stool’.  If you want to see some of the things that will compromise your Gut Flora, HERE is the post to read (hint: it’s not just ANTIBIOTICS).  The resulting DYSBIOSIS is being tied to almost every health problem you can name (not to mention the hundreds you can’t).  And while PROBIOTICS are certainly worth a try, it is critical to remember than when talking about difficult cases, they simply cannot compete with FMT (HERE).

Today I want to take a couple of minutes and talk about what is going on over the course of the past few months in peer-review.  Although I may refer to a study that is geared towards FMT for those dealing with chronic C DIFF INFECTIONS that don’t respond to treatment (the treatment also happens to be their very cause of the problem), there has been so much written on this topic (it works about 90% of the time and it is safe), I am going to bypass it altogether.  And even though I have written about DIY FMT, don’t ever, even for one moment, think that I am suggesting you do this without the consent / supervision of your physician.  However, in the immortal words of Yoda, “think about it you should“.  It is so much easier, cheaper, more effective, and less dangerous than the DIAGNOSTICS, MEDS, and other treatments (see pic at the top) people are routinely put through today.

The material provided in this and other posts is for informational purposes only.  It is not meant to replace or substitute for the recommendations or advice of your doctor or medical provider. This post is not meant to diagnose, treat, cure or prevent disease (the FDA decides who can do that). If you believe you have a medical condition or problem, contact your health care provider immediately.  The statements contained in this post have not been evaluated by the Food and Drug Administration (HERE’S WHY). 

When it comes to FMT, the truth is, the sky is the limit.  The journal with the quote at the top of the page had this to say about modern FMT (I use the word ‘modern’ because the same study says that there are records of this very treatment being used in 4th century China.   “It is very likely that an array of products derived from feces or based on specific microbiotic profiles and commercially prepared in a controlled environment will be available to restore eubiosis to a dysbiotic intestinal microbial community, and thereby correct a variety of GI and non-GI disorders.”  

This sounds great on the surface, but be aware that one of the hottest arenas for gene manipulation is with bacteria (can anyone say GMO?).  Odds are that eventually these bacteria will not be coming from human feces, but from bacteria that were genetically modified, grown in the lab, and then “perfectly” formulated.  Even though you will be told that this is just as good as mother nature, eventually (after companies have made their billions) we will realize that that it’s not — sort of like the way it took the medical community forty years to figure out formula is not really better than mother’s milk — something they touted for decades.  The ‘synthetic stool’ is going to become very popular — mostly due to its ease of use, not to mention it will be heavily promoted by its manufacturer.

Last month’s issue of Expert Review of Gastroenterology and Hepatology (Fecal Microbiota Transplantation in Gastrointestinal Disease: 2015 Update and the Road Ahead) carries more of the same.  Although they do say that, “In tandem with the rise of FMT, the gastrointestinal microbiome has emerged as a ‘vital’ organ armed with a wealth of microbe ‘soldiers’ more powerful than known antibiotics. FMTs’ reputation has diffused into many new ‘indications’ yet these appear to be merely the tip of the iceberg when considering its potential applications,”  they likewise reveal where this is all headed — a theme seen over and over and over again in the studies I looked at.  “FMT as a therapeutic tool has evolved from the original format of blended donor stool and moved towards a refined product comprising a myriad of microbial components, presented aesthetically as encapsulated lyophilized powder.”  Sounds great, but again, leaves me leery.

There are a number of studies going on attempting to determine which bacteria are ‘bad’ and which bacteria are ‘good’ concerning certain diseases, as well as finding out the optimal ratios of bacterial strains to each other.  The Middle East Journal of Digestive Diseases (Physicians’ Knowledge and Attitude Towards Fecal Microbiota Transplant in Iran) reinforces some of what I said earlier.  In the study, almost 1/3 of the physicians polled stated that, “they prefer to skip the stool preparation phase; as they are more in favour of synthetic microbiota as opposed to fecal microbiota.”  Go back and read my earlier post on why synthetic microbiota (probiotics) cannot compete with FMT.

Last month’s issue of European Review for Medical and Pharmacological Sciences carried an Italian study done at Rome’s Institute of Bioethics, Catholic University of the Sacred Heart (Ethical Aspects of Fecal Microbiota Transplantation).  What did the experts consider to be the bioethical considerations for FMT?  There were three of them, “donors’ selection, safety concerns / ratio risk-benefit, and informed consent“.  I’ll get to the others, but the third one is easy; warn patients of the risks and let them decide.  Which begs the question; how risky is FMT?

