This question is directed at Dolittle and Sadman:
Many years ago I worked with a young fellow who always had terrible bad breath. Everyone knew it, but he was a fun guy, always joking around, and he was never offended by anyone.
One day he got married (God knows how he managed that?), but when he came back from his honeymoon there was no more bad breath. It was completely gone. All these years I have wondered how this can be. My theory was that his wife's beneficial oral microbiology was transferred to him during kissing and the good bacteria took hold in his mouth and overwhelmed the anaerobes. Is this possible?
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Saliva Transplant?
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Phantasist
- Sheriff
- Posts: 484
- Joined: Wed Jul 21, 2010 8:32 pm
Phantasist
Let me give you some idea how they do Fecal Transplant :
Fecal Transplant May Treat Stubborn C. diff
Study Shows Procedure Can End Symptoms of Diarrhea
By Kathleen Doheny
WebMD Health News
Reviewed by Laura J. Martin, MD
Oct. 31, 2011 -- It may sound gross, but using fecal transplants can treat stubborn intestinal infections caused by the bug Clostridium difficile(C. diff).
As the name implies, fecal transplant involves taking the stool of a healthy person and putting it into the colon of an infected person. The goal is to restore the natural balance of good and bad bugs in the gut and eliminate the bothersome diarrhea.
"Ick" factor aside, it works, a new study suggests. "Fecal transplantation is a highly effective, well tolerated, and safe form of therapy for this traditionally difficult infection," study researcher Lawrence Brandt, MD, emeritus, chief of gastroenterology at Montefiore Medical Center, tells WebMD.
His team found that 91% of 77 patients who received the transplants got rid of their diarrhea, sometimes within three days, after one treatment.
The research is being presented at this week's American College of Gastroenterology's annual scientific meeting in Washington, D.C.
The procedure is technically called fecal microbiota therapy (FMT).
About 500,000 people in the U.S. are infected with potentially life-threatening C. diff each year, usually after taking antibiotics, Brandt says. Doctors think the antibiotics upset the natural gut balance and trigger the C. diff growth.
Many patients are elderly and in hospitals or nursing homes. C. diff live on bathroom fixtures and medical equipment. The bacteria can be spread person to person from contaminated hospital equipment or from the hands of health care providers.
However, recent research finds that hospital-acquired C. diff has leveled off while C. diff in the community is on the rise. For some, the typical round of antibiotics targeted to treat the C. diff infection does not provide relief. Or, it provides short-term relief and the infection returns.
Tracking Results of FMT
Brandt and his colleagues tracked down 77 C. diff patients -- 56 women and 21 men -- who had FMT done at least three months before at five different centers. The average follow-up time was 17 months and ranged from three months to more than five years.
Their average age was 65.
The patients had had the infection an average of 11 months before undergoing the FMT. They had, on average, taken five courses of antibiotics or other treatments without relief.
Many reported severe fatigue, 20-pound weight loss, and more than six bouts of diarrhea a day.
The FMT was done by colonoscopy (insertion of a lighted flexible tube into the colon), a common method, Brandt says.
After the fecal transplant procedure, patients answered a detailed questionnaire. The results:
At the three-month mark, 70 of 77 patients (91%) reported no diarrhea, considered a treatment success.
Another four recovered after an additional course of antibiotics.
Another two recovered after receiving both more antibiotics and another fecal transplant. That brought the total success rate to 76 of 77. The other patient, in hospice care, died.
Diarrhea resolved on average in six days, sometimes as quickly as in three. Fatigue went away in about a month.
No complications or side effects were reported. The cost of the procedure, which is currently done by a limited number of doctors, is often less than what several rounds of expensive antibiotics could cost, Brandt tells WebMD.
For the FMT, the main charge is the cost of the colonoscopy, which is often covered or partially covered by insurance. Colonoscopy can cost several hundred dollars or more. Among possible complications are tearing of the colon.
FMT is not new. The first successful use was reported in 1958, with a transplant done by enema. In the U.S., the first case of FMT done by colonoscopy was reported in 2000.
