When a thread started up on faecal transplants a couple of years ago, it mostly got a lighthearted response because of the novelty, the yuk factor and because it seemed fairly "out there". Of course now that we all know about the huge role that the microbiome may play in immunity and in our disease and now that we're all familiar with how effective faecal transplants have been in treating C. diff. infections, we all realise it's a serious treatment.
Dr Thomas Borody published a paper claiming a high success rate for transplanting 13 strains (I don't know which) isolated from human donors into CFS patients:
Dr Sarah Myhill (UK ME doctor, for those not familiar), says about faecal bacteriotherapy (transplant):
Dr Myhill links to a clinic that does this in the UK (amazingly - we never seem to have anything in the UK):
http://taymount.com/
Has anyone tried faecal transplant/bacteriotherapy (as opposed to probiotics) for their CFS or know anyone who has? If so, what have the results been?
Dr Thomas Borody published a paper claiming a high success rate for transplanting 13 strains (I don't know which) isolated from human donors into CFS patients:
The GI microbiome and its role in Chronic Fatigue Syndrome: A summary of bacteriotherapy.
Journal of the Australasian College of Nutritional and Environmental Medicine, Volume 31 Issue 3 (Dec 2012). Borody, Thomas J1; Nowak, Anna2; Finlayson, Sarah3
Abstract: Introduction: Chronic Fatigue Syndrome (CFS) has a complex and multifactorial etiology making treatment and definitive diagnosis, currently made through exclusion, difficult.
Current therapies, such as cognitive behaviour therapy and graded exercises, are inadequate and targeted to address symptoms, rather than the underlying disease pathology. Increasing evidence implicates the microbiota of the gut in a number of conditions previously thought distinct from the gastrointestinal system.
Previous work with bacteriotherapy in CFS has suggested a link between the condition and the composition and health of the gut microbiota.
Here, we review and further examine a larger cohort of CFS patients who had undergone bacteriotherapy for their CFS.
Method: A total of 60 patients from the Centre for Digestive Diseases presented with CFS. Of these, 52 patients had concurrent IBS and 4 patients additionally had constipation. All underwent initial transcolonoscopic infusion of 13 non-pathogenic enteric bacteria. 52/60 patients undertook an additional rectal infusion a day later and 3/60 undertook an additional 2 rectal infusions.
Results: 35/60 patients who underwent initial bacteriotherapy responded to treatment. 10/15 patients who failed this course were offered a secondary transcolonoscopic infusion followed by a rectal infusion or an oral course of cultured bacteria. Of these 7/10 responded, giving a total of 42/60 (70%) patients who responded to treatment.
Contact was achieved with 12 patients after 15-20 year follow-up. Complete resolution of symptoms was maintained in seven of the twelve patients and 5/12 did not experience recurrence for approximately 1.5-3 years post bacteriotherapy.
Conclusion: Bacteriotherapy achieves initial success rate of 70% in CFS and a 58% sustained response. Given that manipulation of the colonic microbiota improved CFS symptoms, bacteriotherapy for CFS warrants further investigation and may provide further insight into a possible etiology of CFS.
Journal of the Australasian College of Nutritional and Environmental Medicine, Volume 31 Issue 3 (Dec 2012). Borody, Thomas J1; Nowak, Anna2; Finlayson, Sarah3
Abstract: Introduction: Chronic Fatigue Syndrome (CFS) has a complex and multifactorial etiology making treatment and definitive diagnosis, currently made through exclusion, difficult.
Current therapies, such as cognitive behaviour therapy and graded exercises, are inadequate and targeted to address symptoms, rather than the underlying disease pathology. Increasing evidence implicates the microbiota of the gut in a number of conditions previously thought distinct from the gastrointestinal system.
Previous work with bacteriotherapy in CFS has suggested a link between the condition and the composition and health of the gut microbiota.
Here, we review and further examine a larger cohort of CFS patients who had undergone bacteriotherapy for their CFS.
Method: A total of 60 patients from the Centre for Digestive Diseases presented with CFS. Of these, 52 patients had concurrent IBS and 4 patients additionally had constipation. All underwent initial transcolonoscopic infusion of 13 non-pathogenic enteric bacteria. 52/60 patients undertook an additional rectal infusion a day later and 3/60 undertook an additional 2 rectal infusions.
Results: 35/60 patients who underwent initial bacteriotherapy responded to treatment. 10/15 patients who failed this course were offered a secondary transcolonoscopic infusion followed by a rectal infusion or an oral course of cultured bacteria. Of these 7/10 responded, giving a total of 42/60 (70%) patients who responded to treatment.
Contact was achieved with 12 patients after 15-20 year follow-up. Complete resolution of symptoms was maintained in seven of the twelve patients and 5/12 did not experience recurrence for approximately 1.5-3 years post bacteriotherapy.
Conclusion: Bacteriotherapy achieves initial success rate of 70% in CFS and a 58% sustained response. Given that manipulation of the colonic microbiota improved CFS symptoms, bacteriotherapy for CFS warrants further investigation and may provide further insight into a possible etiology of CFS.
Dr Sarah Myhill (UK ME doctor, for those not familiar), says about faecal bacteriotherapy (transplant):
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 Comprehensive Digestive Stool Analysis .
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 Comprehensive Digestive Stool Analysis .
Dr Myhill links to a clinic that does this in the UK (amazingly - we never seem to have anything in the UK):
http://taymount.com/
Has anyone tried faecal transplant/bacteriotherapy (as opposed to probiotics) for their CFS or know anyone who has? If so, what have the results been?