To date, FMT appears to be safe.  How safe?  Almost absurdly previously-unheard-of so. “Most patients treated with FMT experience diarrhea on the day of infusion, and small percentage report belching and/or abdominal cramping or constipation.   Adverse events were reported for some patients (3 out of 317).”   In our modern age of GROSSLY UNDER-REPORTED SIDE EFFECTS, it makes you wonder what these ‘adverse events’ were.  Wonder no more.   “Upper gastrointestinal tract bleeding, peritonitis, or enteritis. In another case report, nasoduodenal FMT for Crohn’s disease [running a tube through the nose to the small intestine] resulted in transient adverse effects, including fever and abdominal tenderness in 3 of 4 patients.  However, these effects disappeared for all patients over the following 2 days.

Firstly, 3 of 317 patients is significantly less than 1%.  I’m not sure I have ever seen a risk profile so low for any sort of bodily treatment — excepting CHIROPRACTIC ADJUSTMENTS.  And what side effects did occur were minor and were gone in a few days.  In fact, the authors stated in their abstract that, “to date, FMT appears to be safe and without serious adverse effects.”  Similar conclusions were echoed by every single study I looked at on FMT. 

The Polish journal Polski Archiwum Medycyny Wewnetrznej (Fecal Microbiota Transplantation in Gastrointestinal Diseases: What Practicing Physicians Should Know) stated that, “The use of FMT for non-CDI [non-C. Diff Infections] indications such as inflammatory bowel disease and irritable bowel syndrome, is likely to increase. Presently, these indications remain in the domain of research institutions.”   Be aware that most research institutions are not funded by public monies as much as you might think they are.   Instead, they are greatly funded by “BIG PHARMA“.   Unless they can patent some of these GMO’ed bacteria and the techniques for making them, this is not only a bust for them as far as making money is concerned, it has the potential to actually help people get well (as opposed to perpetually covering symptoms). 

I have shown you previously that the number one form of medical treatment in America is based on suppressing the Immune System (see earlier link) — one of the most common classes of drugs used for this are CORTICOSTEROIDS.  In a study published in last month’s issue of the Journal of Translational Medicine (Step-Up Fecal Microbiota Transplantation Strategy: A Pilot Study for Steroid-Dependent Ulcerative Colitis), 8 of 14 patients with steroid-dependent ULCERATIVE COLITIS, “achieved clinical improvement and were able to discontinue steroids following FMT.”  Of the remaining six, “three experienced transient or partial improvement. Microbiota analysis showed that FMT altered the composition greatly, and a microbiota composition highly similar to that of the donor emerged in the patients with successful treatment. No severe adverse events occurred during treatment and follow-up.”  To those dealing with Inflammatory Bowel Disease of any kind; results like this are tantalizing.

Two recent studies, including the June issue of Scientific Reports (Transmissible Microbial and Metabolomic Remodeling by Soluble Dietary Fiber Improves Metabolic Homeostasis) offer up some interesting tidbits concerning the role of FMT in treating those with OBESITY and METABOLIC SYNDROME — two health issues that have both been heavily linked to Gut Health (see the links).  The study reveals the importance of soluble fiber on Gut Health (“dietary fibers are increasingly appreciated as beneficial nutritional components“) as well as the link between poor Gut Health and PRE-DIABETES.  Dietary changes in the amounts and TYPES OF FIBER were associated with, “pronounced and time-dependent improvement in glucose tolerance, indicating a causal relationship between microbial remodeling and metabolic efficacy. These changes correlated with improved metabolism, notably enrichment of probiotics [good Gut Flora]…..

The August issue of the Journal of Physiology and Pharmacology (Emerging Role of Fecal Microbiota Therapy in the Treatment of Gastrointestinal and Extra-Gastrointestinal Diseases) gives us more of the same.  “Approximately 100 trillion microorganisms colonize the intestinal tract.  Diet represents one of the most important driving forces that can define and influence the microbial composition of the gut.  Changes in gut physiology (i.e. gastric hypochlorhydria [HERE], motility disorders [HERE], use of drugs [HERE], degenerative changes in enteric nervous system [HERE]) have a profound effect on the composition, diversity and functional features of gut microbiota.  There is an increased interest in the role of FMT for the treatment of metabolic syndrome and obesity which collectively present the greatest health challenge in the developed world nowadays.”  Speaking of Hypochlorhydria (the cause of the vast majority of GERD and heartburn), let’s look at another study.

The all-too-common (and almost universally misdiagnosed) problem of having too little stomach acid, or having stomach acid that is too weak (Hypochlorhydria) not only leads to Dysbiosis, but PARISITOSIS as well.  In the July issue of Inflammatory Bowel Disease (Donor Recruitment for Fecal Microbiota Transplantation), we get a taste of this.  “Recruitment of fecal donors for FMT is challenging with only a small percentage (about 10%) ultimately serving as donors. Many were unable or unwilling to meet the donor commitment requirements. A surprisingly large proportion of healthy asymptomatic donors failed stool testing, primarily due to gastrointestinal parasites.” 

