Faecal transplant effectively treats recurrent or unresponsive Clostridium diff

https://discover.dc.nihr.ac.uk/portal/article?id=SIG-5000506&utm_content=buffere8198&utm_medium=social&utm_source=twitter.com&utm_campaign=buffer

by DanBC • 9 years ago

106 49 9 years ago

discover.dc.nihr.ac.uk

cpncrunch11• 9 years ago

No it doesnt. Placebo controlled trials show it has no effect. Im surprised at the nhs for this shoddy review.

linkmotif• 9 years ago

You mean shitty review?

dang• 9 years ago

Would you please stop posting unsubstantive comments to HN? We're trying for better than that here, and I'm sorry to see that you've done it before.

elsherbini• 9 years ago

Here's a randomized trial with placebos that did work. I wasn't able to find one where it didn't work.

http://annals.org/aim/article-abstract/2545886/effect-fecal-...

cpncrunch11• 9 years ago

I submitted on a while back. Will check later if people reverse the downvotes and assume good faith.

cpncrunch11• 9 years ago

That's the study I was referring to. You'll see that there was no difference between donor and placebo in the NY group.

jimrandomh• 9 years ago

Checking the meta-analysis paper on sci-hub, Fig. 2 has 7 RCTs, all of which found large effect sizes. I think you're simply mistaken.

http://sci-hub.bz/http://onlinelibrary.wiley.com/doi/10.1111...

cpncrunch11• 9 years ago

I think you didnt read it. It says there were no placebo controlled trials.

ipunchghosts• 9 years ago

Are you thinking of IBS?

cpncrunch11• 9 years ago

No, Clostridium difficile (Kelly et al, 2016, as discussed in the comments above).

jacobkg• 9 years ago

I have had C Diff. It is extraordinarily unpleasant. In addition to the normal symptoms it also came with extreme fatigue and a weird sense of doom about the future. The antibiotics need to be taken every 6 hours (limiting your ability to sleep) and gave me really creepy dreams. Being stuck with recurrent C Diff sounds miserable and I'm so glad that people in that position have a way out

srednalfden• 9 years ago

I don’t want to make you relive the dreams, but can you elaborate on “creepy”?

superb_herb• 9 years ago

I have “creepy” dreams or nightmares that ruin restful sleep. They are exceptionally vivid and nightmarish: horrifying scenarios involving people I love, painfully realistic doomsday scenarios, all kinds of death, monsters who look like people but with horrifying deformities...

PoachedSausage• 9 years ago

Think of the most weird fever dream you've had and that is probably similar.

I think one of the stranger fever dream I've had was sometime in college when I was learning about complex numbers, the red standby LED on the TV in my room seemed to be a portal into the complex plane one feverish night.

Having also tried a number psychedelics, fever dreams do have quite a different quality to them.

bitwize• 9 years ago

One time I dosed up on pseudoephedrine to help with a particularly nasty flu, fell asleep, and dreamed I was watching a disturbing cartoon. It was very slapstick and "wacky", like a Tex Avery cartoon, but something was... off about it, and it was horrifying.

maxxxxx• 9 years ago

I know two people who had serious problems for many years and recovered after doing fecal transplants. Placebo or not, I would recommend it to people who can't be helped by regular medicine. Certainly worth a try.

cdiffthrow• 9 years ago

Throwaway account -- I had recurrant c-diff for the better part of 2 years. For a while I had accepted that I would just be taking Vancomycin for the rest of my life. Thankfully I was able to get into a study at the U of Minnesota doing transplants. The first one didn't 'stick' and the c-diff repopulated within 6 months, but after the second one I've been clear of it. Horrible stuff. Worsened my Crohn's disease by a large amount.

jesperlang• 9 years ago

This is a super interesting topic but the cynical side of me thinks it doesn't get enough attention because you can't patent bacteria(?)..

