Fecal transplants for CFS/IBS etc typically result in almost immediate resolution of symptoms — followed weeks or months later with relapse. Fecal transplant for Clostridium difficile has a high persistent success rate. (“of the approximately 200 cases reported, regardless of route, a mean success rate of 96% has been achieved.27” )
So why the difference? In one case we are talking of displacing a single bacteria species (C. difficile); in the CFS case, we are having to both replace/reduce multiple strains AND restart other strains.
Determining suitable donor to match the patient
For C.difficile — any apparently healthy donor (i.e. does not have C. difficile) is a viable candidate.
For CFS, the donor criteria should be:
- Normal levels of
Matching uBiome profiles
It should be apparent that the donor should not have any bacteria genus > 1.5x that the recipient has > 1.5x.
Ideally, at the strain level (of any existing bacteria of the recipient) — Lactobacillus, Bifidobacterium and E.Coli should be extremely close matches.
To illustrate this aspect, examine this chart of L.Reuteri strains [Source 2009]
6 weeks before the transplant, the recipient should be on a probiotic and diet regime based on their own uBiome to reduce the over growth.
Track microbiome shift immediately before and after transplant
To better improve the transplant method, I would advocate the following uBiome (or equivalent) samples be taken:
- Two days before transplant of both recipient and donor (or on donation day)
- Two, four, eight, sixteen, thirty-two, sixty-four days after the transplant
Recipient should keep on the probiotic and diet regime based on their own uBiome for at leasy 30 days after the transplant.
Logic: We want to suppress the overgrowth before the transplant and keep it suppressed while the transplant gets established.
To the best of my research, I have not seen any studies tracking the microbiome regularly after a transplant…. there appear to be process happenings with the failures that we need to understand better.
Again, this is just a theoretical protocol applying logic to known facts.