People cured by laxatives & link with FMT

[Mad Hatter]

After a bit of reading I realized one of the most shared cure by people here, albeit temporary, was colonoscopy preparation, i.e. bowel cleansing via fasting/ heavy laxatives use.

The effects are often drastic, extreme, and can't be due to placebo because nobody expects to feel better after a colonoscopy, as far as I know. The effects can stay for various amounts of time after the preparation: hours, days, weeks, months, or be permanent.

For example:

• User tedstark felt "incredible" for 3 days after colonoscopy preparation.
• User EddieB experienced "nearly complete remission" for weeks after multiple colonoscopy preps. User Hip said that EddieB ended up permanently cured of CFS.
• User bread. reported "similar effects" to EddieB's, although the benefits were mostly cognitive ans were shorter.

You can find a lot of testimonies of the efficacy of this treatment in IBS and SIBO patient on the internet.

Now I thought about something interesting. Before doing FMT, clinics usually do a bowel flushing, like for a colonoscopy. Could some of the effects attributed to FMT actually come from the bowel cleansing?

Could this have a link with the benefits of the "hangover effect" ? The hangover effect is the opposite of a hangover, meaning one feels healthy and refreshed the day after drinking alcohol. There is no official theory as to why this happens. Could this effect be the consequence of the cleansing & antiseptic effects of alcohol in the digestive track?


I am soon ordering polyethylene glycol and bisacodyl, both OTC drugs, to do my at-home colonoscopy prep in order to see for myself. I think it may help greatly with what I suffer from. Whatever the results of the experiment, I will update you here. I may take a month or more before experimenting.

 

[hapl808]

Interesting idea. I think FMT and the microbiome and everything else in that area are still poorly understood. I did an elemental diet once for SIBO for a few weeks, and I was more mild back then but I had some crazy fluctuations in my energy level, brain fog, etc during those weeks. Unfortunately it didn't affect me long term, but my 'moments of clarity' during the elemental diet were remarkable - a glimpse of what I used to be.

 

[Mad Hatter]

The more you look into it, the more you understand we don't understand.

And so you have to come back to your "gut" feelings, your instinct. Personally, I find introducing someone shit in someone else's asshole sounds silly. That's my gut feeling about it.

 

[JES]

Very interesting ideas, I tend to agree. I experienced the hangover effect quite a few times. Not so many times lately, I reckon because after having ME/CFS like condition for X amount of years, the effect of these temporary remissions tend to diminish.

The problem with FMT as with most other treatments and the reported remissions is that the results tend to be temporary. The list of my temporary remissions that I collected in a previous post (link) is the following:

-Catching a cold. This is the best working one for me, but unfortunately I wasn't lucky enough to catch one since 2016. Ever since my ME/CFS symptoms started, I also seem to almost never get acutely ill.
-Brain MRI. This is a bit sketchy as I only did it once, so could have been some other factor involved, but it produced a great temporary improvement that lasted for 24 hours.
-Sleep deprivation. Not as complete as above, but still gave me let's say 50% improvement. Nowadays a bit less.
-VNS stimulation. This also gave what I thought was a cure, but then stopped working the next day.
-Switching in and out of ketosis, it seems my body gets fooled to work normally for a while.
-Alcohol. Very temporary, but following consumption of more than 2-3 portions, I usually feel better at some point in the next 24 hours.
-Certain drug and certain antidepressants. The remission only lasts a day or sometimes even less.
-Constipation. Weird one, but seemed to produce some improvements last time.
-Certain changes of environment or traveling have triggered weird improvements, but don't seem 100% replicable.

I never tried the bowel flushing, so interested to see what effects it does have for you. If FMT effects are also temporary, I reckon doing some kind of bowel flush is safer than going to redo FMTs several times a year, as each FMT carries a risk of you getting some infection or bacteria from the donor that your immune system doesn't respond well to, so I ruled out doing this over and over again.

