Why FMT Fails Some People

Some new research into why FMT fails for some people:

“Although [FMT] is a powerful therapy for individuals who develop recurrent CDI (rCDI), 10% to 15% of patients still fail to recover following FMT”

Researchers have identified a number of risk factors for treatment failure after fecal microbiota transplantation (FMT) for Clostridioides difficile infection (CDI), some of them modifiable.

“In univariate analyses, poor cleansing of the transverse colon (P=0.043) and narcotic use were significant predictors of rCDI after successful FMT (P=0.039).”

“In multivariate analyses, the presence of diabetes predicted initial FMT failure (odds ratio [OR], 0.03; 95% CI, 0.001-0.81), and failure to deliver transplanted stool to the terminal ileum predicted rCDI after initial success (OR, 0.81; 95% CI, 0.66-0.99).”

“Of 26 different risk factors identified in the studies, the current meta-analysis identified inpatient FMT administration (OR, 5.2; 95% CI, 3-8.92), older age (OR, 1.05; 95% CI, 1.021-1.086) and the presence of IBD (OR, 5.2; 95% CI, 2.53-10.67) as predictors of failure. Other predictors of FMT failure included early antibiotic use after FMT (OR, 4.73; 95% CI, 1.77-12.65), immunosuppression (OR, 3.85; 95% CI, 1.85-8), higher Charlson Comorbidity Index scores (OR, 1.34; 95% CI, 1.1-2.87) and the presence of pseudomembranes at the time of FMT (OR, 4.681; 95% CI, 1.79-12.25).”

research

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This article was in my morning reading feed. I have worked really hard on chewing properly! It’s amazing what a difference that makes. It’s helped with acid reflux and with general digestion. I take much more time to eat now than before. Such a small thing but big difference. I’ve also been careful about the times of day I eat, and I’m a big fan of the benefits of fiber (as many of you have heard me say over and over). There’s some good points here about sleep and stress (and general mental health and we’ll being).

The one thing I haven’t heard of or tried is Panta Bhat (fermented rice). Obviously, I know fermented foods are good for digestion and for a healthy gut, but I had never heard of fermented rice. Super simple to make, so I might give it a try.

On a different note, I’m over 9.5 months post-treatment. This time of year is when I first started getting sick. My first antibiotic was prescribed August 31. It was all downhill from there! Stress is real right now with my work life, so I’m trying to remember to manage that because it’s important for my gut. I’ve been using Banatrol as a preventative pretty regularly lately just because I don’t think my mental health can handle any PI-IBS flares right now. Anyway…onward!

https://www.freepressjournal.in/lifestyle/8-best-ways-to-improve-your-digestion

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C-Diff: Stopping the Spread

From my morning reading feed, here’s a slightly different take. We already know that Vancomycin and Fidoxamycin have show superior clinical results (i.e. better cure rate, less chance of relapse) than Metronidazole, which is why treatment guidelines have changed. And of course that’s important to us as individual patients. But according to this study, treating with Vancomycin or Fidoxamycin is also better for decreasing transmission because they decrease shedding of spores more quickly than Metronidazole. That’s important in hospitals and assisted living facilities especially. So, these treatment options are better for individual patients and better for the community. #research

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Stress, c-diff, PI-IBS

Can stress cause a PI-IBS flare? Absolutely! Could it even make you more susceptible to bad bacteria (like c-diff)? Yup. Can it make active c-diff symptoms worse? Also yes. I’ve know all that to be true based on my own experience and other reading. It’s why I’ve focused so much on not just diet but also lifestyle changes. I know I had high stress when I first contracted c-diff. I know it played a role in my illness. I believe had I not been so stressed, I might never have even gotten sick…or at least it wouldn’t have been so bad.

But it’s always nice to have a little medical expert back-up, right? So…from this article in my morning reading feed:

➡️ “Stress very directly impacts gut health because it impacts the trillions of microbes that live within our digestive tracts, collectively known as the gut microbiome.”

➡️ “…stress changes the way the gut functions, which affects the bacteria balance. Your gut microbiome can also impact your mental health through the gut-brain axis.”

➡️ “…stress can actually enhance bad bacteria — meaning that the bacteria could cause even more harm to the gut than if you weren’t experiencing stress.”

➡️ “Stress can wreak havoc on your stomach, often at the most inconvenient times like before a big meeting or when you’re working overtime. This happens because stress changes the way your digestive tract functions.”

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PPIs and CDI

I’m just gonna leave this right here. Some points of interest:

👉 “The authors noted that in Europe and the United States, an estimated 20% to 30% of CDIs (clostridioides difficult infections) are now believed to originate in the community, rather than the clinic.”

This is a substantial increase. Previously, most CDI originated in hospitals or assisted living facilities and mainly affected the elderly. That’s simply no longer true. Case in point: me.

👉 “Patients prescribed proton pump inhibitors had roughly double the risk of community-associated Clostridioides difficile infection compared with those not taking the drugs.”

👉 “Patients who use proton pump inhibitors face a moderately increased risk of community-associated Clostridioides difficile infection (CDI), and the risk can persist for up to a year following the treatment, according to new research.”

