In September, 2011, a friend of mine (age 60) started having loose stools and diarrhea. He tried all sorts of dietary changes (including a “cleanse” in which he eliminated grains, dairy, and sugar, and added lots of good stuff, including probiotics), with no improvement. He had his stool tested, but the lab found nothing unusual.
I told my friend about a chronic urinary tract infection that I had had about 15 years ago. Doctors were unable to find a treatment/cure for it. I had started listening to Dr. Gabe Mirkin's radio show while driving home from work, and he had talked frequently about mycoplasma as a cause of the very symptoms that I had been experiencing. Mycoplasma is an extremely small, and difficult to test for, form of bacteria that lacks a cell wall, and therefore does not respond to many antibiotics. There are several strains of it, the one causing pneumonia being the best known. Mirkin said that azithromycin (Zithromax) was effective against mycoplasma. I went to my doctor and practically had to beg him to prescribe it (he wanted to give me Cipro, which had not worked before). Well, I took the Zithromax and, within a week, the 10-year-long urinary tract symptoms were gone.
When my friend started having diarrhea and stool problems, I did some online study and discovered that there is a strain of mycoplasma that some researchers have implicated in ulcerative colitis. I suggested to my friend that mycoplasma might be to blame for his problem, so he went to a doctor acquaintance (not his personal physician) and got a course of Zithromax. He decided not to take it, however, because he was scheduled for a colonoscopy, and he had not yet given up on dietary solutions. Anyway, the colonoscopy revealed a mild form of ulcerative colitis, and his doctor put him on Apriso.
about six weeks ago my friend's family went on a ten-day vacation. I volunteered to take care of their dog, cats and chickens while they were away. I was especially good to the cats (though I'm not a cat person), cleaning out their litter boxes (six of them!) daily. The day before they were to arrive home I started experiencing diarrhea/loose stools. After a month of these symptoms, I knew that this was not going to go away on its own, and I told my friend that I thought that I had the same thing he had, and that it seemed likely that the problem had an environmental trigger related to his house or pets (while I was pet sitting, litter-box dust had often filled the air).
My earlier research had indicated that mycoplasma is so small that it can be dust-borne. I told my friend that there was a chance that his problem (and mine) was caused by mycoplasma in cat feces and might respond to Zithromax. By that time he had been taking Apriso for many weeks, with only some occasional relief. His doctor wanted him to continue it for another month, so he was reluctant to start another medication. I asked him if I could have his unused course of Zithromax and become a "guinea pig" in a drug experiment. At this point I had been suffering for over five weeks. He agreed to give it to me, and I started taking it immediately (two 250-mg tablets the first day, one 250-mg tablet each of the next four days).
After the first day the symptoms dramatically lessened. After four more days, they disappeared entirely, though my stools were very slightly softer than usual (a listed side effect of Zithromax). Three days after stopping the drug, I am COMPLETELY back to normal.
My understanding of the way that mycoplasma operates is that, lacking a cell wall, it invades the cells of the human body, in this case, the colon. Zithromax does not kill the mycoplasma; rather, it prevents it from reproducing, which it must do outside the human cells, and within the gastrointestinal tract. The body's immune system eventually overwhelms the unable-to-reproduce bacteria. The fact that I had a relatively short "infestation" means that a single course of Zithromax was enough. I have read that chronic cases may require months and many courses of the drug.