 

[datadragon]

Interesting. The most likely answer is that its the fasting and nothing to do with the laxatives. TDO is an enzyme found predominantly in the liver and can be induced by a number of factors including fasting, glucocorticoids, hydrocortisone, L-tryptophan and nicotinic acid. This enzyme helps reduce tryptophan. Ketogenesis also is a metabolic pathway that produces ketone bodies, which provide an alternative form of energy for the body to use. Your metabolism moves from using glucose to ketones to power the body. https://www.ncbi.nlm.nih.gov/books/NBK493179/

 

[Mad Hatter]

Interesting. The most likely answer is that its the fasting and nothing to do with the laxatives. TDO is an enzyme found predominantly in the liver and can be induced by a number of factors including fasting, glucocorticoids, hydrocortisone, L-tryptophan and nicotinic acid. This enzyme helps reduce tryptophan. Ketogenesis also is a metabolic pathway that produces ketone bodies, which provide an alternative form of energy for the body to use. Your metabolism moves from using glucose to ketones to power the body. https://www.ncbi.nlm.nih.gov/books/NBK493179/

They are not really fasting. During the colonoscopy preparation, they are authorized to eat sugary drinks & sodas, which blocks ketosis from happening, until 8 hours before the colonoscopy. By the way, I plan to eat a full sugar diet following my flushing, because the sugar is mostly absorbed in the stomach and upper intestine and does not "create" stool.

Also, I've reached ketosis a number of times, either via fasting or by cutting any carb intake, and it didn't do much. I just felt even more tired because I am so slim already. If flushing + sugary drinks helps me, it would prove the helping didn't come from ketosis.

I strongly believe ketosis is another bandwagon that leads to nowhere. After much research, I do not believe it can cause such drastic changes as what has been reported to happen after a flushing. I believe it may be very useful, but not for most people with CFS, maybe more with people that have weight to lose

 

[Hip]

Now I thought about something interesting. Before doing FMT, clinics usually do a bowel flushing, like for a colonoscopy. Could some of the effects attributed to FMT actually come from the bowel cleansing?

That is an interesting idea, though note that colonoscopies are routine procedures, so if remission from ME/CFS were common after a colonoscopy, we would hear more stories about this.

In the UK, for example, as soon as you reach the age of 55, the NHS automatically sends you a letter inviting you for a colonoscopy.

User EddieB experienced "nearly complete remission" for weeks after multiple colonoscopy preps. User Hip said that EddieB ended up permanently cured of CFS.

I believe EddieB found that his improvements after colonoscopy lasted for several months, but then his ME/CFS returned. His post is here.




You may be interested to know that there is a yoga technique called shankhaprakshalana (salt water flush), which involves drinking many litres of salty water, while at the same time performing specific yoga twisting asanas which rapidly move this water from your stomach through the intestines. You will need to use the toilet multiple times during shankhaprakshalana.

This technique might be an alternative to a bowel flush with laxatives.


When I was healthy, I performed shankhaprakshalana occasionally. It takes about an hour, but it is remarkable that at towards end of the hour, when you go to the toilet, only clean salty water comes out of the rectum. It's amazing how this yoga technique cleans the entire digestive tract.

Unfortunately, since getting ME/CFS, I find that the asanas involved are exhausting, so I am not really able to do shankhaprakshalana now.

 

[Mad Hatter]

That is an interesting idea, though note that colonoscopies are routine procedures, so if remission from ME/CFS were common after a colonoscopy, we would hear more stories about this.

In the UK, for example, as soon as you reach the age of 55, the NHS automatically sends you a letter inviting you for a colonoscopy.

I keep that in mind. I also keep in mind that some colonoscopy preparations don't involve a "full flush" but just fasting and enemas, which would not clear the entire digestive track. If I recall correctly, it is precisely how went your colonoscopy preparation. It would be interesting to find numbers, statistics about the repartition of "full flushes" and "just enema"s, and also if the doctors prefer the enemas in certain parts of the population. Maybe they prefer enemas in elder people because flushes involve a lot of dehydration. Just an idea.