Researchers try to get a stool sample from someone close to the patient, such as a spouse. They believe the healthy person will have exposure to some of the same bacteria, living in the same environment, so their stool will be a good match.
Before transplant, the donor's sample is screened for hepatitis, HIV, and syphilis, Brandt says.
Second Opinion
Martin H. Floch, MD, MS, clinical professor of medicine at Yale University, says that the process is simple. He reviewed the study findings for WebMD.
Although the new study reported no complications, Floch says it is possible some could develop later.
He cautions that the donor stool must be thoroughly screened to avoid disease transmission.
Overall, however, he considers the results good news. The 91% success rate, he says, is ''terrific. Nine out of 10 people doing this succeed, and remember these are resistant cases."
Although more study is needed, he says FMT should be viewed as a successful therapy for stubborn cases when medications don't work.
As you already mentioned , a number of members in this forum have reported that their bad breath problem started right after a course of antibiotics just as Dysbiosis of the gut usually happened after antibiotic use . My theory is that if that's the cause of halitosis , a saliva sample from someone who lives in the same environment with the patient at the time the halitosis occurred will have exposure to some of the same bacteria , thus will be a good match and can help the patient to restore their normal oral microflora . A replacement with just one type of bacteria such as S. Salivarius will not be suffice .
The sad thing is that we do not know what causes the Dysbiosis in the mouth yet .
Dysbiosis (also called dysbacteriosis) refers to a condition with microbial imbalances on or within the body. Dysbiosis is most prominent in the digestive tract or on the skin, but can also occur on any exposed surface or mucous membrane such as the vagina, lungs, mouth, nose, sinuses, ears, nails, or eyes. It has been associated with different illnesses, like inflammatory bowel disease[1][2] and chronic fatigue syndrome.[3]
In small amounts the microbial colonies found on or in the body are benign or beneficial in most cases. These beneficial and appropriately sized microbial colonies carry out a series of helpful and necessary functions. They also protect the body from the penetration of pathogenic microbes. These beneficial microbial colonies also compete with each other keeping one another in check so no specific microbial colony dominates.
When this balance is disturbed, by such diverse things as repeated and inappropriate antibiotic exposure[4] or alcohol misuse,[5][6] these colonies exhibit a decreased ability to check each other's growth. This can lead to an overgrowth of one or more of the disturbed colonies which then may damage some of the other smaller beneficial ones.
This type of situation often instigates a vicious cycle. As more beneficial colonies are damaged, making the imbalance more pronounced, more overgrowth issues occur since the damaged colonies are less able to check the growth of the overgrowing ones. If this goes unchecked long enough, a pervasive and chronic imbalance between colonies will set in, which ultimately minimizes the beneficial nature of these colonies as a whole.
Microbial colonies also excrete many different types of waste byproducts. Using different waste removal mechanisms, under normal circumstances the body effectively manages these byproducts with little or no trouble. Unfortunately, over-sized and inappropriately large colonies, due to their increased numbers, excrete increased amounts of these byproducts. As the amount of microbial byproducts increases, the higher waste byproducts levels can overburden the body's waste removal mechanisms.
It is the combination of these two negative outcomes that causes many of the negative health symptoms observed when dysbiosis is present.
Let me give you some idea how they do Fecal Transplant :
Fecal Transplant May Treat Stubborn C. diff
Study Shows Procedure Can End Symptoms of Diarrhea
By Kathleen Doheny
WebMD Health News
Reviewed by Laura J. Martin, MD
Oct. 31, 2011 -- It may sound gross, but using fecal transplants can treat stubborn intestinal infections caused by the bug Clostridium difficile(C. diff).
As the name implies, fecal transplant involves taking the stool of a healthy person and putting it into the colon of an infected person. The goal is to restore the natural balance of good and bad bugs in the gut and eliminate the bothersome diarrhea.
"Ick" factor aside, it works, a new study suggests. "Fecal transplantation is a highly effective, well tolerated, and safe form of therapy for this traditionally difficult infection," study researcher Lawrence Brandt, MD, emeritus, chief of gastroenterology at Montefiore Medical Center, tells WebMD.
His team found that 91% of 77 patients who received the transplants got rid of their diarrhea, sometimes within three days, after one treatment.