Decades ago, science established the fact that the Gut Flora of individuals with AUTISM is quite different than than those without Autism (the most likely reason that virtually all Autistic children have bowel / Gut issues).  A study published in the May issue of Microbial Ecology in Health and Disease (Approaches to Studying and Manipulating the Enteric Microbiome to Improve Autism Symptoms) reinforces this.  “An increasing number of research studies have provided evidence that the composition of the gut (enteric) microbiome (GM) in at least a subset of individuals with autism spectrum disorder (ASD) deviates from what is usually observed in typically developing individuals. There are several lines of research that suggest that specific changes in the GM could be causative or highly associated with driving core and associated ASD symptoms, pathology, and comorbidities which include gastrointestinal symptoms, although it is also a possibility that these changes, in whole or in part, could be a consequence of underlying pathophysiological features associated with ASD.” 

THE STUDY (actually it was the transcript of a symposium held in Little Rock, AR last summer) went on to talk about that fact that since the Microbiome is intimately linked to Autism Spectrum Disorders, and that it is now possible to manipulate the Microbiome via FMT, it stands to reason that, “manipulation of the GM could potentially be leveraged as a possible therapeutic approach to improve core and associated ASD symptoms and also address important comorbid medical factors that may be present in some children with ASD, such as GI symptoms.” 

It amuses me how the same doctors that decry the natural approach to healing usually end up acting as if they had discovered something that the natural health community has been talking about for decades (HERE).  If you have Autistic children, you should be spending some time on this site.  By the way, this study talked about the importance of having certain parasites in your system.  It seems that some of these critters act in a symbiotic nature in similar fashion to the bacteria that make up your Microbiome.   But if you follow the work of DR. ART AYERS you already knew that.


Firstly, remember that I am not advocating you do your own FMT, as that would be against my license to practice.  Secondly, if you or your family are struggling with chronic health issues, you should do some serious research into FMT.  The really cool thing is that there are lots and lots of pros to this approach, with very few cons.  The two biggest aspects of any treatment (cost notwithstanding) are safety and efficacy — does it work, and if so, is there a significant chance of said treatment causing harm.  FMT proves its grit on both counts.  After scouring the peer-reviewed literature, about the worst thing I found was a case study of one individual who gained weight after an FMT.  Which all begs the question — what is the profile of the ultimate dukie donor?

  • THEY ARE HEALTHY:  Firstly, you don’t want a donor who has all sorts of overt diseases or health issues.  But more than that, you are looking for someone who has a high degree of overall health and vitality.
  • THEY ARE HAPPY:  Because DEPRESSION is heavily linked to the Microbiome in peer-review (HERE), I would strongly suggest that you not take stool from an individual with problems in this area.
  • THEY ARE THIN:  Because your Microbiome is so intimately linked to your weight (HERE), the last thing you want is to have an FMT that will make you heavier — like the example above.
  • THEY DO NOT TAKE DRUGS:  Particularly true of those drugs that suppress the immune system (see earlier link).  Does this mean VACCINES as well?  I would certainly be leery of those who are getting annual vaccinations such as FLU SHOTS.  But be aware that if “No Vaccines” is your criteria for a donor, you have dramatically cut your pool. 
  • THEY ENJOY THE EARTH:  People who are out in the sun and in the dirt GARDENING are typically going to have much better Microbiomes than work-a-day Joe who watches TV in his spare time.
  • THEY ARE NOT CLEAN FREAKS:  I have written about the Hygiene Hypothesis as it relates to your Micribiome many times (HERE and HERE are a couple).  Cleanliness might be next to Godliness, but when it comes to your Microbiome, too much of a good thing is definitely a bad thing.  I am certainly not suggesting you in filth, but best evidence shows us that as a society most of us are far too clean.
  • THEY DON’T HAVE FOOD SENSITIVITIES:  You certainly don’t want to pick up a GLUTEN SENSITIVITY or issue with DAIRY if you can at all help it.
  • A BLOOD RELATIVE WHO LIVES IN YOUR REGION:  Gut Flora tend to be shared by families.  Certain bacteria are specific to the environments of certain regions.  Although these certainly aren’t deal-breakers, it’s something to think about.  On the flip side of this coin, it is important to remember than EPIGENETICS are far more important than Genetics when it comes to health.
  • OTHERS:   Check peer-review and online resources.  Testing (medical screening) is not a bad idea either.  My link on Parasites provides some of this detail.  If your donor happens to be your ultra-healthy spouse, this might not be such a big deal.  If it is a stranger off the street that you found via an advertisement in the local paper, definitely do what needs to be done to protect yourself.

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