When fasting, I notice that I always have one meal stuck inside of me, and I cannot get rid of it even after multiple days of not eating. It is as if I need one meal to push the other out.

 

[Hip]

I also keep in mind that some colonoscopy preparations don't involve a "full flush" but just fasting and enemas, which would not clear the entire digestive track.

That's true, and if someone were suffering from SIBO (which is well-known to make ME/CFS symptoms considerably worse), an enema flush would not target the small intestine where SIBO is located.


It would be interesting to research the mechanism of bowel flushing. How to laxatives such as magnesium sulphate evacuate the bowels? What happens locally on the mucous membranes which might help clear bacteria attached to the intestinal lining, or might help temporarily fix a leaky gut?

Some theories speculate that ME/CFS may be caused by bacterial toxins leaking into the blood stream.

Google tells me that magnesium works as a laxative by pulling water into the intestines, via an osmotic effect. This water then makes the stool softer.

When fasting, I notice that I always have one meal stuck inside of me, and I cannot get rid of it even after multiple days of not eating. It is as if I need one meal to push the other out.

If your ME/CFS is mild, you might look into shankhaprakshalana. That will clean out the entire digestive track. It's easy to do, but for those with more severe ME/CFS, I think it will be too exhausting.

 

[Mad Hatter]

That's true, and if someone were suffering from SIBO (which is well-known to make ME/CFS symptoms considerably worse), an enema flush would not target the small intestine where SIBO is located.


It would be interesting to research the mechanism of bowel flushing. How to laxatives such as magnesium sulphate evacuate the bowels? What happens locally on the mucous membranes which might help clear bacteria attached to the intestinal lining, or might help temporarily fix a leaky gut?

Some theories speculate that ME/CFS may be caused by bacterial toxins leaking into the blood stream.

Google tells me that magnesium works as a laxative by pulling water into the intestines, via an osmotic effect. This water then makes the stool softer.





If your ME/CFS is mild, you might look into shankhaprakshalana. That will clean out the entire digestive track. It's easy to do, but for those with more severe ME/CFS, I think it will be too exhausting.

It may also be that bacteria in the gut release metabolites that directly attack or benumb the nervous system, like the vagus nerve for example, or the nerve that control the genitalia (I believe it may be why I am impotent and have lost sensitivity in my genitalia, just like people with PSSD.). If the bacteria released toxins into our bloodstream, we surely would have found a blood test to show it by now.

The gut-nerve connection is more credible than the gut-blood connection, because the former is invisible and can not be diagnosed, as far as I know, whereas the former would be found instantaneously with all the blood tests being done.

Also, the gut-nerve connection would explain why our states can shift so dramatically so quickly sometimes, whereas I feel that the gut-blood connection would have more "inertia" (sorry for bad english ).

I do not believe in the official version of the polio. I do not believe polio was caused by a virus but by DDT in the insecticides. According to what I have read, in children the digestive track is right next to the nerve that allows your brain to control your lower body, and so heavy metal ingestion would cause that nerve to be damaged and then paralysis would occur in children. I am not looking to make a controversial statement just for the sake of it, once again I'm throwing ideas around.


I will certainly look into the yoga technique if the laxatives have an effect on me, as I wouldn't like taking laxatives too regularly. But I will first begin with the hard, fully-cleaning flush, just so I know if flushing is effective in the first place.

 

[Mad Hatter]

Also, there are different types of laxatives.

For a colonoscopy prep, I've read that they usually give a prokinetic laxative (which promotes bowel movement) and an osmotic laxative, that, as you said, works by pulling watter into the intestines. I believe the mechanism is as simple as washing anything else when it comes to the osmotic effect. Just, lots of water passing through. Salty water drinking + yoga technique would surely do the same as AFAIK salt attracts water.

 

[Hip]

If the bacteria released toxins into our bloodstream, we surely would have found a blood test to show it by now.

