Poop Transplants: Helpful for COVID & Gut Health?
Poop Transplants: Helpful for COVID & Gut Health?
A paper just came out of BMJ, the British Medical Journal, which is a well-respected peer-reviewed journal entitled Rapid Resolution of COVID-19 After Fecal Microbial Transplantation.
And this alongside some of the other research I've highlighted only continues to bring to light this gut-lung connection and what you can do for your gut health to help prevent you from getting severe symptoms from COVID-19.
So I'm Ashley Oswald I'm a registered dietitian and founder of Oswald Digestive Clinic, where we help people improve and often eliminate bothersome gut issues like gas, bloating, diarrhea, and or constipation.
So let's just go ahead and dive right into the topic today.
Poop Transplants: Helpful for COVID & Gut Health?
What is Fecal Microbiota Transplantation?
Let's start by talking about what is fecal microbiota transplantation, otherwise known as FMT, which I'm going to use in this topic because it's a tongue twister. If I say it, the full name.
So FMT is basically taking somebody else's stool or their microbiota, their microbiome, all those bugs living inside of your gut, mostly in your large intestine, the bigger intestine before it comes out in the stool.
So it's taking the stool of somebody else and putting it into you or whoever is getting the FMT because we're finding that it's more effective than just giving a probiotic supplement. Cause if you think about it, if we're giving somebody else's stool like a healthy donor, then it's more likely to adhere because you're getting all the diversity that you're not going to be getting in just the probiotic supplement.
And so the FDA has only approved this for a C. difficile infection so far, this is a really severe reoccurrence bacterial infection that if somebody gets it, they're then put on antibiotics, the antibiotics, may or may not work, but it's such a high chance of reoccurring. They have to keep using antibiotics over time. The bacteria become resistant to those antibiotics. and these individuals can get really severely malnourished.
And so with FMT, there's a 90% success rate for a relatively low risk.
There's no risk to FMT where there is an FMT transfer and the donor individual had e-coli in their stool because they were doing the transfer kind of under the table, maybe like in a home setting, which is starting to happen because it's only approved for C. difficile and in research settings.
So the individual ended up getting this really bad e-coli infection and passing away. So who donates then when, thinking about a healthy donor and when we're doing in the research setting or in the clinical setting with C-Difficile, it's a really, important screening process and it goes through the lab and this stool, we make sure that it doesn't have these aggressive pathogens in it that could then cause more issues than maybe even the C difficile. They could put the person over the edge. And that could cause death.
And so practically, how is this even done?
Basically, this is how it started with just a small bore and J tube. That means nasal to jejunal. So that middle part of the intestine, usually we take it through the first part of the intestine, and the tip lands there.
So it's all the way down the esophagus through the stomach, past the pyloric sphincter into the small intestine and why we would want to do it into the small intestine is because if we're putting somebody else's stool in your stomach like you might be able to taste it. And that might be kind of disgusting to you.
I actually used to place these tubes kind of a fun fact about me when I used to work in the intensive care units. so it's maybe something like that small and they just will drip the stool through that, tube, because you can't just pour in those really small tubes. You can drip it out, maybe 100, or 200 milliliters an hour until it's all in your small intestine. And it's going to make its way down into the large intestine.
Now they are coming out with capsules and the funny name for it is Crapsule, the crap, the stool is inside of this capsule and you just swallow it. And it has like coating that's meant to withstand stomach acid.
So then it can make it down into your large intestine without you tasting it again into the large intestine and where it can really have its benefit to help to change your microbiota, hopefully for the better.
And when thinking about each individual person, who's going to get FMT what kind of donor we should use for them? Things like age and sex and that donor's medical history, their overall health, and all in relation to who's going to be getting it.
So age, trying to find somebody of similar age is all taken into consideration because we honestly just don't quite know yet. when it comes to the microbiota, you can think of it like an iceberg and we just know the tip of the iceberg. And that's why I always say if these probiotic companies are telling you and making these claims that like ours is the best it's going to cure all these things.
We don't know that much information as a community yet, but we know enough to be able to help people feel better. Like, look at this FMT, being able to cure C difficile infection for people that's powerful. But as far as all the details of what's going on in the microbiota, we have trillions and trillions of bugs in there.
And we just know the tip of the iceberg, but they do their best. And they try to fit an individual with whom they think a healthy donor would be similar to them. And this is a good spot to bring up the conversation of, if you need to be put on an antibiotic or something, please ask your healthcare provider, if it's really necessary.
And we made a youtube video about Should you take probiotics with Antibiotics? I would really encourage you to watch this. And then if you absolutely have to be put on antibiotics, we talk on that topic about what probiotics to consider, to decrease your likelihood of certain symptoms from that.
So FMT, as you know now it's approved only for C. difficile infection, but in the research setting, they are now exploring how it might help with IBD, which is an inflammatory bowel disease. That's, Crohn's, ulcerative colitis, IBS irritable bowel syndrome with colon cancer, and even autism and obesity.
And we're still learning how this is going to affect somebody long-term cause it's still pretty new, so stay tuned for that. And that's where they're being more cautious before they just approve it for all these other diseases.
Now, is it safe to do at home?
