iPoop said...
rbartolo said...
I think I need to go to med school to figure out what the heck you guys are talking about
Lol, Old Mike, Tunnelvisionary, Canada Mark, and Dreadsteel are pubmed heads for sure. I wonder if they'd do my taxes...
Being a biochem major about
to graduate, I should be grateful for getting UC in that it has allowed me to hone skills I could apply to a career. For all the searching I might do on pubmed, you are the master of practical knowledge about
disease, and i'm sure many people (including myself) are ultra grateful for that! Also, I always find the little parables about
UC in your signature hilarious. They're so true.
I did learn how to file taxes in a class in high school though...a skill I promptly forgot haha.
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OM: Ah yes, so would bacterial penetration of the inner mucus layer be the fundamental reason the immune system is stimulated? Would it be what sustains UC? Perhaps as Mark stated earlier, UC is a protective mechanism in that the while the chronic inflammation is damaging to our guts, preventing bacteria from getting past the mucus layer and into our bloodstream possibly is the goal of our immune systems. So perhaps UC is a protective response? But this protective mechanism ends up becoming chronic because the inflammation continues to degrade the mucus layer, so the immune system has no choice but to keep up the attack? Catch 22...might be life preserving because once bacteria get into the blood stream its pretty much game over for us.
So biofilm formation might be a way our colons sustain an environment where healing doesn't really happen? Perhaps there is some sort of mucus weakening, penetration (likely starting at the rectum), where bacteria can make their way in...inflammation begins to occur, possibly helping to weaken the mucus layer and create an environment where bacteria can continue to penetrate the mucus layer and possibly take up residence on it through biofilm which is not easily destroyed. They slowly make their way up the colon until it takes up the entire colon. Makes me wonder why it stops at the colon. I know backwash ileitis exists, but why doesn't this damage occur all the way through the small intestine in UC? (EDIT: Perhaps this is why getting on meds like mesalamine can slow the progression of UC up the colon. The inflammation stops which might slow the degradation of the mucus layer?)
I don't know if I necessarily buy the argument that we all have faulty mucus production and that is really the reason. Maybe i'm just naively hopeful, but I think it may be a series of crappy events occurring that may sustain the chronic inflammatory response.
Mouse studies have indicated that mice develop thicker mucus layers with greater bacterial diversity than germ-free mice who have thin/weaker mucus layers. Perhaps lower bacterial diversities over generations in industrialized societies as well as frequent antibiotic usage within a single person gives a microbiome that makes our mucus layers more susceptible to damage, and entering this vicious cycle of inflammation.
With regards to FMT, perhaps in addition to implanting a ton of bacteria, ensuring the colon environment is also worked on would be a lasting source of remission for UC?
- Somehow work on destroying/degrading biofilms (interfase enzyme, green tea enemas?, vitamin D, anything else that may help)
- Use conventional meds to suppress the inflammatory response
- Feed the microbiome with a variety of prebiotics, fibers, etc. Maybe even supplement with probiotics like VSL#3 as well, might help with the above factors.
- Ensure the FMT enema reaches all surfaces of the colon
- Perform frequent FMT enemas...amount is not set in stone, but symptoms decreasing is a good sign.
- Get lots of calories. Damaged colon needs energy to heal. Mucus layer needs energy and material to regenerate. Get lots of protein from whey shakes, gelatin...anything source of protein with all the amino acids, and lots of it. If the mucus layer can begin to regenerate itself quickly, the speed of regeneration prevents biofilm formation according to a paper Mark posted here.
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Many of those steps I found from the two most noteworthy cases (imo) of lasting remission from FMT. Michael Hurst and Michael Briggs. Hurst used whey protein shakes while doing FMT, Briggs used Interfase enzymes to break up the biofilm as well as orienting his body in different positions to ensure the FMT reached all surfaces of his colon. Both suppressed inflammation with conventional drugs while doing this procedure. Both are still in remission despite doing this years ago. Many people who do FMT can experience lots of improvement on it alone, but do end up seeing a resurgence in symptoms, which I suspect is that while the symptoms improve, many of the factors that led to the chronic inflammation might still be there.
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Some problems with this might be that we would still need to figure out if 75% of IBD cases do not have any known gene associations, if biofilm is indeed present in many of us with UC, and that getting a donor may not necessarily mean you are getting the microbes you need. In that sense, FMT is still very inefficient, but I'd say potentially much more effective than any probiotic.
This is all just speculation on my part...but I feel it's fairly comprehensive. It might have a possible explanation for why UC starts in the rectum and works its way up, how the mucus layer might become weak in absence of any genes that make it that way, why FMT has a few great successes, lots of improvement, but many failures, what our immune systems are attacking and possibly why they are attacking it, etc.
What do you guys think?
Post Edited (Tunnelvisionary) : 4/8/2015 7:36:50 PM (GMT-6)