Medical technology generally does not have the ability to detect bacterial toxins in the blood. Only in recent years has a commercial test for the most common bacterial toxin, LPS, become available. But there are hundreds of other nasty bacterial toxins created by gut bacteria which we cannot detect in the blood.

In the case of LPS, a recent study found this high in the blood of some ME/CFS patients.



Though both viruses and bacterial toxins can travel along the vagus nerve by retrograde axonal transport. Dr Chia said that it takes enterovirus just 3 days to travel along the vagus nerve from the stomach and into the brain.

 

[Wishful]

Drastic changes in the bowel contents would be expected to have multiple effects on the rest of the body and brain. You're changing the microbiome, with multiple chemical effects on the body and brain. You're probably changing levels or ratios of various chemicals in the body (Na/H2O, for example). You'd be changing a bunch of signals from the digestive system, which the brain and other organs would try to compensate for, resulting in changes to other parts of the brain and body.

Experimenting with different bowel-affecting techniques might reveal something useful. Finding that something is likely to be a matter of luck though, since there are so many interacting variables, and our ME symptoms vary so much day-to-day even without trying something new.

As for some people getting a cure from this or some other treatment, some people might be balanced on the cusp of switching between ME state and non-ME state, and the removal of one microbe species might be enough to make a difference. Some people might be on that cusp and spontaneously switch state by some other variable. None of that helps people who are more solidly locked into the ME state.

 

[Mad Hatter]

Drastic changes in the bowel contents would be expected to have multiple effects on the rest of the body and brain. You're changing the microbiome, with multiple chemical effects on the body and brain. You're probably changing levels or ratios of various chemicals in the body (Na/H2O, for example). You'd be changing a bunch of signals from the digestive system, which the brain and other organs would try to compensate for, resulting in changes to other parts of the brain and body.

Experimenting with different bowel-affecting techniques might reveal something useful. Finding that something is likely to be a matter of luck though, since there are so many interacting variables, and our ME symptoms vary so much day-to-day even without trying something new.

As for some people getting a cure from this or some other treatment, some people might be balanced on the cusp of switching between ME state and non-ME state, and the removal of one microbe species might be enough to make a difference. Some people might be on that cusp and spontaneously switch state by some other variable. None of that helps people who are more solidly locked into the ME state.

Taking heavy laxatives for one day might affect a lot of things in the body, you're right. But the body quickly finds homeostasis again. The body would find its balance quite rapidly. The concept of "imbalance" is by the way in se very problematic, because the body always balances itself. It is a core concept of medecine and biology.

If the effects of the laxative last longer than the body takes to finds homeostasis, then it means that something must certainly have changed in the gut. That is what I think, at least.

In any way, I am soon to try the laxatives for myself. This will be my trial of fire.

Have you tried for yourself such a thing before?

 

[Wishful]

Have you tried for yourself such a thing before?

Accidentally. My ME started with a type IV food sensitivity. That lasted 2.5 years. Then I had a dramatic "flushing out" due to food poisoning. No type IV response after that. My guess is that it flushed out some microbe that was chronically stimulating my immune system, and the "flush out" dropped the population to the point where other microbes could completely eliminate it.

I take psyllium regularly, because that's the only fibre I have available that isn't fermentable, and thus doesn't worsen my ME symptoms. Psyllium is considered a laxative, but it's not a "flush you completely out" type. Drastic "flushing" isn't without risk though. It could remove a beneficial microbe, or strengthen a problematic one long-term. The chance of a benefit seems very small to me, and the risk might be larger.

because the body always balances itself.

I question that claim. I can imagine cases where the balancing mechanism fails, leading to chronic symptoms or even death. I'm not sure that any control mechanism is perfect and can't somehow fail. My Tsh is always a bit elevated, but I believe that's due to incorrect kynurenine metabolism that results in elevated picolinic acid, which elevates Trh and thus Tsh. So, my thyroid "governor" might be keeping my Tsh at what it sees as the proper set point, but the set point it's monitoring is incorrect.

