Theortical Protocol for Fecal Transplants for CFS/IBS etc

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” [2011])

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
    • Lactobacillus
    • Bifidobacterium
    • E.Coli
    • Akkermansia

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]

figure-2-phylogenetic-analysis-of-116-strains-of-lactobacillus-reuteri-based-on-the

Pre-Transplant Preparation

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.