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cludwig
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Medical Questions

Post by cludwig »

Hi All,

I have some more test results back and need you alls advice. I got my stool culture test back and the good news is that I don't have any parasites. However, the bacteria results weren't so good. The way these are rated is by dividing the petri dishes into quarters and if none is found in all 4 quarters it gets a 0....if it's found in all 4 quarters it gets a 4. For the bad bacteria, Citrobacter freundii (4+), Proteus mirabilis (4+) . The good bacteria Lactobacillus and good E.coli were both (4+). and the bifodobacter was (0+). No problem with yeast was found.

My question is about the treatment. They tested the bad bacteria with different anibiotics and also with various natural agents. Cipro was the best antibiotic ( I was relieved as I've heard you guys say it works best for mc). The natural agent that was effective was caprylic acid. The doc thought we should start with the caprylic acid first as it's not supposed to hurt the good bacteria. ...so I agreed. I looked the stuff up on the web...it's pharmax caprylate complex...and it says not suitable for people with gastritis and colitis.Awwww.

So does anyone have any experience with this stuff???? Should I even try it if it already states that it's not good with colitis. Would it be a less risky choice to go with the cipro???I'd love to know what you guys think.


Thanks so much.
Love,
Cristi
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tex
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Post by tex »

Hi Cristi,

I'm thoroughly confused. Why does your doctor want you to take caprylic acid? It's an anti-fungal, used for treatment of a candida overgrowth. While it "might" help with the undesirable bacteria in your GI system, it is definitely contraindicated for patients with colitis, and/or any other GI tract inflammation. I thought you said that your culture tests showed no problem with yeast. So why does he want to treat you for a problem that you don't have, with a med that is contraindicated for colitis? Some doctors do weird things, don't they.

Personally, I would go with the cipro. When I was having major issues with uncontrollable D, (before starting the diet), I was given cipro twice, and both times, it stopped my D.

I have no experience with caprylic acid, but I would guess that it will add to the inflammation in your colon, and possibly in your ileum.

Love,
Tex
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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.
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Post by celia »

Tex, according to Wikipedia, caprylic acid is used to treat some bacterial infections. The type of testing that Cristi had done indicates which specific agents are effective for the specific bateria at hand, at least in vitro, so this probably explains the recommendation.

Cristi, that's TERRIFIC about your good bacteria!!!!! Although it looks like the bifobacteria need a little boost!

I wonder if it is this particular form/brand of caprylic acid (which, it looks like, is sourced from magnesium and calcium) that is counter-indicated for colitis (as it says on the website) or all forms of caprylic acid? Could it be the magnesium that is problematic in this brand which definitely can contribute to D? There are many different caprylic acid products, and I would check before assuming they all come from magnesium.

A great place to call to talk to knowledgeable people about supplements is NEEDS 1 800 634 1380, www.needs.com They provide supplements for people who are environmentally sensitive, so they really know their stuff about sensitivities and supplements. They could answer the above question about caprylic acid.

Is caprylic acid the only agent recommended by the test? There are many different types of antimicrobials, and the lab may not have test information on all of them. Paraguard is one excellent brand that you can ask you naturopath about as an alternative. Can you call and ask your naturopath to call the lab for their standard 15 minute consultation to discuss other options? Also, the lab typically recommends repeating the test in a certain number of weeks or so to confirm the finding, so you might want to consider that as an option too. The baterial in the gut are fluctuating all the time.

According to Jordan Rubin ND and Jospeph Brasco MD, coconut oil contains caprylic acid and lauric acid, supports the immune system and helps prevent bacterial, viral, and fungal infections. They says it reduces the symtpms of UC and Crohns, and he recommends it in the use of MC as well. It helps to balance the thyroid and improve metabolic function. It can be used to replace your regular cooking oil. Perhaps this might be a form that you could use that would not be counter-indicated. You would have to test it out to be sure it didn't exaccerbate the D.

I'm not encouraging you to do anything that would increase your D. or the inflammation. My husband has used coconut occassionally when he had proctitis (a form of colitis), not all the time though, and his proctitis is completely healed now. But if you get sufficient evidence that it's the caprylic acid that is counter-indicated for colitis, by all means listen to that advice.