The research is being presented at this week's American College of Gastroenterology's annual scientific meeting in Washington, D.C.
The procedure is technically called fecal microbiota therapy (FMT).
About 500,000 people in the U.S. are infected with potentially life-threatening C. diff each year, usually after taking antibiotics, Brandt says. Doctors think the antibiotics upset the natural gut balance and trigger the C. diff growth.
Many patients are elderly and in hospitals or nursing homes. C. diff live on bathroom fixtures and medical equipment. The bacteria can be spread person to person from contaminated hospital equipment or from the hands of health care providers.
However, recent research finds that hospital-acquired C. diff has leveled off while C. diff in the community is on the rise. For some, the typical round of antibiotics targeted to treat the C. diff infection does not provide relief. Or, it provides short-term relief and the infection returns.
Tracking Results of FMT
Brandt and his colleagues tracked down 77 C. diff patients -- 56 women and 21 men -- who had FMT done at least three months before at five different centers. The average follow-up time was 17 months and ranged from three months to more than five years.
Their average age was 65.
The patients had had the infection an average of 11 months before undergoing the FMT. They had, on average, taken five courses of antibiotics or other treatments without relief.
Many reported severe fatigue, 20-pound weight loss, and more than six bouts of diarrhea a day.
The FMT was done by colonoscopy (insertion of a lighted flexible tube into the colon), a common method, Brandt says.
After the fecal transplant procedure, patients answered a detailed questionnaire. The results:
At the three-month mark, 70 of 77 patients (91%) reported no diarrhea, considered a treatment success.
Another four recovered after an additional course of antibiotics.
Another two recovered after receiving both more antibiotics and another fecal transplant. That brought the total success rate to 76 of 77. The other patient, in hospice care, died.
Diarrhea resolved on average in six days, sometimes as quickly as in three. Fatigue went away in about a month.
No complications or side effects were reported. The cost of the procedure, which is currently done by a limited number of doctors, is often less than what several rounds of expensive antibiotics could cost, Brandt tells WebMD.
For the FMT, the main charge is the cost of the colonoscopy, which is often covered or partially covered by insurance. Colonoscopy can cost several hundred dollars or more. Among possible complications are tearing of the colon.
FMT is not new. The first successful use was reported in 1958, with a transplant done by enema. In the U.S., the first case of FMT done by colonoscopy was reported in 2000.
Researchers try to get a stool sample from someone close to the patient, such as a spouse. They believe the healthy person will have exposure to some of the same bacteria, living in the same environment, so their stool will be a good match.
Before transplant, the donor's sample is screened for hepatitis, HIV, and syphilis, Brandt says.
Second Opinion
Martin H. Floch, MD, MS, clinical professor of medicine at Yale University, says that the process is simple. He reviewed the study findings for WebMD.
Although the new study reported no complications, Floch says it is possible some could develop later.
He cautions that the donor stool must be thoroughly screened to avoid disease transmission.
Overall, however, he considers the results good news. The 91% success rate, he says, is ''terrific. Nine out of 10 people doing this succeed, and remember these are resistant cases."
Although more study is needed, he says FMT should be viewed as a successful therapy for stubborn cases when medications don't work.
As you already mentioned , a number of members in this forum have reported that their bad breath problem started right after a course of antibiotics just as Dysbiosis of the gut usually happened after antibiotic use . My theory is that if that's the cause of halitosis , a saliva sample from someone who lives in the same environment with the patient at the time the halitosis occurred will have exposure to some of the same bacteria , thus will be a good match and can help the patient to restore their normal oral microflora . A replacement with just one type of bacteria such as S. Salivarius will not be suffice .
The sad thing is that we do not know what causes the Dysbiosis in the mouth yet .
