New poo for you!

Kristin Fleider-Zoph, PT

NOVEMBER 29, 2018


You are probably asking yourself right now, do I need new poo? What is wrong with the poo I have?

Believe it or not there are clinical examples of what constitutes good or normal stool compared to poor or abnormal stool. Many people think that stool or fecal matter is a waste product that is full of bacteria and microorganisms that cause infectious diseases. However, today it is becoming increasingly evident that bacteria and organisms living in our colon play a key role in keeping us healthy. The bacteria that exist in the stool actually improve human immunity, digestion and metabolism.

The reason many individuals may need to improve their stool is that the “good” bacteria found in their colon has been disrupted or suppressed. This can happen for a number of different reasons. For example, a person may have had food poisoning or been on antibiotics which has caused an imbalance of the bacteria in the colon. When the bacteria is disrupted, the individual is exposed to small bacteria called Clostridium Difficile or more commonly known as C.diff the “bad bacteria”.

Clostridium DifficileC.diff is found all around us. It’s found in the air, soil, water and in the fecal matter of animals and humans. Many people have C.diff in their intestines without having any symptoms. The problems may occur when antibiotics are prescribed which actually kill the healthy bacteria changing the flora or microbiota of the colon. This allows C.diff to overpopulate the colon. This condition is known as C.diff Colitis, which can become very debilitating and often leads to chronic diarrhea, fever, nausea and abdominal pain. More than 500,000 cases are reported annually each year in the US with 29,000 deaths per year. If untreated, this can lead to death particularly in the elderly and those with a compromised immune system.

The common treatment for C.diff infection is MORE antibiotics (Metronidazole or Vancomycin ) but this can often be ineffective for 15% to 26% of people. When a doctor prescribes an antibiotic a second time due to reoccurrence of C.diff, it is ineffective up to 40% of the time and continues to be less effective each new occurrence. Sometimes the individual may be considered cleared from the C.diff condition by having exhibited no C.diff in their stool or cultures but continue to have residual symptoms of abdominal bloating, nausea, constipation and /or abdominal and pelvic pain. Today there is a treatment to provide individuals with new stool, a way to reset the balance of bacteria to the colon.

The process to get new stool is called Fecal Microbiota Transplant (FMT). FMT is a procedure in which fecal matter is collected from a healthy donor then mixed in a saline solution and placed inside the patient by way of a colonoscopy, endoscopy, sigmoidoscopy or enema. Stool transplantation can bring back a healthy balance of microorganisms (microbiota) to the colon. Over the past few years, there have been several clinical studies that show fecal transplantation can work quite well, restoring normal function to the patient.

Fecal transplantation is not a new process. In fact it was often mentioned in fourth century Chinese medical literature for treating food poisoning and severe diarrhea. In other areas of the world, it is custom for newborn infants to receive a small amount of their mother's stool by mouth. This is thought to give the baby’s immune system a “jump start”.

Clostridium DifficileThe fight against C.diff and the contraction of bad bacteria begins with you. Prevention is the key to most diseases. It begins with thorough and frequent hand washing, cleaning fresh foods like fruits and vegetables and keeping cooking surfaces and utensils clean. To help keep your “gut” healthy, avoid processed foods, refined sugars and foods with trehalose, a sugar additive that was, in 2000, approved by the FDA for use in our foods. In 2018 a study published by Nature found that trehalose might give C.diff bacteria an extra source of food, so their numbers multiply significantly.

Another way to help prevent C.diff from causing an imbalance in your colon is to make sure you take a probiotic when taking a broad spectrum antibiotic for any type of infection. The probiotic should have a high number of Colonizing Forming Units (CFU’s). CFU’s are good bacteria that help with maintaining a healthy colon. You may also want to take a prebiotic which is a non-digestible carbohydrate that serves as a food source for your probiotic in your intestinal tract. Taking supplements like vitamin D, A, B and Omega 3 help build your immunity system and also help reduce inflammation.

Current research is being done to develop fecal transplant pills that may become a new cutting edge treatment for C.diff patients. This revolutionary pill treatment may have advantages over the current FMT procedure as it would ultimately eliminate the need for patient sedation and be less invasive. Research is also finding that stool transplantation may be valuable in treating other conditions associated with the colon, such as inflammatory bowel disease (Crohn’s) and IBS. Soon it may be proven to help even with obesity, Type II diabetes, constipation and pelvic pain.

Clostridium DifficileIf you have been plagued by C.diff in the past or have residual symptoms of lower abdominal and/or intestinal discomfort, bloating, constipation, pelvic pain, bowel urgency or incontinence, you may have an associated pelvic floor dysfunction. A physical therapist who specializes in pelvic floor disorders cannot cure C.diff, but can work with these conditions to help alleviate pain, and discomfort, address muscle dysfunction, and improve quality of life.

Our “gut” (colon/intestines) does more than perform digestion. The “gut” can alter our mood and play a key role in many diseases and disorders. It is often considered our “second brain” which can have a mind of its own. Research is continuously being conducted to help understand and determine the full impact our “gut” plays in our everyday lives both physically and mentally.

So as the saying goes …“Trust Your Gut” and keep it healthy.


References

My Health Alberta – Government of Alberta
Image by Healthwise Incorporated

The Bottom Line UCSB – Joanne Rhee
Illustration by April Gau, Staff Illustrator

Henning Gerke, MD University of Iowa Hospitals and Clinics
Does Fecal Transplantation Hold the Secret to Future Cures?

Bruce Y. Lee, Contributor – Forbes / Pharma & Healthcare
June 2018, “The Latest Poop on Fecal Transplants Vs. Antibiotics for C. Difficile Diarrhea”

GI Society of Intestinal Research – Newsletter Issue 191-2014

F. Perry Wilson, MD – Yale University School of Medicine
Bottom Line Newsletter – June 15, 2018 - “When Ice Cream Turns Deadly”

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