The cipro might really do the trick and help the D. at the same time. However, antibiotics tend to destroy your good gut flora. I wouldn't take it without taking a good probiotic to replace the gut flora or your gut problems could be exaccerbated down the road. I beleive that taking a short course of antibiotics is the trigger to my rapid health decline in 2004. I use them with extreme caution.

Good luck with this!

Hugs, Celia
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Post by Sally »

This is probably a stupid observation, but here goes anyway. Aren't our intestines full of so-called "bad" bacteria as well as "good" and isn't that a "normal" state of affairs?

Now this is me and just me. When I was having trouble with UTIs I took Cipro for it. Pretty big doses. I have taken Culturelle for years. When I stop taking it because I run out or something, I can really feel it in terms of stomach rumbling and gas and even D. So...... My reasoning is that when I have to take Cipro I take double doses of Culturelle to make up for the action of the antibiotic on all bacteria. It works. For me.

My question is, wouldn't taking a pro-biotic with good bacteria overwhelm the bad bacteria and make the whole matter of taking caprylic acid moot?

This is all very confusing to me. I have a natural suspicion when any doctor wants to load me up with all kinds of meds. I ask her to go with the simplest solution first. We discuss it in great detail. I would take the Cipro with a good probiotic and hope for the best.

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Post by cludwig »

Hi All,

They did test the bacteria to see what would kill it and they came up with 4 antbiotics and 2 natural agents...caprylic acid and Uva Ursi. He said to go with the caprylic acid because theoretically it shouldn't harm the good bacteria but said although he has tried he has yet to see any studies proving this.

I'm still looking into this. He is also willing to go with the cipro if I want. So there seems to be two ways to get cipro...pill form which has some corn starch, or liquid form which has "strawberry flavoring" . I'm thinking that if I should choose the pill with the cornstarch as it's for a short time and probably won't be a problem. However, he doesn't have a problem with giving me a compounding prescripion...should I ask to do that and leave out the cornstarch?? I'm not sure which way to jump...but I'll definitely take a probiotic in both cases.

Sally, I'm not sure why my good guys aren't taking care of the bad guys...it seems there are enough of them to do it. The doctor said that one of the bacteria is uncommon and more difficult to kill ( I can't remember which one it was).

I have no idea why, but I'm leaning towards the cipro...so do you think i should ask to have it compounded without the cornstarch?

Thanks for your advice everyone.
Love,
Cristi
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Post by cludwig »

Hi Again,

Yet another question. The probiotics that he gave me is for acidophilus and bifidobacterium...no problem here. then it has 600 mg FOS. I seem to remember that us MCers don't do well with FOS. I've got to read these bottles more carefully while I'm in the doctor's office. I'm trying to listen carefully and absorb it all and forget to check out the contents carefully. So is my memory correct that FOS is risky for us?

Again..thanks so much.

Love, Cristi
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Post by tex »

Cristi,

I don't know much about FOS, but I don't recall ever seeing any evidence that is was contraindicated for MC. Here's an article suggesting that it should help:

http://www.ncbi.nlm.nih.gov/entrez/quer ... t=Abstract

Sally raises a very good point. The mere presence of "bad" bacteria is usually irrelevant. We are continuously exposed to various bacteria, and there are almost always many different types present in our digestive sysems. They only matter if they are present in large enough numbers to cause problems, (IOW, if they overwhelm the "good" bacteria). For most of us, they will probably never be a problem. The question is, are the "good" bacteria present in sufficient quantities to allow the digestive process to proceed normally.

Love,
Tex
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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.
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Post by cludwig »

Hi Tex,

So let me see if I understand what you guys think. Just because the two bad bacteria guys are too high doesn't neccessarily mean that I need to try to kill them off. Another approach would be to just use probiotics to see if introducing more good bacteria is enough to kill off the excess bad bacteria. If I understand you correctly...I'm thinking it wouldn't hurt to approach this conservatively and try this first as I can re test later and if it's not working ....go with the bigger guns.