Because it's only approved for C difficile, some people are doing FMT at home, but is it really safe? So maybe, but remember that story, I just told you about the individual who is doing it at home, the stool had e-coli in it and the person ended up dying because that e-coli actually overtook their gut. And if somebody is trying this at home, they likely don't have the healthiest immune system the way it is.
And it might mean that they're at higher risk of having an issue with doing this home FMT because it comes down to the stool just isn't tested. If you're taking stool from a family member that seems healthy, It could be fine. You would assume it's fine, right?
But it might just be that person's healthy enough. And if they have too much e-coli in their gut, they're not having a reaction to it. And the way that you might, because you have inflammatory bowel disease.
I want to tell a story of a teenager that came to me many years ago with ulcerative colitis. And they had done FMT at home with his sister's stool. And thankfully nothing happened actually like nothing happened, no benefit either.
And upon digging deeper into the possible root causes of his gut issues it came to light that there is a lot that we could do from a functional nutrition approach. And so I share this because sometimes symptoms aren't, I mean, all the time symptoms, aren't a medication deficiency.
That's not getting to the root cause. And certainly, FMT can be really helpful in those severe instances, but with chronic gut issues, there are often other things that we can do to make a significant improvement before trying to do this just quick fix, I think that is what people are wanting with this online FMT, or they're just kind of to the end of their rope. And they're really anxiously waiting for this to be approved. I'm sure if you look online, there might be options for you to maybe get into some of these research studies like for the IBD Crohn's ulcerative Colitis, et cetera.
Okay Ashley that's cool, but I thought we were going to be talking about COVID okay? We are going to talk about COVID now.
And I want to share that paper that just came out of the MJ, but I thought it was important to give you a little bit of background because this is all about FMT and how it was, used for C-Difficile for two individuals in the hospital setting, they ended up getting a diagnosis of COVID-19. They had risk factors for getting severe COVID-19 and they didn't. So they didn't.
And that alongside the other papers that have come out, some of which I've already shared on this channel really highlights how there is this gut-lung connection. And if somebody's having chronic gut issues, or if they're at risk, it could be why they're getting a more severe COVID-19 reaction.
And for you, this is going to be good news again, because there are things that you could do to improve your gut health, to decrease your risk of getting severe COVID. So let's talk about what these two cases are. So you can just have a little bit more information and I'll kind of wrap it all up at the end.
So the first individual was an elderly 80-year-old male with multiple co-morbidities really frail. Really high risk of getting severe COVID. He didn't even get severe COVID he got COVID, but he recovered pretty quickly.
And the other is a 19-year-old male with ulcerative colitis on immunosuppression. So a medication suppresses the immune system. So you would expect because of that, he would also have a severe reaction, but no, he recovered really pretty quickly because again, they both had FMT for this C. difficile infection that they had.
And so it really brought up the question among these providers of how is it that the FMT, the stool that we're putting into their gut, how is that modulating the immune system?
And then that gut lung connection to where these individuals aren't having the severe cases we would expect them to have. And it makes sense because 70% of our immune system is in our gut. And I will also link here that topic that we did on the gut-lung connection.
It was a full long one-hour interview I did with a woman, a dietitian over in Italy, and then we really go into some, awesome information that I think that you probably wouldn't have heard before. So long story short because of this, the providers and these researchers decided we're going to do a bigger trial about FMT for COVID and see what more we can find out, which is music to my ears, because now we're kind of getting to more root cause, right.
Instead of saying we're just at a loss. If you get, COVID just hopes for the best we know there are things that you can do that we can do so that we don't just have to hope for the best we can say, wow, I actually, really, my hypertension is well managed or I worked with a functional dietitian and I actually reversed my high blood pressure or reversed my type two diabetes, or I made so many improvements and I'm on half the insulin I used to be on, or my gut is really healthy.
Now I'm not having those bothersome symptoms that I used to have. And all of that is going to hopefully make you say if you end up getting COVID-19. I'm more likely to be fine from this because I prepared over here. Obviously, I'm really passionate about that conversation because it's not happening as much as I think it should.
A really quick story to leave you all out is, as you might have, might know, or might remember maybe don't know, I was in Bali in early 2020, and I got Dengue fever, which is a virus. And I, as somebody convinced me to kind of go into the doctor, they actually gave me nutrients like echinacea and vitamin C. It was a combination supplement to help support my immune system, to fight the virus that was like their main treatment, because there was not like vaccine for this.
There's not, there's really not anything else you can do. You just have to wait out the clinical course and allow your body to fight it. So it's really important that you have a strong, healthy body and immune system. And so that's something that we really have to keep to the forefront of our mind, especially if you're getting really concerned about these new strains of viruses, et cetera, et cetera.
If you want to get right down to it, I'm struggling with type two diabetes. This is what I'm doing. This is my medical history, review it all. And then we can work with you and get a personalized nutrition plan going right away.
So I want to thank you all. I hope this topic was helpful and interesting to you.
And I will see you next week.
If you'd like to explore any of this information further or obtain an individualized nutrition plan, you can schedule an initial appointment at our clinic. We also take insurance and some of our clients get full coverage, which is great.
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