Faecal bacteriotherapy

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The idea of faecal bacteriotherapy is to replenish the gut with friendly microbes. This treatment is of established benefit in inflammatory bowel disease and clostridium difficile infections. It is also used in the veterinary world to treat animals with a range of gut symptoms. The difficult bug to replace is bacteroides because this does not survive for more than a few minutes outside the human gut. In addition, I suspect there may be a viral element involved in the health of human gut.Up to 15% of microbes residing in our bodies may be viruses - not the more familiar human pathogens which are responsible for viral illness and infections, but viruses which predate on bacteria. These are called bacteriophages. Phages have been greatly studies and used in Russia and Eastern Europe as natural antibiotics. Even the gut has its own predator-prey balance! More details on Wikipedia - Bacteriophage.

Phages and obligate anaerobes, like bacteroides, do not survive easily outside the gut. So the only way to replenish this is to use fresh material. There is now also evidence that this therapy is beneficial in Chronic fatigue syndrome. Dr Borody has recently published a paper on this - The GI microbiome and its role in Chronic Fatigue Syndrome: A summary of bacteriotherapy. In this paper 70% of ME patients see clinical benefits of bacteriotherapy.

Indications for use

I would suggest trying this for people who lack bacteroides in the gut since this is the only way they can be replenished. Since the main problem is with bacteroides, I would want some evidence this bacteria was lacking. One can look for this by doing a Microbial ecology profile at the American laboratory Metametrix/Genova. Bacteroides does not show up in the Genova lab test GI Effects Comprehensive Profile - stool .

If numbers of bacteroides were low, then they could be improved by attention to upper gut fermentation, combined with consuming desirable foods, i.e. those rich in fibre.

I am a great fan of low tech treatments which can be implemented fairly easily and inexpensively with very little potential to cause harm! The idea here is to take a small sample of fresh faeces from someone with normal gut flora, most importantly with good numbers of bacteroides and free from pathological strains, and instill this by enema into the prepared gut of the recipient.

The procedure

There are now a number of publications with details of the microbial/probiotic transfer procedure.

I recommend enlisting the help of a colonic therapist so that this can be done as cleanly and efficiently as possible.

  • It is clear from Dr Borody's review of the literature that the amounts are not critical. Given the right substrate, bacteria can double their numbers every 20 minutes!

For the science and clinical trials behind the above suggestions see Bacteriotherapy using Fecal Fauna", by Thomas J Borody et al. J Clinical Gastronterology. Vol 36, Number 6, July 2004

Recent Study

A recent [2019] study - A retrospective outcome study of 42 patients with Chronic Fatigue Syndrome, 30 of whom had Irritable Bowel Syndrome. Half were treated with oral approaches, and half were treated with Faecal Microbiome Transplantation concluded that -

This study shows that FMT is a safe and a promising treatment for CFS associated with IBS. Adequately powered randomised controlled trials should be carried out to assess the effectiveness of FMT in patients with CFS and IBS.

Related Tests

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