Increased malabsorption after FMT? (H2S Dysbiosis/SIBO) Outcomes 

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effecolprep

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Hello,

Long story short, I got SIBO after food poisoning several years ago. Initially, I thought I made something with probiotics ingestion, but then GI map shows extremely high levels of E. Coli (Enteropathogenic E. Coli). I tried many treatments during the years (antimicrobials, antibiotics, antifungals etc.), but nothing helped significantly. Even worse, my microbiome was wiped and got different sensitivities (salicylates, oxalates, sulfur etc.).

So, I decided to give a try to FMT (oral / rectal) from a clinic, which tests and monitor it's donor. I've done a course of 10 days treatment with Vancomycin to clear, followed by 5 days waiting to clear the antibiotic and then laxative (basically, colonscopy like prep before FMT).

Then, I got the FMT in the clinic rectally and orally at the same day. I felt relaxed afterwards and had a good sleep. Two days after I took another liquid solution (orally), as I got no bad reactions whatsoever.

Now almost ~2 months after, I continue to have yellow stool (fat malabsorption) - TUDCA/UDCA/Ox bile just worsen that. So, my doctor decide me to use frozen solution - basically, he prepared FMT with glycerol (frozen) and gave it to me (I am storing it at home at -22 C).

I have started to take 1 capsule per day (~700-800 mg of FMT orally). The reactions I got are mainly joint pains and stomach gurgling (like really noisy), but still nothing crazy.

I am taking it for about a week and I started to notice increase of overall malabsorption (food pieces in the stool, fat malabsorption, yellow stool etc.). I feel extreme hunger after a big meal, which indicates serious malabsorption.

However, at the same time my salicylate sensitivity dropped a bit, H2S doesn't seem to be SO hard as before and I am confused.

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  1. Is it possible to get overgrowth in small intestine from FMT?
  2. Can I get temporary malabsorption when I introduce FMT orally or it's indication of something bad?
I am concerned because weight loss is there and I can't afford to loose much, because I already lost weight with SIBO for so many years. Dosages that I am taking a way too less compared to what they gave me initially.

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Thanks in advance.
 
effecolprep said:
I got SIBO after food poisonin
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What are you basing that on? Have you read the wiki page on SIBO? https://humanmicrobiome.info/sibo/

effecolprep said:
GI map shows extremely high levels of E. Coli (Enteropathogenic E. Coli)
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Read this: FMT donor-matching and selection, screening for specific microbes, and pre-treatment/eradication. "Killing things off" vs suppression & ecosystem restoration.

effecolprep said:
I decided to give a try to FMT (oral / rectal) from a clinic, which tests and monitor it's donor.
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What clinic? Most of the clinics do not have good donors. High-quality donors are extremely rare.

effecolprep said:
I've done a course of 10 days treatment with Vancomycin to clear, followed by 5 days waiting to clear the antibiotic and then laxative (basically, colonscopy like prep before FMT)
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Why? This is not supported by the scientific evidence, so wherever you're getting your information and advice from is a dangerously poor source.

effecolprep said:
However, at the same time my salicylate sensitivity dropped a bit, H2S doesn't seem to be SO hard as before and I am confused.
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You're messing with an extremely complex ecosystem that regulates the entire body. Your experience is not confusing. FMT can absolutely make things worse and/or better, depending on the donor. Overall, it sounds like you have a bad donor, which is very common.

You should read this: https://forum.humanmicrobiome.info/threads/the-fda-and-fmt-regulation-part-2-jul-2024-humanmicrobes-org-i-met-wit.520/#post-1370
 
@Michael Harrop - thanks for response, so let me start:

1) Yes, maybe just "dysbiosis", but because my digestion impaired (got malabsorption) after that moment thats why I called it this way

2) Thanks for the read.

3) Clinic is in Bulgaria and it has high end equipment lab for screening their donor (tests for pathogens etc.). Actually many kids with autism etc. are using that exact same donor. I was there when people were receiving rectally and orally from that donor.

4) Vancomycin - the Dr. advised me to do it, I didn't know prior that

5) What if the donor is bad indeed or there is some kind of a mismatch with me? Should I do some antibiotic treatment or what is advised in that cases?

Thanks again, Michael. Really desperate what to do, as majority of the people I see on reddit etc. are actually with very good feedbacks. Didn't expected that.
 
effecolprep said:
Clinic is in Bulgaria and it has high end equipment lab for screening their donor (tests for pathogens etc.). Actually many kids with autism etc. are using that exact same donor. I was there when people were receiving rectally and orally from that donor.
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Were you able to follow up with any of the other patients to see what their results were?

The main issue with these clinics is that they don't publicly track and report results, and people who use them don't publicly post about their results, so no one actually knows how safe and effective the clinics/donors are.

This is why people need to use the FMT clinics & commercial stool providers | experiences & reviews
section.

"High-end equipment lab for screening their donor" is something a clinic would say to market their product/service to uninformed patients. That is not an important factor. You can review the FMT wiki page https://humanmicrobiome.info/where-to-get-fmt/ for more info.

effecolprep said:
4) Vancomycin - the Dr. advised me to do it, I didn't know prior that
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You should write up a detailed experience report in the clinics subforum and include that information. It will help everyone vet the various clinics to see which is best.

effecolprep said:
What if the donor is bad indeed or there is some kind of a mismatch with me? Should I do some antibiotic treatment or what is advised in that cases?
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I tried antibiotics after I used a bad donor. It's very hard to determine the right antibiotic to take. For me, I used one that helped temporarily but did long-term damage.

