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Thursday, January 17, 2013

Treating C. diff with Fecal Transplants: Proven 94% Effective

So in October of 2010 I wrote "Fecal Transplants, er, I mean bacteriotherapy" after reading this article in MedPageToday.
C. diff is a serious health problem created when antibiotics kill your good gut flora along with whatever bad bacteria they are being used to treat.

C. diff kills some 14,000 people a year.

Fecal transplant is the technique of replacing bacteria in the colon killed by these antibiotics with feces (and the healthy gut bacteria contained therein) from another healthy individual - typically via enema.

Recently a study was published in The New England Journal of Medicine that demonstrated a 94% effective rate for curing C. diff using fecal transplants.

Now all this is sort of old news at this point.  Yes it works.  Yes, it even makes sense when you think about it - after all gut flora are bacteria.  Antibiotics indiscriminately kill bacteria in your body good and bad.

The more interesting question is why does the modern medical establishment not get this?

According to Wired  Lawrence Brandt, a US pioneer of fecal transplant wrote in Clinical Infectious Diseases last year: "Patients with (C. diff infection) and their accompanying family and friends who come to see me were highly knowledgeable and not “turned off” by the fecal nature of the fecal reconstitute; rather they were “turned on” by the possibility—indeed the likelihood—of cure. For many the major stumbling block has been the intransient negativism of their physicians, who told them, uninfluenced by any of the positive reported data, that FMT was “quackery,” “a joke,” “snake oil,” or other pithy labels that were discouraging but served only to delay, not dissuade, these perseverant individuals."

So the major stumbling block is the physician...

Now if you think about this for even a few minutes its completely obvious that its the use of antibiotics that's the problem.

Image that you are being attacked by a rabid rat or other small animal climbing around on your shirt.

Antibiotics are like shooting a shot gun full of buckshot at you from 30 feet in order to kill your attacker.

The pellets in the buck shot don't care whether or not they hit the animal attacking you, you, or miss entirely.  Just like antibiotics - they kill bacteria good or bad.

(Of course there are many reasons, this among them, that antibiotics are bad, but that's another story.)

So for some reason physicians are more comfortable with this approach.

Even though modern medicine knows that

A) Antibiotics are over-prescribed

B) Bacteria are evolving strong immunity to them.

C) Antibiotics cause problems like C. diff.

Science and medicine have known about bacteria and how they are necessary for human life for decades (see "Life on Man" as an example from 1969).

The problem I think is that the American Medical Association and the FDA are far, far too comfortable controlling every aspect of medicine and that there is very, very little interest in actually changing the average doctors perspective from what is "common practice" - e.g. over-prescribing antibiotics.   (Another example is h pylori and its relation to stomach ulcers which took decades to penetrate modern medicine's approach to treating ulcers.)

The people with the problem are much more open than doctors.


Because the treatments doctors are giving them are wrong and not working.

People are smart enough to notice this, but not doctors. 

In fact, it makes so much sense once you understand the relationship between bacteria and human health you have to wonder why doctors continue to do what they do...

In fact, it seems like a crime that 14,000 people should die of this each year.

But I am sure the FDA and AMA will want decades more research before changing anything they recommend or love.

Good thing Walmart sells enema kits and strainers...

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