I'm going to have to think about this further...but I like the idea of putting the least number of unpredictable variables into my body...especially if I start taking my thyroid medication ( soon I hope). Thanks for helping me think through all my options.
Love,
Cristi
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Post by celia »

Sally and Cristi,

Doesn't it depend on the degree of dysbiosis that the individual is experiencing? If you are strong, sure no problem. You can just offset the fact that the antibiotic kills the good bacteria by supplementing with a probiotic. But if you have a high level of dysbiosis, way more bad bacteria than good bacteria, it's not so easy to resore balance to the gut flora. I really don't think it's like bad bacteria, no big deal. It really depends on the individua and the pathogen in question.

Some practitioners do take the approach of supplementing with probiotics, even very high dose probiotics for specified periods. If that can bring you back into balance, great!

On these tests, a 4+ level is indicative of a pretty active level of a potential pathogen. Normally, they wouldn't treat a 1 or 2 or even 3 level in some cases.

Crisit, I think it might really help to get advice from someone who knows how to interprest these particular tests, if that's possible. The clinician at the lab can really tell you how seriously to take a 4+ level, but normally they will only speak with the doctor, not the client.

Good luck with this! Hugs, Celia
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Post by Sally »

Thank you all for taking my question seriously. I am always amazed by what I learn here. You CAN teach an old dog new tricks. :lol:

Love, Sally
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Post by celia »

Sally, What you said made total sense to me!

Just to clarify, having had a number of this type of test before, a doctor like Dr. Sherry Rogers, MD says that we should have way more good bacteria than bad bacteria...I forget what the actual percentage is...but tons more good bacteria...so that the bad bacteria don't even show up on a test like this. If they are showing up, then it's good to pay attention, especially at the plus 4 level. They may not be a pathogen yet, but can become one the more the numbers increase. Normally, the bad bacteria aren't pathogenic if they are kept at bay. It's only when they outnumber the good bacteria that they become potentially pathogenic.

Dr. Rogers talks about how to interprest these tests in her book No More Heartburn: Stop the Pain in 30 Days--Naturally! : The Safe, Effective Way to Prevent and Heal Chronic Gastrointestinal Disorders (Paperback)

This is THE number one best book I've read on treating gastro disorders, although she doesn't deal with MC specifically.

I don't think that addressing this bacteria will solve all of your problems Crisit, but it is one piece of the picture, and taking care of each piece adds up to better health!

Hugs, Celia
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Post by tex »

Not to cast aspersions on the good Dr. Rogers, but there seems to be a wide difference of opinon here on the "good/bad" bug ratio in the average gut. Here, for example is a quote from a site that leans toward "natural" methods of treatment:
In a healthy gut, you would expect to find around 3lb of bacteria with the so-called “friendly” ones making up a third of the population at best. At worst, and especially after the prolonged use of antibiotics or years of a diet that is too high in refined foods and sugar, levels of the good bacteria may be so low they are virtually undetectable.

Conditions caused by dysbiosis include IBS, acne, food allergies, Chronic Fatigue and depression - but you can help repopulate the good bacteria by eating foods that act as natural probiotics. These include bananas, artichokes, asparagus, and honey. You can also take a probiotic supplement and something called Fructo-oligosaccharides (FOS), which act as a “fast food” for these good bacteria.
Note that 3 pounds is slightly less than "tons", and the normal ratio of one good bug out of three, brings the total average weight of "good" bugs down to only around one pound, (definitely out of the "tons" catagory).

This quote comes from this site:

http://www.whatreallyworks.co.uk/start/ ... cle_ID=458

This was presumably written by Susan Clark, a self-proclaimed "award-winning UK health journalist, author & broadcaster". I say presumably, because it is a page from her site, and she describes herself as noted in quotes in the previous sentence.

Tex

P S I realize that a lot of "experts" claim that the ratio should be at least 85% probiotic bacteria, to 15% pathogenic bacteria, in order to minimize any risk of disease, but I wonder if that's a realistic figure, or just just an arbitrary goal, designed to sell probiotics, and/or treatment services. I'm wondering if anyone has actually researched this topic, and documented the findings.