I think the best option is to use a better donor, which is why I suggested reading this.

But even a better donor usually does not completely remove everything bad. Which is why I'm pushing for clinical trials focused on clearing the gut microbiome.

effecolprep said:
majority of the people I see on reddit etc. are actually with very good feedbacks
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There's no shortage of people on reddit eager to give feedback. Unfortunately, most of the time it's misinformation. I try to avoid reddit for that reason and many others. I look for specific people/sources that are evidence-based and trustworthy.
 
Thanks for the response @Michael Harrop

So, no, I am not able to follow up with other people. Just talked with the Doctor and he told me that he has 20 people with cancer and all of them responded very well. As I said in front of me I saw people (even a lot of kids) drinking the solution, so I was curious, but never asked anyone.

Also, the doctor gave me (my desire) a frozen solution with glycerol to be frozen at home (-22C) to take small amounts here and there, but I didn't responded very well.

He is doing FMT since 2004, that's why I trusted him.

Michael Harrop said:
I tried antibiotics after I used a bad donor. It's very hard to determine the right antibiotic to take. For me, I used one that helped temporarily but did long-term damage.
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it's always like this with antibiotics unfortunately:(
Michael Harrop said:
You should write up a detailed experience report in the clinics subforum and include that information. It will help everyone vet the various clinics to see which is best.
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I didn't react way too badly to Vancomycin to be honest. I also didn't react after FMT during the first week or two at all.
 
The doctor is selling you a product and service. You can't just take their word for it. It's essential for results to be publicly and systematically tracked & reported, and/or for patients to write up detailed public reports of their results.
 
@Michael Harrop - I asked several other (2-3) people who were treated in that clinic. All positives (kids with autism mainly), kids are better.

That not aligned with me. So, I already suspect something, but please let me know if you have ever met such reaction elsewhere (I personally didn't find anything).

I think I have developed celiac disease from FMT (hopefully I will test soon). Prior FMT I was eating gluten without a problem, now on the 2nd-3rd minute of eating gluten, I got joint pains and some forehead tingling. I also feel like I didn't eat so much after meal with gluten (a bit hunger, which also indicates malabsorption).

I'll be thankful if you ever met that.
 
effecolprep said:
I asked several other (2-3) people who were treated in that clinic. All positives (kids with autism mainly), kids are better.
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You should invite them to post detailed reports of their experience here.

effecolprep said:
please let me know if you have ever met such reaction elsewhere
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I've seen numerous reports of all sorts of worsening and new conditions developing/contracting after FMT. I experienced it myself as well.

effecolprep said:
I think I have developed celiac disease from FMT (hopefully I will test soon). Prior FMT I was eating gluten without a problem, now on the 2nd-3rd minute of eating gluten, I got joint pains and some forehead tingling. I also feel like I didn't eat so much after meal with gluten (a bit hunger, which also indicates malabsorption).
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Not surprising at all. Most likely there are other patients getting worse from the same donor/clinic. They just don't bother to write up detailed experiences, which is very frustrating and guarantees that things like this continue to happen to more people.
 
@Michael Harrop , I want to share some feedback in the last month:



Bad:
  • Malabsorption remains
  • Klebsiella and Enterobacter skyhigh on microbiome (previously they were only slightly elevated)
  • Allergy symptoms (not sure whether it's propolis or lemon, no issues prior that)
  • Cold sores (herpes like?) and canker sores twice in the last 2 months
  • LPS symptoms (a bit lowered since I removed most of the starches)

Good:
  • Citro, E. Coli and Fuso are within a range (before FMT they were bad)
  • Firmicutes boosted (previously Bacteroides prevailed)

I've tested ANA Screening and CRP to check for autoimmunity and inflammation, but those were negative. I also started to react very bad to gluten (no issues whatsoever before that) with some inflammation (Celiac tested - negative).
What kind of a reaction are those? Can it be somehow increased zonulin, which is causing those immune flares? Any suggestions are more than welcomed. Should I take any antibiotics at all?

Not sure what to test or do anymore. I've personally contacted people (several mothers) who were with me, none of the kids developed those kind of issues.
 
That's fine, but I have some suspicion of contamination. Because I requested from my Dr. frozen material to be in my fridge
So I took only about 5 capsules and I think it worsen the situation. This was a month and a half after my fresh FMT.


Is it possible some contamination to happen? Because as I said, I discussed with multiple people (some of them were with me on day of fresh FMT), no issues whatsoever.
 
These types of reports are extremely common and virtually always attributable to a low-quality donor. Your reasoning of why you think it may be contamination is not clear to me.

Was your fresh FMT via capsules or upper-route? Or lower-route only? It's possible that the adverse side effects are more apparent for you when taken via the upper route (capsules).
 
Fresh FMT was from both routes. Capsules later on (frozen at -22C) were only orally.

But maybe its just bad. I had a chat with a person from USA, which received a donor stool by FedEx for a straight whole year. The result is fascinating. She has done that orally and enema (at home).
 
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