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Last week's visit with my alternative med doc was fruitful! She is definitely in favor of the procedure and was willing to assist. As we discussed the procedure, we both felt it would be more beneficial to do it at home; time is of the essence. My DH is going GF/DF & SF this week. She would like me to take Xifaxan for 4-5 days prior to the enema and then finish it. Although I have been prescribed this med 2 other times (which I did not take), I did not see the value for this until now. Our visit covered many things and I wish I had explored further the benefit or thinking of continuing the drug (the 4-5 days) after the transplant. Polly/Tex, if you read this, I would like to know what you think. I feel this is to cover the many different strains of bacteria we possess or do not possess. Anyhow I am encouraged.
She also did a "Standard Food Panel: IgG/IgE test" with US BioTek and the only thing I showed reacting to is eggs, almonds, pineapple and a very low reaction to bananas and broccoli. However, IMO, the results I received from Enterolab and the MRT test are far more accurate and true to what I can and can not eat.
One last note, the probiotic enemas I am taking seem to be helping. At least they give me a couple of days of more formed bowels. BUT I am still taking 2 Entocort and 4 Imodium a day.
Later this week I have my appt at Baylor College of Medicine. This last week has been more hopeful...............again. Ginny
God, grant me the serenity to accept the things I cannot change; courage to change those things I can, and WISDOM to know the difference
I am confused about the reason for the xifaxan. I guess I don't understand why an antibioic would be used, when the whole goal of the procedure is to preserve and encourage bacterial regrowth. Wouldn't the xifaxan likely wipe out mucho bacteria (and we know that "good" bacteria are always wiped out with the bad).? I guess I am missing something here. Has xifaxan been used in other fecal transplants? Most of the ones I have read about were done because of C. difficile infection, which is not an issue here.......or is it?
Hugs,
Polly
Blessed are they who can laugh at themselves, for they shall never cease to be amused.
Polly, glad you replied. I am a little confused as to why she would consider keeping me on the antibiotic AFTER the transplant. I can see in theory of using it prior to the transplant, but I have the same opinion as you that it could kill the whole purpose of the transplant. What do you think about taking it prior and then stopping 2 days before transplanting or would you suggest not at all? In her defense, she did ask me had I ever taken an antibiotic for this condition and I had said no; possibly this had something to do with her thinking. She is out of the office for a couple of weeks. One thing she said right up front is that it would be 80% more effective than any probiotic because of all the strains of bacteria it can attack or help. This backs up what Tex has said.
I know that this doc is trying to help me, but you all know such much more of what we are going through so I really value your opinions and suggestions.
In my research, I have noticed that patients that had the C-diff they did keep them on the antibiotic upto 24-48 hours prior and then kept them on S. boulardii (Florastor) which has lactose. I have just switched to a probiotic; 20 billion of BifoViden ID (bifidobacteria), this being the bacteria I have zilch of!
I'm really anxious to try but I want to make the best effort the first time.
Ginny
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God, grant me the serenity to accept the things I cannot change; courage to change those things I can, and WISDOM to know the difference
Your thinking seems sound to me - questions and all, though I don't really have answers. I can tell you that there are formulations of S. boulardii that do not contain lactose - but that is used in those cases because it can successfully compete with C. diff., which doesn't seem to be your issue. I can see why you want to give this every chance of working... and I hope it does!
That sounds very encouraging. Here are my thoughts:
I share some of Polly's concerns about the use of Xifaxan, (rifaximin), prior to a fecal transplant. I'm not sure if any studies have been done on that particular application, or if some doctors have simply made an arbitrary choice to use it, when treating a C. diff infection. If I recall correctly, the professional label specifically recommends that it should be used only to treat E. coli. For example, it's not effective against Campylobacter jejuni, and there's no documentation that it has any effect on Shigella or Salmonella species. Part of it's claim to fame, is supposedly it's ability to control E. coli populations, while preserving many beneficial bacteria species. The big question is, do you have a high E. coli population that needs to be eliminated, or at least significantly reduced, and/or do you have a significant number of beneficial bacteria that should be preserved? If you really need to "clean-house", so that the bacterial re-population procedure will start with a "clean slate", a broader spectrum antibiotic might be more appropriate, (though I'm not recommending that, unless you and your doctor are sure that you don't have enough "good" bacteria remaining to justify trying to preserve them. I believe you mentioned to me that stool cultures indicate a high E. coli population, and if that is the case, then Xifaxan might be the ideal antibiotic for the job.
The downside is that several members here have tried rifaxamin with very little success, (some have tried it more than once, on their doctor's recommendation). Of course they weren't doing stool transplants. It sort of appears, though, that rifaxamin is a very expensive antibiotic, which is highly promoted by the drug companies, and because of that, many doctors recommend using it, but the results so far don't seem to live up to the claims made by the manufacturer. (Where have we heard that before?)