Dysbiosis (also called dysbacteriosis) refers to a condition with microbial imbalances on or within the body. Dysbiosis is most prominent in the digestive tract or on the skin, but can also occur on any exposed surface or mucous membrane such as the vagina, lungs, mouth, nose, sinuses, ears, nails, or eyes. It has been associated with different illnesses, like inflammatory bowel disease[1][2] and chronic fatigue syndrome.[3]
In small amounts the microbial colonies found on or in the body are benign or beneficial in most cases. These beneficial and appropriately sized microbial colonies carry out a series of helpful and necessary functions. They also protect the body from the penetration of pathogenic microbes. These beneficial microbial colonies also compete with each other keeping one another in check so no specific microbial colony dominates.
When this balance is disturbed, by such diverse things as repeated and inappropriate antibiotic exposure[4] or alcohol misuse,[5][6] these colonies exhibit a decreased ability to check each other's growth. This can lead to an overgrowth of one or more of the disturbed colonies which then may damage some of the other smaller beneficial ones.
This type of situation often instigates a vicious cycle. As more beneficial colonies are damaged, making the imbalance more pronounced, more overgrowth issues occur since the damaged colonies are less able to check the growth of the overgrowing ones. If this goes unchecked long enough, a pervasive and chronic imbalance between colonies will set in, which ultimately minimizes the beneficial nature of these colonies as a whole.
Microbial colonies also excrete many different types of waste byproducts. Using different waste removal mechanisms, under normal circumstances the body effectively manages these byproducts with little or no trouble. Unfortunately, over-sized and inappropriately large colonies, due to their increased numbers, excrete increased amounts of these byproducts. As the amount of microbial byproducts increases, the higher waste byproducts levels can overburden the body's waste removal mechanisms.
It is the combination of these two negative outcomes that causes many of the negative health symptoms observed when dysbiosis is present.
Last edited by sadman on Thu Jan 12, 2012 4:48 am, edited 1 time in total.
-
Phantasist
- Sheriff
- Posts: 484
- Joined: Wed Jul 21, 2010 8:32 pm
Phatasist :
Please read my comment in bold letters in my previous post . To apply the same principle to correct the dysbiosis of the mouth , we should know in details the reasoning of treatment with Fecal Transplant :
Jul 27
2010
Bowel Disease, Part IV: Restoring Healthful Gut Flora
Filed under: Bowel Disease, Medicine and Treatments
A healthy gut is a multi-species society: it is the cooperative product of the human body with trillions of bacterial cells from a thousand or more species.
An unhealthy gut is, more often than not, the product of a breakdown in this collaboration. Often, it is triggered by displacement of cooperative, commensal species of bacteria by pathogenic bacteria, fungi, viruses, and protozoa. This is why a long course of antibiotics, killing commensal bacteria, is often the prelude to bowel ailments.
It is difficult for the immune system to defeat gut infections without the help of commensal bacteria. Think about what the immune system has to deal with. The ulcers in ulcerative colitis are essentially the equivalent of infected skin abscesses, but in the colon. Here is a description of a bowel lesion in Crohn’s disease:
Ileal lesions in Crohn’s disease (CD) patients are colonized by pathogenic adherent-invasive Escherichia coli (AIEC) able to invade and to replicate within intestinal epithelial cells. [1]
Now imagine an infected skin abscess, but with feces spread over it three times a day, or stomach acid and digestive enzymes. How quickly would you expect it to heal?
Commensal “probiotic” bacteria are like a mercenary army fighting on behalf of the digestive tract. By occupying the interior lining of the digestive tract, they deprive pathogens of a “home base” that is sheltered from immune attack. If commensal bacteria dominate the gut, the immune system can usually quickly defeat infections.
This suggests that introduction of probiotic bacteria to the gut should be therapeutic for bowel disease.
Probiotic Supplements Are Inadequate
Most supermarket probiotics contain Lactobacillus or Bifidobacterium species. These species are specialized for digesting milk; they populate the guts of infants as they start breastfeeding, and are used by the dairy industry to ferment cheeses and yogurt.
These supplements are very effective at fighting acute diarrhea from most food-borne infections. A fistful of probiotic capsules taken every hour will usually quickly supplant the pathogens and end diarrhea.
