Hi there, Eric Bakker, back again.
We're going to talk about something not so pleasant this time, so I hope you haven't
had your breakfast yet or your dinner, or you're about to have it.
So, if you are going to have a meal, come back and then watch the video maybe later.
We're going to talk about fecal microbial transplant, or FMT.This is a topic I've been
following now for some time.
I just saw on Wikipedia that it was first performed in 1958 in the States, but more
recently since the 1980s, it's been performed and probably likely pioneered by the Center
for Digestive Diseases in Sydney, Australia.
I've have some discussions with some of the doctors that work at the CDC, after a medical
conference in Sydney, in fact, I had a dinner function.
Not exactly something that the average person is going to sit down and have a nice meal
and glass of wine and talk about stool and implanting stool, and stuff, but those things
don't faze me, it's part of my job.I won't mention any of the doctor's names but I know
some of the doctors at the CDC.
My personal opinion on FMT is, in most cases, it's not really going to have much effect
on the patient.
One of the doctors said that when they first started doing the pilot studies with a group
of about 20 patients, after 12 months all patients had exactly the same problem that
they began with.
So it's not a cure-all.
It was originally used particularly for Clostridium difficile, quite a nasty gut infection you
can get which can lead to some serious bowel problems.
In fact, it's sort of become now the standard treatment for C. diff in America.
I don't think it's covered by Medicare, so you're going to have an out-of-pocket expense
which could be many tens of thousands of dollars in some case, and sometimes you need top-up
treatments.
Doctor Thomas Borody from the CDC, for example, in 1988 had a successful attempt at working
with a patient with ulcerative colitis with FMT.
The patient went into remission for a considerable period of time and then relapsed.
I worked with over 100 cases of UC, ulcerative colitis, just in the last several years and
they had almost a complete remission for a long period of time using no FMT whatsoever.
Just by doing stool testing, just by eliminating the main pathogens in the gut by rebuilding
the gut with probiotics, by looking at the correct kind of anti-inflammatory diet, we
got a fantastic effect with ulcerative colitis.
Fecal microbial transplant, in my case, is clutching at straws.
It's a last resort kind of thing that many people jump into, but now it's sort of seen
like it's a first resort.
I think it's for really rare and unusual and strange cases where other avenues have been
exhausted.
But in my personal opinion, it's not required in 99% of cases.
Now, I'm probably going to get blasted by saying this, by some comments, "I had successful
FMT or I would've been dead years ago."
I'm sure there'll be people out there like that but you'll likely be that 1% then, but
for 99% of people, if those people start making lifestyle and diet changes, particularly if
they did that a long time ago before they developed pathology in the gut.
If those people had regular stool tests done and got on top of their leaky gut, their CBO,
their candida, if all those were slowly fixed over time, they wouldn't have fallen into
the hole that they did with their bad gut.
Again, a stitch in time saves nine.
So, if you fix things up earlier, they don't become serious problems down the track, requiring
things like FMT.
Now, as I mentioned, there will be rare cases that will require either a genetic ... Genetically
linked cases or some serious issues there, but in most cases, I just can't see the benefit.
I had a case, for example, about four years ago.
We had a young lady from the UK with a seriously bad gut.
I tried many things with her and I really couldn't get the result I was looking for.
The parents had plenty of money so they flew the girl to Sydney.
The girl had FMT, and for three months it was all hunky-dory.
Okay?
If you don't know what that expression means, it was all fine.
Everything went great and this girl thought she was cured, but then, bang, straight back
to where she was.
30 grand later, she's back in the same hole she was in the beginning.The thing that fixed
that girl up was probiotics.
Once we found the correct probiotics for her, literally within a month, she was back at
university again.
It's as simple as that, okay?
This girl spent a lot of money going to all different clinics, tried all of the different
types of antibiotics, many different things, but in the end it was just probiotics that
fixed her up.
Right?
It's not the cure-all-end-all, to me it's a novel technique that may work for some people.
As in Borody's case, it was an expensive way to get remission which, in my opinion, could've
been done by using other methods, particularly identifying things in the gut, cleaning them
up, and getting the patient on the correct diet.
This seems to, in my opinion, to be the best outcome for most people with gut problems.
I've worked like this for decades now and, yeah ... Well, anyway, I think the results
speak for themselves in most cases.I don't recommend FMT for that reason.
May be well in the years ahead, when we've mapped out the bacteria genetically to a higher
degree with people and we can have more specific therapies for that patient, it might all change.
But today, I don't think it's really the perfect fit for most people.
That's my take on it.
Thanks for tuning in.