P P S Cristi, without at least a rough estimate of the ratios of those pathogenic bacteria, to the total bacterial load in your GI tract, it's difficult to draw any worthwhile conclusions. The proticol for the type of test that was done may spell out a rough estimate of ratios, based on the results given, but one would have to be familiar with that particular test to be able to recognize that in the interpretation.

P P P S Celia, bacteria do not segue in and out of a state of pathogenicity, as far as the human GI tract is concerned. They are either probiotic, or pathogenic in nature, and this state never changes for the classification of a given species.
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Post by Matthew »

Early in my recovery I took a probiotic containing FOS that resulted in explosive diarrhea. Wondering why something so highly touted would cause such a reaction far worse than the D I was already experiencing I took a look around. Just as their is a research that highly promotes Soy products and other research that says it is the worst thing you can eat, just as their is research that indicates that whole grains are the best thing to eat and other research that says it it the worst so it is with
FOS. It has been a while since I looked but I found plenty of evidence that FOS promotes bacterial growth in the gut and equal evidence that it is not selective. In other words it promotes bad bacteria equally as well as it does the good bacteria.

Certainly the recent research that shows the close relationship of gluten intolerance and MC would indicate that a lot of food is going through the gut undigested because of damage to the villi. The unassimilated food along with warm moist conditions creating an ideal breeding ground for good and bad bacteria. The great results that so many of us have had with a gluten free diet, the Specific Carbohydrate Diet, or the Paleao diet that help the body repair the damage first, and eliminate high carbohydrate foods that when poorly digested breed bacteria also eventually brings the bacteria balance back to equilibrium.

My biggest concern is that taking all kinds of treatments to eliminate the bad bacteria without first addressing the real problem of what is causing it is kind of like throwing stones in a glass house. It may seem like you are doing something but when you are done the original problem is still the culprit and you then have to deal with the original problem along with all the side effects of the powerfull drugs, natural or otherwise, that have further disrupted the body’s ability to heal itself.

I highly recommend reading or rereading the first half of Elaine Gottschall’s Breaking The Vicious Cycle for a really comprehensive view of how the cycle starts.......and Ends

Love

Matthew
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Post by tex »

Mathew,

I have to agree with you. Thinking back, I believe that I have read more than one article that pointed out that FOS tends to be nondiscriminating in it's bacteria-nourishing properties. As you pointed out, it nourishes the bad, along with the good.

It might possibly speed up the repopulation process, (after the use of an antibiotic, for example), but the balance of power probably needs to be already established on the side of "good", before such a supplement is tried, lest the "evil" forces simply become stronger.

Also, some of us just may not be able to handle certain supplements like that, at certain stages in our recovery. On one occasion, for example, I tried an enzyme supplement, and it made me sick as a dog. Also, for a long time, the only sugar that I could tolerate was maple sugar.

Love,
Tex
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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.
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Post by cludwig »

Hi Mathew and Tex,

I've been thinking a lot about everyones suggestions ...re-read the beginning of Elaine Gottscall's book (was in the middle of major brain fog the first time I read it), and taking into account how incredably sensitive I am to anything...medicine, natural medicine, vitamins, alcohol...I've decided to give diet and time a chance to balance the gut bacteria.
The last two weeks I've felt better than I have since my surgery last November...and I think that it is only diet that has gotten me here. You guys clued me into the gluten link and then suggested I may need to get rid of all grains to feel better....which I did and am feeling sooo much better.

My BMs have not returned to before MC, they are all softly formed and more importantly I don't feel nearly as sick as I did. I think there is a good chance my hyperthyroidism is responsible for some of the remaining symptoms. I'm having to eat a lot more than before to not lose weight....as I'm eating my whole body gets so hot and I just sweat through my clothing. I think the increased metabolism is making my gut transit time too fast....which means even more undigested food is going through my system...feeding all those bacteria. So if I have to take meds, I think I should take the thyroid medicine first( if my doctor would ever get me the prescription).

Again, you guys are great to help me think about all the possibilities before I make a decision.Thanks you so much.

Love
Cristi


PS. This is my pooch Strider. He's been my loyal companian while I've been sick.
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