However, against more severe bowel diseases caused by chronic infections and featuring damaged intestinal mucosa, these species are usually not helpful. One issue is that they provide only a tiny part of a healthful adult microbiome. A recent study surveyed the bacterial species in the human gut, and found these species to be most abundant [2]:
Figure: Abundant gut bacterial species
As this figure shows, Bacteroides spp. are the most common commensal bacteria, with Bacteroides uniformis alone providing almost 10% of all bacterial genes in the gut. Lactobacillus and Bifidobacterium do not appear among the 57 most abundant species.
This study showed, by the way, that patients with inflammatory bowel syndrome have 25% fewer types of bacterial gene in their gut than healthy people, and that the composition of bacterial genes in feces clearly distinguishes ulcerative colitis, Crohn’s disease, and healthy patients. In other words, in the bowel diseases a few pathogenic species have colonized the gut and entirely denuded it of about 25% of the commensal species that normally populate the gut. This finding supports the idea that restoring those missing species might be therapeutic for IBS.
Bacterial Replacement Therapies Work
So if IBS patients are missing 25% of the thousand or so species that should populate the gut, or 250 species, and if common probiotics provide only 8 or so species and not the ones that are missing, how are the missing species to be restored?
The answer is simple but icky. Recall that half the dry weight of stool consists of bacteria. A healthy person daily provides a sample of billions of bacteria from every one of the thousand species in his gut. They are in his stool.
So a “fecal transplant” of a healthy person’s stool into the gut of another person will replenish the missing species.
Scientists have known for a long time that this was likely to be an effective therapy, but it is only now entering clinical practice. The New York Times recently made a stir by telling this story:
In 2008, Dr. Khoruts, a gastroenterologist at the University of Minnesota, took on a patient suffering from a vicious gut infection of Clostridium difficile. She was crippled by constant diarrhea, which had left her in a wheelchair wearing diapers. Dr. Khoruts treated her with an assortment of antibiotics, but nothing could stop the bacteria. His patient was wasting away, losing 60 pounds over the course of eight months. “She was just dwindling down the drain, and she probably would have died,” Dr. Khoruts said.
Dr. Khoruts decided his patient needed a transplant. But he didn’t give her a piece of someone else’s intestines, or a stomach, or any other organ. Instead, he gave her some of her husband’s bacteria.
Dr. Khoruts mixed a small sample of her husband’s stool with saline solution and delivered it into her colon. Writing in the Journal of Clinical Gastroenterology last month, Dr. Khoruts and his colleagues reported that her diarrhea vanished in a day. Her Clostridium difficile infection disappeared as well and has not returned since.
The procedure — known as bacteriotherapy or fecal transplantation — had been carried out a few times over the past few decades. But Dr. Khoruts and his colleagues were able to do something previous doctors could not: they took a genetic survey of the bacteria in her intestines before and after the transplant.
Before the transplant, they found, her gut flora was in a desperate state. “The normal bacteria just didn’t exist in her,” said Dr. Khoruts. “She was colonized by all sorts of misfits.”
Two weeks after the transplant, the scientists analyzed the microbes again. Her husband’s microbes had taken over. “That community was able to function and cure her disease in a matter of days,” said Janet Jansson, a microbial ecologist at Lawrence Berkeley National Laboratory and a co-author of the paper. “I didn’t expect it to work. The project blew me away.” [3]
Fecal transplants can be done without a doctor’s help: someone else’s stool can be swallowed or inserted in the rectum. If taking feces orally, swallow a great deal of water afterward to help wash the bacteria through the stomach and its acid barrier.
Dogs and young children sometimes swallow feces. It is unpleasant to consider, but desperate diseases call for desperate measures. Perhaps one day, healthy stools will be available in pleasant-tasting capsules, and sold on supermarket shelves. Not yet.
Attacking Pathogenic Biofilms
Most bacterial species will build fortresses for themselves, called biofilms. These are polysaccharide and protein meshworks that, like bone, become mineralized with calcium and other minerals. These mineralized meshworks are built on bodily surfaces, like the gut lining, and protect bacteria from the immune system, antibiotics, and other bacterial species.
Pathogenic species known to generate biofilms include Legionella pneumophila, S. aureus, Listeria monocytogenes, Campylobacter spp., E. coli O157:H7, Salmonella typhimurium, Vibrio cholerae, and Helicobacter pylori. [4]
Biofilms favor the species that constructed them. So, once pathogens have constructed biofilms, it is hard for commensal species to displace them.