One consideration might be that if you do indeed have a well-established presence of E. coli in your intestines, it's possible that their presence might prevent the newly-introduced strains from finding suitable locations to "attach", if the resident colonies are well established. IOW, your problem may be more than just an absence of certain beneficial strains. Those strains may be absent because they are essentially "locked out" by firmly-established colonies of less-than-optimum species. If that's the case, then a course of Xifaxan prior to the transplant might possibly be beneficial. I'm not so sure, though, that it should be continued after the transplant procedure.
Xifaxin has a half-life of 6 hours, so theoretically, at least, it should be mostly out of your system after half a day. I can see no logic in continuing an antibiotic treatment after the transplant procedure. IOW, like Polly, I'm not convinced that rifaxamin is particularly protective of beneficial bacteria.
Also, while it's claimed to be a non-systemic antibiotic, (roughly 97% is excreted with feces), that may not apply to someone with the leaky gut syndrome, (though that may be irrelevant, for the purpose at hand). My thoughts are, though, that even if it misses some species, (which it almost surely will), that may be beside the point, because it will provide plenty of luminal surface area to allow the new transplants to attach, and with any luck at all, the transplants will hopefully eventually out-compete the remaining undesirable residents.
So if I were in your shoes, I would make a decision about Xifaxin based on my, (or rather my doctor's), best estimate of my existing gut bacteria profile, and go from there. I believe I would need to see some evidence of a cost/benefit ratio, (in terms of probable success, not money), though, before agreeing to continue the antibiotic treatment after the transplant procedure.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
I don't have any insight into this, but I wanted to wish you well. You will be our pilot case for the procedure. Bless your husband for being willing to forgo gluten, dairy and soy for your sake.
Keeping my that it works for you.
Gloria
You never know what you can do until you have to do it.
Polly, Tex, Sara, Gloria, thanks for your support and knowledge.
Tex, after reviewing what you said I went back to my test results, and look what it says about E. Coli:
Beneficial Bacteria:
Lactobacilius species; normal range(2+)
Escherichia coli; NO GROWTH
Bifidobacterium; NO GROWTH
Additional Bacteria; non-pathogen appear in the normal range:
Coag.negative Staphylococcus (3+)
Enterobacter cloacae (2+)
Kiebsiella phneumoniae (3+)
Mycology: No Growth
Metabolic:
Low in Beneficial SCFA's and n-Butyrate
High in Beta-glucuronidase
Secondary Bile Acids all in normal range:
Lithocholic acid & Deoxycholic acid
Digestion/Absorption:
Pancreatic Elastase very high but Putrefactive SCFA were low
Gut Immunology indicated no inflammation
Your comments here are the only thing that would make sense to me to use the antibiotic:
My thoughts are, though, that even if it misses some species, (which it almost surely will), that may be beside the point, because it will provide plenty of luminal surface area to allow the new transplants to attach
I'm leaning to doing the transplant without the antibiotic and IF it did not take the first time, I can certainly try it again and Xifaxan prior to the second time. Thoughts??
I have to keep in mind that she is a Family Medicine doc that adheres to healing through our foods; she is not a GI and might not have the extensive knowledge of the gut. She has helped a lot of people, particulary kids.
Added note; the price of the antibiotic will only cost me $40.
Your knowledge is invaluable to me, Ginny
God, grant me the serenity to accept the things I cannot change; courage to change those things I can, and WISDOM to know the difference
Ginny wrote:I'm leaning to doing the transplant without the antibiotic and IF it did not take the first time, I can certainly try it again and Xifaxan prior to the second time. Thoughts??
I think that sounds like an ideal plan, since the cost of retreating is quite nominal.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Polly & Tex, thank you so much for your insight, knowledge and support.
Our plan right now is for my hubby to do GF/DF/SF for a week and then proceed. I hope my next report will cause me to celebrate!!
In the meantime I will let you know what Baylor College of Medicine has to say. I have a bet with my DH that they will want to do another colonoscopy since my last one was two years ago this past July.
Love, Ginny
God, grant me the serenity to accept the things I cannot change; courage to change those things I can, and WISDOM to know the difference
She is definitely in favor of the procedure and was willing to assist. As we discussed the procedure, we both felt it would be more beneficial to do it at home; time is of the essence. My DH is going GF/DF & SF this week. She would like me to take Xifaxan for 4-5 days prior to the enema and then finish it. Although I have been prescribed this med 2 other times (which I did not take), I did not see the value for this until now. Our visit covered many things and I wish I had explored further the benefit or thinking of continuing the drug (the 4-5 days) after the transplant. Polly/Tex, if you read this, I would like to know what you think. I feel this is to cover the many different strains of bacteria we possess or do not possess. Anyhow I am encouraged. 
that it works for you.
since my last one was two years ago this past July.