October 30, 2017 by Amy Hollenkamp
Ever since my FMT post, I have received an endless stream of messages wanting to know how the heck I am doing! So, I apologize for not doing this sooner and leaving you all waiting with baited breath.
It has been 10 months since my last FMT treatment! My gut symptoms have improved about 60-75%. I do get some bloating and abdominal pain occasionally , but not nearly as bad as I used to. I honestly think that my remaining symptoms are a result of some lingering thyroid issues. It feels more like a water retention bloating versus a gassy bloating (if that makes sense).
I recently did my first post FMT stool test. I decided on the GI MAP tests, because it was recommended by my functional dietitian and it’s PCR technology appears to be more sensitive at detecting micro-organisms than culture based stool analysis.
My test provided some interesting insights. First, my colon appears to be completely free of pathogens! My stool test in the September right before my FMT was a hot mess. Opportunistic bugs were overgrowing all over the place!
My functional dietitian said she rarely sees stool tests as clean as mine (without any colonic pathogens). In addition, I had robust levels of health promoting flora like Lactobacillus and Bifidobacterium. So, my dietitian believes that my stool test confirms that the FMT was successful at rebalancing my large intestine dysbiosis.
But, my stool test wasn’t totally scotch free. I did have high levels of H. pylori, the bacteria that is found primarily in the stomach. H. pylori has traditionally been labeled a “bad bacteria” due to its role in ulcer formation.
But, recent evidence laid out by Martin Blaser in the book Missing Microbes refutes the long held belief that “the only good H. pylori is a dead H. pylori.” Research has shown that H. pylori is a natural member of our gut flora and actually can play a protective role in our health.
But, H. pylori can become pathogenic if it overgrows and starts producing virulence factors that results in damage to the stomach lining (ulcers) and a decrease in stomach acidity. Martin Blaser refers to H. pylori as a Dr. Jekyll and Mr. Hyde bacteria. It is Dr. Jekyll when it remains a part of a diverse microbiome, where it has immune boosting benefits. But, in the context of an unhealthy gut, H. pylori can mutate and overgrow creating something truly monstrous and destructive to your GI tract
While I had high h. pylori, I tested negative for the virulence factors. You can think of virulence factors as weapons that certain bacterial strains have that increase their ability to cause disease and become pathogenic. So, its good news that I don’t have a strain of h. pylori that was producing these factors! But, that left me and my dietitian scratching our heads as to whether we should treat this with antimicrobials or not.
I actually contacted my favorite microbiologist, Kiran Krishnan, online about how I should interpret my higher H. pylori levels and whether treatment was indicated. Here is what Kiran said:
“H. pylori is a normal part of the microbiome and should be there. It has beneficial roles in fact. I would say that there is no reason to treat it unless you have ulcers. If you have gastric ulcers then you have a strain of h. pylori that is more virulent, if not, you likely have a normal, cooperative strain. Trying to treat a non-threatening strain of H. pylori can do more harm than good.”
We also contacted the GI MAP people to get their two cents. They said that the h. pylori, while not causing symptoms could be lowering my stomach acid levels, which may be why my pancreatic enzymes markers were slightly low. Low stomach acid can also result in SIBO, which is something that also needed to be considered when choosing a treatment option.
We decided to take a more conservative treatment route for now. We decided try some additional digestive support with enzymes while continuing to take my probiotic (MegaSpore) and consuming fermented foods. I am also taking some additional supplements to help support detoxification and to optimize my hormones. We are keeping some H. pylori killing supplements in our back pocket in case we deem them appropriate in the future.
Overall, I think FMT has been a valuable tool at jump starting my recovery. It corrected my colonic imbalance and has relieved a lot of my symptoms. But, it is not a cure all!
I still need to make tweaks to address the other root causes of my gut problems like hormonal disturbances, stress and h. pylori (low stomach pH) to continue to improve.
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Until next time!!