Therapies that dissolve pathogenic biofilms can improve the likelihood of success of probiotic and fecal transplant therapies. Strategies include enzyme supplements, chelation therapies, and avoidance of biofilm-promoting minerals like calcium. Specifically:
Polysaccharide and protease digesting enzymes. Human digestive enzymes generally do not digest biofilm polysaccharides, but bacterial enzymes that can are available as supplements. Potentially helpful enzymes include hemicellulase, cellulase, glucoamylase, chitosanase, and beta-glucanase. Non-human protease enzymes, such as nattokinase and papain, might also help. [5]
Chelation therapy. Since biofilms collect metals, compounds that “chelate” or bind metals will tend to gather in biofilms. Some chelators – notably EDTA – are toxic to bacteria. So EDTA supplementation tends to poison the biofilm, driving bacteria out of their fortress-shelter. This prevents them from maintaining it and makes the biofilm more vulnerable to digestion by enzymes and commensal bacteria. It also tends to reduce the population of pathogenic bacteria.
Mineral avoidance. The supply of minerals, especially calcium, iron, and magnesium, can be a rate-limiting factor in biofilm formation. Removal of calcium can cause destruction of biofilms. [6] We recommend limiting calcium intake while bowel disease is being fought, since the body can meet its own calcium needs for an extended period by pulling from the reservoir in bone. Upon recovery, bone calcium can be replenished with supplements. Iron is another mineral which promotes biofilms and might be beneficially restricted. We do not recommend restricting magnesium.
Some commercial products are available which can help implement these strategies. For instance, Klaire Labs’ InterFase (http://www.klaire.com/images/InterFase_ ... rticle.pdf) is a popular enzyme supplement which helps digest biofilms, and a version containing EDTA is available (InterFase Plus).
Please read my comment in bold letters in my previous post . To apply the same principle to correct the dysbiosis of the mouth , we should know in details the reasoning of treatment with Fecal Transplant :
Jul 27
2010
Bowel Disease, Part IV: Restoring Healthful Gut Flora
Filed under: Bowel Disease, Medicine and Treatments
A healthy gut is a multi-species society: it is the cooperative product of the human body with trillions of bacterial cells from a thousand or more species.
An unhealthy gut is, more often than not, the product of a breakdown in this collaboration. Often, it is triggered by displacement of cooperative, commensal species of bacteria by pathogenic bacteria, fungi, viruses, and protozoa. This is why a long course of antibiotics, killing commensal bacteria, is often the prelude to bowel ailments.
It is difficult for the immune system to defeat gut infections without the help of commensal bacteria. Think about what the immune system has to deal with. The ulcers in ulcerative colitis are essentially the equivalent of infected skin abscesses, but in the colon. Here is a description of a bowel lesion in Crohn’s disease:
Ileal lesions in Crohn’s disease (CD) patients are colonized by pathogenic adherent-invasive Escherichia coli (AIEC) able to invade and to replicate within intestinal epithelial cells. [1]
Now imagine an infected skin abscess, but with feces spread over it three times a day, or stomach acid and digestive enzymes. How quickly would you expect it to heal?
Commensal “probiotic” bacteria are like a mercenary army fighting on behalf of the digestive tract. By occupying the interior lining of the digestive tract, they deprive pathogens of a “home base” that is sheltered from immune attack. If commensal bacteria dominate the gut, the immune system can usually quickly defeat infections.
This suggests that introduction of probiotic bacteria to the gut should be therapeutic for bowel disease.
Probiotic Supplements Are Inadequate
Most supermarket probiotics contain Lactobacillus or Bifidobacterium species. These species are specialized for digesting milk; they populate the guts of infants as they start breastfeeding, and are used by the dairy industry to ferment cheeses and yogurt.
These supplements are very effective at fighting acute diarrhea from most food-borne infections. A fistful of probiotic capsules taken every hour will usually quickly supplant the pathogens and end diarrhea.