I tossed the PPI I was prescribed once I learned it was a risk factor for recurrence. Not worth it. I had only started it sometime in the last year. I’d had heartburn on and off for years. And took Ranitidine (an H2 blocker) for years. Some people told me that wasn’t how the drug was meant to be used. But my doctor prescribed it, so I thought it was fine. Then Ranitidine got yanked off the market. I dealt with it. I still had Tums, or I’d pop some Famotidine if needed. Then I talked to my doctor about how sometimes when I was working out hard and going down to the floor and back (hello, burpees), it felt like everything was sliding up my throat and about to come out. Like maybe I’d vomit. So she said, “let’s try Omeprazole.” She told me it was a different kind of heartburn medicine, explained basically how it worked, that was all. Ok, cool. I took it. But not religiously honestly. So IDK how much of a contributing factor it was in contracting c-diff…but it could have been a factor. I mean, the antibiotics were the main culprit, and alone they could have done it, but they also might have had a solid assist from the PPI and its impact on my gut.

So anyway: patient beware the PPI script, especially for long-term use. And especially if you need antibiotics regularly for some reason. Ask questions. No offense to my friends in the medical field, but don’t take what they say as gospel truth…or the fact that they offer no warnings imply there’s not a reason to beware. They’re only human too.

Today I manage without medication. Natural aids for indigestion as needed, diet & lifestyle changes (including protecting my lunch time at work…so if we work together, sorry no more sacrificing it for meetings).

Article: https://www.ajmc.com/view/proton-pump-inhibitors-appear-to-heighten-community-associated-c-diff-risk

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Milestone: first meal out

ETA: Update: I SO wanted this to be a success. But at around the 24 hour mark, it became clear it was not. On the upside, unlike with previous attempts, there wasn’t the terrible, painful abdominal pain. So I guess that’s still a win(ish). 🤷🏼‍♀️😭

First meal out in over a year and a half. We walked around downtown and passed on 4-5 restaurants after checking the menus. Settled on Shortfields. I had a turkey burger with feta cheese and sauteed spinach and mushrooms with a plain baked potato. I kept the lettuce and tomato off. It was so good. And so nice not to have to make a meal! Fingers crossed it’s still good tonight and tomorrow, but so far this is a success, and I am grateful for that!

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Filed under C-Diff, Healing 2021, Practicing Gratitude

I’ve said a number of times that the practice of gratitude has been key in my healing and recovery. It especially helped with the post-infection anxiety/PTSD. Even during this latest PI-IBS flare, it helped me. Every night, I list at least three things I’m grateful for. I spend my day looking for those things. It makes a big difference in my emotional and mental well-being.

From this article (courtesy of the gratitude app this AM): “Simply being grateful can give your mood a big boost, among other benefits. For example, a recent two-part study found that practicing gratitude can have a significant impact on feelings of hope and happiness.”

The gut-brain connection is real. Research and my own experience has taught me one can impact the other: a lot! I really believe this healing journey is mental, emotional, and physical. So if you need a reminder this morning to take care of yourself, here ya go! Mind, body, spirit: you got this! 💜

I’m grateful my zinnias are blooming!

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Back to Basics: Kitchari

I’m having a rough week. My gut is too. Or my gut is having a rough week and therefore so am I. Tomato-tomato.

So tonight I made a pot of kitchari to try to reset my gut, resolve some lingering pain and discomfort, and feel better.

As I’ve mentioned before kitchari was one of the first real meals I could eat after treatment. In addition to being gentle on the gut and easy to digest, kitchari has a number of nutritional benefits to promote healing.

For example, Moong or mung beans are incredibly beneficial. Read about 10 major health benefits here. Most notably for c-diff recovery: “Mung beans contain soluble fiber and resistant starch, which can promote digestive health. The carbs in mung beans are also less likely to cause flatulence than those of other legumes.”

Here’s hoping a quick kitchari cleanse gives my body the break it needs to get back to normal (or what counts as normal these days anyway).

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Health Benefits of Oatmeal

This article was in my morning news feed. Oatmeal has a lot of health benefits! I am still eating overnight oats bran most mornings. Important to us recovering from c-diff or working on gut health:

北 “Oatmeal also contains soluble fiber which can help lower cholesterol and blood sugar levels. In addition, the fiber helps keep your intestinal system regular, and we know regular bowel movements are important.”

北 “Oatmeal contains high levels of polyphenols, an antioxidant.”

北 “Oatmeal contributes to a healthy gut.”

I read a lot about polyphenols when I picked up Dr. Mark Hyman’s book. He thinks they’re very important. They are actually a prebiotic! Here is a link to a study on polyphenols and their effect on the gut. A lot of science-y jargon, but a key point: “…dietary polyphenols present prebiotic properties and exert antimicrobial activities against pathogenic GM, having benefits in distinct disorders.” It also says they have anti-inflammatory properties. Link: https://bit.ly/3jD8jCb

Overnight oats in the car!

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New Book on C-diff

This article was in my lunchtime news feed.

🗞️ A three-time C. diff. Survivor and Registered Dietician publish book for patients, families, and caregivers impacted by Clostridioides difficile.

🗞️ The book will answer the many questions focused on C. difficile infections, C. difficile prevention, home environment cleaning, nutrition, while introducing the readers to the microbiome and clinical trials.

I checked Amazon, and the book is only $4.99 on Kindle. I have found the C-diff Foundation to be a valuable resource. I also did one of the free telesupport sessions with the dietician who is co-author of this book.

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