For more on this, checkout the work of Martin Blaser

https://www.youtube.com/watch?v=KwK_O0ahDKo&t=168

jungletime• 9 years ago

I wonder to what extent is Obesity contagious. If you can improve your gut bacteria, surely you can make it worse. Can you pick up gut bacteria from Obese people. Maybe going to the gym helps you lose weight because you touch surfaces and pick up bacteria from fit people. And so on. Just conjecture.

toomuchtodo2• 9 years ago

I don’t think obesity itself is contagious (unless you’re mucking about in an obese person’s fecal matter). My hunch is antibiotic usage disrupts your gut biome enough that it pushes your energy extraction balance off, causing obesity.

As a society, we abuse antibiotics in the aggregate (demanding it from health care providers and pouring it into factory farms). It can’t possibly not be disrupting our guy biome.

It also doesn’t help that the sugar lobby/industry is so powerful, and sugar/corn syrup is in everything.

eru2• 9 years ago

I don't think it's the energy extraction that's changing, but people's set points for weight.

It also doesn’t help that the sugar lobby/industry is so powerful, and sugar/corn syrup is in everything.

Corn syrup ain't good, but we have fat people in other parts of the world, too.

xinyhn• 9 years ago

Seems like in the next few years might see some more information about fecal transplants for obesity.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5045147/

not_that_noob• 9 years ago

There is ongoing investigation in this area on mother-child transfers of gut bacteria that may influence body weight. The evidence seems to be pointing to diet influencing the type of bacteria that thrive in the gut - so my gut (ha ha) says that a few bacteria entering the gut won’t change things - you need to more or less farm them.

stevebmark• 9 years ago

Fluoroquinolone antibiotics (cipro, levaquin, etc) are dangerous and horrific, and irreversibly destroy gut bacteria. This article is about fluoroquinolones, which are well documented to cause C.Diff infections because they destroy most gut bacteria except C.Diff, allowing it to overrun.

ilamont• 9 years ago

After initial “cure” of Clostridium difficile with antibiotics, about 15-25% of patients develop a recurrence within a few days to several months. The chance of a recurrence depends in large part on the type of antibiotic being taken, such as Flagyl, Vanco, or Dificid, as well as the age of the patient.

This repeat infection can keep on recurring, even after multiple courses of antibiotics. We have seen some unfortunate patients with 10 or more attacks of C. diff in a two-year period. It can lead to chronic diarrhea, weight loss, and diminished quality of life.

We think that recurrence of C. diff depends on a “Perfect Storm” of several factors:

1. Simultaneous failure of the immune system with inadequate antibody formation

2. Failure of the colonic flora to regenerate, owing to exposure to antibiotics.

Failure of the immune system to generate an antibody response is quite common after age 60. The older the patient, the weaker the response to an infection or to vaccination

http://cdiff.in30minutes.com/recurrent-c-diff-why-does-c-dif...

chmike• 9 years ago

I new someone with serious repetitive (daily) diarrhea. Not treatment helped and it lasted for years. Doctors had no solution. Don't know if it was Clostridium Difficile. It started after taking a medication.

One day, a solution was found on Internet. It was to eat cheese made with raw milk. After three months eating various cheese with raw milk every day, the person had no more diarrhea. This has to be done in country with strict health control on cheese production.

phonon• 9 years ago

Drinking Kefir is easier and better.

kazinator• 9 years ago

Ancient Chinese yellow soup!

https://en.wikipedia.org/wiki/Fecal_microbiota_transplant#Hi...

Orally administered, too.

amelius• 9 years ago

There seems to be a correlation between gut balance and lifespan, in animal models, [1]. I wonder if a suitable fecal transplant could (somehow) promote longevity.

[1] https://www.sciencedaily.com/releases/2014/01/140116130646.h...

BVthrowaway• 9 years ago

I recall reading a similar clinical trial involving bacterial vaginosis. In BV, vaginal bacteria are imbalanced and thus it was hypothesized that transplanting healthy flora would be helpful.

Faecal transplant effectively treats recurrent or unresponsive Clostridium diff

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