However, against more severe bowel diseases caused by chronic infections and featuring damaged intestinal mucosa, these species are usually not helpful. One issue is that they provide only a tiny part of a healthful adult microbiome. A recent study surveyed the bacterial species in the human gut, and found these species to be most abundant [2]:
Figure: Abundant gut bacterial species
As this figure shows, Bacteroides spp. are the most common commensal bacteria, with Bacteroides uniformis alone providing almost 10% of all bacterial genes in the gut. Lactobacillus and Bifidobacterium do not appear among the 57 most abundant species.
This study showed, by the way, that patients with inflammatory bowel syndrome have 25% fewer types of bacterial gene in their gut than healthy people, and that the composition of bacterial genes in feces clearly distinguishes ulcerative colitis, Crohn’s disease, and healthy patients. In other words, in the bowel diseases a few pathogenic species have colonized the gut and entirely denuded it of about 25% of the commensal species that normally populate the gut. This finding supports the idea that restoring those missing species might be therapeutic for IBS.
Bacterial Replacement Therapies Work
So if IBS patients are missing 25% of the thousand or so species that should populate the gut, or 250 species, and if common probiotics provide only 8 or so species and not the ones that are missing, how are the missing species to be restored?
The answer is simple but icky. Recall that half the dry weight of stool consists of bacteria. A healthy person daily provides a sample of billions of bacteria from every one of the thousand species in his gut. They are in his stool.
So a “fecal transplant” of a healthy person’s stool into the gut of another person will replenish the missing species.
Scientists have known for a long time that this was likely to be an effective therapy, but it is only now entering clinical practice. The New York Times recently made a stir by telling this story:
In 2008, Dr. Khoruts, a gastroenterologist at the University of Minnesota, took on a patient suffering from a vicious gut infection of Clostridium difficile. She was crippled by constant diarrhea, which had left her in a wheelchair wearing diapers. Dr. Khoruts treated her with an assortment of antibiotics, but nothing could stop the bacteria. His patient was wasting away, losing 60 pounds over the course of eight months. “She was just dwindling down the drain, and she probably would have died,” Dr. Khoruts said.
Dr. Khoruts decided his patient needed a transplant. But he didn’t give her a piece of someone else’s intestines, or a stomach, or any other organ. Instead, he gave her some of her husband’s bacteria.
Dr. Khoruts mixed a small sample of her husband’s stool with saline solution and delivered it into her colon. Writing in the Journal of Clinical Gastroenterology last month, Dr. Khoruts and his colleagues reported that her diarrhea vanished in a day. Her Clostridium difficile infection disappeared as well and has not returned since.
The procedure — known as bacteriotherapy or fecal transplantation — had been carried out a few times over the past few decades. But Dr. Khoruts and his colleagues were able to do something previous doctors could not: they took a genetic survey of the bacteria in her intestines before and after the transplant.
Before the transplant, they found, her gut flora was in a desperate state. “The normal bacteria just didn’t exist in her,” said Dr. Khoruts. “She was colonized by all sorts of misfits.”
Two weeks after the transplant, the scientists analyzed the microbes again. Her husband’s microbes had taken over. “That community was able to function and cure her disease in a matter of days,” said Janet Jansson, a microbial ecologist at Lawrence Berkeley National Laboratory and a co-author of the paper. “I didn’t expect it to work. The project blew me away.” [3]
Fecal transplants can be done without a doctor’s help: someone else’s stool can be swallowed or inserted in the rectum. If taking feces orally, swallow a great deal of water afterward to help wash the bacteria through the stomach and its acid barrier.
Dogs and young children sometimes swallow feces. It is unpleasant to consider, but desperate diseases call for desperate measures. Perhaps one day, healthy stools will be available in pleasant-tasting capsules, and sold on supermarket shelves. Not yet.
Attacking Pathogenic Biofilms
Most bacterial species will build fortresses for themselves, called biofilms. These are polysaccharide and protein meshworks that, like bone, become mineralized with calcium and other minerals. These mineralized meshworks are built on bodily surfaces, like the gut lining, and protect bacteria from the immune system, antibiotics, and other bacterial species.
