Fecal transplant log Part I

hey curl, i was wondering what your diet is like while doing FT? are you fasting or still eating?

Today's update;
No blood left in stool. Basically no symptoms of UC at this stage. Really good transplant session today with good amounts of donor feces. Wife drank some more water yesterday and that seemed to help. Administered close to 200 ml. Stool has stabilized in consistency and smell. It is very much similar to my wife's now. Increased fiber intake by eating more fruit (dried fruit is yum) and munching sunflower seeds as snack.

I'll be on the chat channel for a few hours if anyone wants to ask or chat about FT/UC

EATING: According to SCD, Probiotic yoghurt in the morning
SYMPTOMS: 1 BM/24h, no blood,no urgency, no discomfort, no mucus
MEDICATION: 25 mg prednisone (been eating for 18 days now, tapering down each Thursday by 5mg), 1200 mg Asacol
WEIGHT: stable around 74 kg (I'm male, 1.74m tall)
FECAL TRANSPLANTS PERFORMED: 7

If you are considering FT it is probably best to do it when you are not flaring badly. This way the good bacteria will have a good chance of sticking and colonizing. If you are flaring with many BMs a day they have less chance of sticking.

I'm going to post my procedure for how I administer the feces for anyone who is doing this on themselves. If you are grossed out then simply don't read it. I think its important that we educate each other on this since the medical industry seem slow and unwilling ($$)

curl3d's administration procedure:
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Equipment:
1 enema bottle (100 ml) emptied out of contents
saline
blender
baby wipes (great for wiping hands etc)
vaseline

Procedure:
Try to empty your bowel as much as possible prior to procedure. I get up early (5am) and eat breakfast to give me enough time. I even drink a bit of espresso sometimes just to kick start the stomach but you should probably avoid this if you are not having solid bowel motions.

Get the feces inside the blender as fast as possible after donation, make it about 1/4 feces vs saline (25% poo 75% saline). Make sure you have covered the feces with saline before starting the blender and mix the feces for no longer than necessary to make the solution pourable (max 20 secs) as this increases the risk for exposing the bacteria to oxygen (which may kill some of the bacteria due to osmotic shock).

Pour the mixed solution into the enema and put the tip back on. Put some vaseline on the tip. Place a towel on the floor and get down on your knees with face down on the floor. Get the enema between your legs and get it into your bum as far as the tip goes. Just be careful and make sure you point it slightly downwards as this is how your colon will be aligned. Squeeze the enema with a long consistent squeeze. Don't let it stay in there after you finished squeezing or it may suck the contents back into the bottle again. Stay in this position for 1-2 minutes and massage left side of tummy gently from bottom upwards. Imagine your colon going from bottom to the left and then up and right (picture: VIEW IMAGE). Get up and fill up the enema with whats left. Repeat injection procedure. Aim to get 200 ml (I could never empty the enemas completely but almost). Massage tummy from bottom left to upwards (for a minute or two) after injecting second time.

Rinse all equipment in hot water

Get into your bed with your bum in the air for the next 10 minutes. After this alternate lying on left and right side for the next 2-3 hours
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Post Edited (curl3d) : 3/7/2012 4:20:45 PM (GMT-7)

I don't mind at all. Thats what its there for. Remember this is just my way of doing it I am sure it can be improved further

curl, im headed to my gastro. right now with all my FT literature!! i am praying that she will do one for me via colonoscopy.

correction; went to toilet a second time this morning but still no symptoms. I just seemed to have a lot to get out of there this morning. I have been eating a lot more the last few days.

curl3d, I'm just curious as to why your using 2 enemas for each FT? That is a lot of material and wondering if its necessary. Also, what is your reasoning with the saline? This seems to be a variable ingredient....what's its purpose? Lastly, I get why your doing 3 hours of bedtime for each FT, but do you think 1 hour is sufficient otherwise?

Hi,

curl3d said...
The only reason of why I am using saline is because it has been used in the fecal transplant guides and articles I have read. It is supposedly easier for your colon than just distilled water but I am sure either works.

I think saline will be fine and important, otherwise the osmotic shock or osmotic stress will burst the bacteria-cells.

curl, just got back from the hospital. my doctor doesn't ever do FT, but she said 2 other doctors in the hospital are interested in doing it. I told her to let them know I really want it done so she said she would. also, i've been sick lately for no reason- still on my drugs- so my doctor thinks i have C. diff. I am praying that i do because i think it would be way easier to convince a doctor to do it for c.diff than for U.C.

Great news bananagirl. Also, cdiff is notorious for false negative test results....OR, being clear until the spores hatch again....it is a vicious cycle. Regardless, it sounds like this GI is going to work with you....keep us posted.

FYI: We don't use a blender or saline. We simply mix poo and purified h20 in a ziploc bag, filter, and administer. This whole process takes about 20 minutes.

Thanks for this thread curl3d, you might have inspired me to begin my FT quest.

Just wanted to mention that your immune system behaves erratically when weaning off of Prednisone - and you're right at the dosage when most our symptoms act up (20mg and lower). I would venture to say that trying to measure the efficacy of FT while tapering off of Prednisone is probably much harder to do than if you were in a mild flare up, so I'm curious to see how things progress when you're finally off the drug.

Rooting for you my friend!

Just reading this from Borody's report about someone who was also on 25 mg Prednisone and doing fecal transplant:

{SNIP START}
A 25-year-old man presented with a 6-year history of UC. Hehad experienced frequent blood in stools, diarrhea (6–7 motions per day), abdominal pain, cramping, urgency, nausea, fevers, fa- tigue, and weight loss of 6 kg over 2 years. He had previously beentreated with prednisone 25 mg/d, salazopyrin 3 g/d, codeine phos-phate 30 mg/d, and nightly prednisolone sodium phosphate enemas, (see Table 1), but he refused azathioprine. A number of attempts to reduce steroid dosage resulted in recurrence of diarrhea and bleeding. Colonoscopy confirmed pancolitis with granular mucosa, contact bleeding, microulceration and histologically active chronic colitis. The patient had low serum iron and elevated alanine aminotransferase (ALT) levels, at times up to 10-fold above normal, together with elevated alkaline phosphatase (ALP) and g-glutamyl transpeptidase (GGT), presumed (no liver biopsy per- formed) to be due to associated sclerosing cholangitis. Immediately preceding HPI, his symptoms were moderately controlled using prednisone 25 mg/d and salazopyrin 1 g/d. The patient was infused with bowel flora donated by his female partner via retention enemas. He ceased taking salazopyrin on the final day of infusion. Prednisone was withdrawn stepwise at a rate of 5 mg per week over 5 weeks. One week following HPI, his symptoms had improved markedly with an accompanying reduction in stool frequency and rectal bleeding. Four months post-HPI, he remained asymptomatic without treatment, defecating 2 to 3 times per day with no bleeding. The patient had not experienced a recurrence of symptoms since the infusion.
{/SNIP END}

So, it took quite a while for this guy to get asymptomatic it seems. Which means that I should probably not get too hung up on if symptoms are coming back slightly as I am weaning of pred