 

[datadragon]

Among other things, Manipulating the gut microbial composition can modulate plasma concentrations of Trp and Trp metabolites . The gut microbiota can directly utilize Tryptophan, which partially limits Trp availability for the host. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5808205/ However at this moment I was looking more first at the common ground of IFN-y upregulation due to intensive exercise and ifn-a activation as also mentioned by Dr Phair and then whats going on in the kynurenine pathway (some of the normal functioning is mentioned in that study) and likely 5-ht because lower IDO activity leads to both decreased kynurenine and increased 5-HT concentrations which will better help researching what best to take to fix it. At the moment there are a number of things that can be tried until we find what works best, but its certainly easier when you have the exact mechanisms at play. It also mentions that other kynurenine metabolites, quinolinic, and picolinic acids, can also enhance IFN-γ-dependent iNOS expression so again finding whats going on in the pathway is important.

 

[Wishful]

I was looking more first at the common ground of IFN-y upregulation due to intensive exercise

Back before I knew about ME and PEM, I noticed that I felt worse 24 hrs after major exertion. I already knew that TRP made my symptoms worse, so the consistent 24 hr delay for IFN-y fit the IFN-y->IDO->kynurenine mechanism. 5-HTP did not affect my symptoms, so that pathway wasn't involved. Sadly, I couldn't find any simple way to modulate the individual pathways for kynurenines. I thought it likely that QUIN was elevated at the expense of beneficial kynurenic acid, but how to test that? I don't seem to be abnormally sensitive to TRP-rich foods now, so I can't experiment with that.

There could be multiple pathways that affect ME symptom severity. Even if the KYN pathway isn't adding to it, some other pathway is maintaining the symptoms.

 

[datadragon]

Back before I knew about ME and PEM, I noticed that I felt worse 24 hrs after major exertion. I already knew that TRP made my symptoms worse, so the consistent 24 hr delay for IFN-y fit the IFN-y->IDO->kynurenine mechanism. 5-HTP did not affect my symptoms, so that pathway wasn't involved.

5ht is more complex which might explain that as I mentioned in a post in this link so its involvement is currently likely, and further I also mentioned that Adenosine A3 receptors regulate serotonin transport via nitric oxide and cGMP. Activation of an A3 adenosine receptor results in an increase of 5-hydroxytryptamine (5HT) uptake in RBL cells so nitric oxide/cgp or adenosine a3 activation are further paths to 5ht. https://forums.phoenixrising.me/thr...d-abnormalities-in-me-cfs.90173/#post-2437359 kynurenine metabolites can enhance IFN-γ-dependent iNOS (which promotes lots of nitric oxide). In kynurenine catabolism you have tdo enzyme in liver, ido1 that can be blocked with too much tryptophan, nutrients like active b6 involved in some of the conversions plus conversion to serotonin the other way, and the gut bacteria is also part of regulation. TRPV1 can enhance nitric oxide which can become uncoupled after inflammation https://pubmed.ncbi.nlm.nih.gov/21493704/ and is known for sedation like effects, and can lower blood pressure and weight.
Lots of pieces to the puzzle.

 

[Mad Hatter]

Addendum & response to @Wishful.

Wishful, you said what I was about to try with laxatives couldn't work for severe CFS. But I just found out your symptoms improved after diarrheas from food poisoning!

Food poisoning cured my type IV sensitivity, and greatly improved my quality of life. Maybe more PWME should experiment with it. First make sure you're not short of toilet paper...

It also happened to user @JES :

Twice more or less full remission from pain, cognitive and blood flow issues (POTS). First time after some form of food poisoning (bacterial infection), second time following a classic cold.

Could it be that temporary remissions after food poisoning were due to the diarrheas such poisonings provoked?

@Hip I feel this might be of interest to you.

Stay put everybody, I should have the laxatives by tomorrow morning!

 

[Rufous McKinney]

I experience considerable improvement in digestion following my severe gastroperesis acute attacks. Unable to eat any food for several days, I think something gets starved out. My IBS is much improved for a bout a week to ten days. Then it gradually reverts.