Pathogenic species known to generate biofilms include Legionella pneumophila, S. aureus, Listeria monocytogenes, Campylobacter spp., E. coli O157:H7, Salmonella typhimurium, Vibrio cholerae, and Helicobacter pylori. [4]
Biofilms favor the species that constructed them. So, once pathogens have constructed biofilms, it is hard for commensal species to displace them.
Therapies that dissolve pathogenic biofilms can improve the likelihood of success of probiotic and fecal transplant therapies. Strategies include enzyme supplements, chelation therapies, and avoidance of biofilm-promoting minerals like calcium. Specifically:
Polysaccharide and protease digesting enzymes. Human digestive enzymes generally do not digest biofilm polysaccharides, but bacterial enzymes that can are available as supplements. Potentially helpful enzymes include hemicellulase, cellulase, glucoamylase, chitosanase, and beta-glucanase. Non-human protease enzymes, such as nattokinase and papain, might also help. [5]
Chelation therapy. Since biofilms collect metals, compounds that “chelate” or bind metals will tend to gather in biofilms. Some chelators – notably EDTA – are toxic to bacteria. So EDTA supplementation tends to poison the biofilm, driving bacteria out of their fortress-shelter. This prevents them from maintaining it and makes the biofilm more vulnerable to digestion by enzymes and commensal bacteria. It also tends to reduce the population of pathogenic bacteria.
Mineral avoidance. The supply of minerals, especially calcium, iron, and magnesium, can be a rate-limiting factor in biofilm formation. Removal of calcium can cause destruction of biofilms. [6] We recommend limiting calcium intake while bowel disease is being fought, since the body can meet its own calcium needs for an extended period by pulling from the reservoir in bone. Upon recovery, bone calcium can be replenished with supplements. Iron is another mineral which promotes biofilms and might be beneficially restricted. We do not recommend restricting magnesium.
Some commercial products are available which can help implement these strategies. For instance, Klaire Labs’ InterFase (http://www.klaire.com/images/InterFase_ ... rticle.pdf) is a popular enzyme supplement which helps digest biofilms, and a version containing EDTA is available (InterFase Plus).
why does it have to be someone who lives in same environment? How is the good bacteria in the mouth exposed to someone else?sadman wrote: As you already mentioned , a number of members in this forum have reported that their bad breath problem started right after a course of antibiotics just as Dysbiosis of the gut usually happened after antibiotic use . My theory is that if that's the cause of halitosis , a saliva sample from someone who lives in the same environment with the patient at the time the halitosis occurred will have exposure to some of the same bacteria , thus will be a good match and can help the patient to restore their normal oral microflora . A replacement with just one type of bacteria such as S. Salivarius will not be suffice .
The sad thing is that we do not know what causes the Dysbiosis in the mouth yet .
Wouldn't family members and relatives have same or similar group of mouth bacteria? What about a new-born baby?
ANd if we were to to the saliva transplant? How would we do it? does the healthy person just spit saliva in the mouth of those suffering with BB, and have as much healthy saliva as possible in the mouth?
applen wrote :
, may be just collect a small sample of a healthy donor , mix it with some saline and let the recipient keep in the mouth for as long as possible . In fecal transplant , it needs just one treatment since the donor feces can stay in the recipient gut for a long period , while in saliva transfer , it's impossible to keep the sample for a long time without swallowing it but there is proof that saliva transfer can happen just by kissing :
http://www.msnbc.msn.com/id/35989527/ns ... xV8sHqHv8k
It's just a theory , I have no idea of how it can be doneANd if we were to to the saliva transplant? How would we do it? does the healthy person just spit saliva in the mouth of those suffering with BB, and have as much healthy saliva as possible in the mouth?
, may be just collect a small sample of a healthy donor , mix it with some saline and let the recipient keep in the mouth for as long as possible . In fecal transplant , it needs just one treatment since the donor feces can stay in the recipient gut for a long period , while in saliva transfer , it's impossible to keep the sample for a long time without swallowing it but there is proof that saliva transfer can happen just by kissing :http://www.msnbc.msn.com/id/35989527/ns ... xV8sHqHv8k
