Pills Made From Poop? Don’t Laugh!

It's no laughing matter to those 550,000 in the U.S. who at some point each year - come down with c.diff. or clostridium difficile infection. C. diff. now kills 14,000 a year and is ranked by hospitals as one of the top two or three 'superbugs' getting out of control. This is especially as there are now too many cases in the community itself, outside of hospitals.

What is c. diff.? It's a bowel infection but that barely begins to describe it. My wife got it back in December, 2006, after taking a prescription of amoxicillin for a stubborn sinus infection. But within a few days, the antibiotic had eradicated nearly all the 'good' bacteria in her gut, paving the way for a much less benevolent (indeed, vile) gut bacteria to take up residence. This was none other than c.diff. Related to the botulism and tetanus bacteria, this bug is described in med lit as a "gram positive, anaerobic, spore -forming rod which exists as a non-infectous spore (in the gut) and as an infectious form that can't exist long in the environment for prolonged periods." It was the latter form that we suspected got released from latent spores that created havoc in Janice's intestinal tract - causing gallons of fluid to literally pour out - in up to 22-25 diarrhetic releases per day.

Within days she had to be hospitalized on account of dehydration, whereupon she was put on an antibiotic called flagyl- 2nd ranked to the univeral powerhouse vancomycin. But then the bug got through it within a week, so, she was re-hospitalized and this time - and had to be administered vancomycin. This time, after the new course and being isolated in her own room, it finally worked. Most of those who die do so after being left with peritonitis, toxic megacolon, and peforation of the colon - from the violent expulsive force (which I pointed out to my wife - seemed to resemble cholera).

Since that bout of c. diff. infection 7 years ago, medical centers have scrambled for a treatment that doesn't require use of antibiotics - given how close we are to full antibiotic resistance. (See the excellent PBS Frontline series on this ). One of the first alternative measures was the use of 'poop enemas' - delivered uniquely to the victim - harvested from her family and bearing loads of good gut bacteria. At some point the enemas result in the bad guys being overwhelmed by the good, and the gut health restored to normal.

Now, thanks to Canadian researchers such as Thomas Louie at the University of Calgary, an alternative method has been developed where, instead of using enemas - the healthy variety of poop is administered via pills. Basically, it's being described as a "less invasive way" to get healthy poop into guts ravaged by the deadly c.diff. bacteria. So far, according to reports in the Canadian press, clinicians have treated 27 people succesfully after antibiotics failed to alleviate symptoms. This is huge news given a particularly virulent form of infectious c.diff. is all but indifferent to even vancomycin.

The process of extraction and preparation, according to Dr. Louie, isn't that difficult. A relative is first brought in and assorted stools obtained. Next, the material is processed in the lab to remove food, extract the bacteria and clean it. The residue is then infused into triple-coated gel capsule capable of surviving all the way into the gut. Be aware, as Dr. Louie points out, there's no stool as such left, only the necessary bacteria. The c.diff. victims thus are not technically eating poop, but instead just "stool bugs" after stools have been processed, diluted, cleaned. There are no smelly "shit" burps because the contents aren't released until they are well passed the stomach.

Louie has thus far found that 24 to 36 capsules are generally needed for treatment and patients can down them in one sitting. The pills thereby find their way to the colon and seed it with the healthy bacteria.

Don't laugh! This is all quite true, and the treatment had been announced two weeks ago at an infectious disease conference in San Francisco. This may well be the remaining life saver left for many more patients who contract c. diff.

For those who still wonder why I never got treatment for my severe bronchitis reported back in July (July 7 blog post) it was because I feared the use of antibiotics and the triggering of c.diff. I am certain I have the spores residing in my gut and that they've been there since Janice was ill - perhaps picked up by contact with contaminated surfaces, and then ingested with food - by hand. Who knows? At least now, I am not so deadly paranoid of getting c.diff. if I do have to take antibiotics at some future date.

Super-Bugs are Super-BAD!

The issue of antibiotic -resistant superbugs has more and more entered the repositories of the mainstream media, and well it should. Right now, we may stand on a precipice of wholesale generation of these bugs if we carelessly continue down the path we've been on - stupidly using anti-biotics for every little thing (as well as for viral infections like the common cold and flu) as well as stuffing antibiotics into our food supply.

In this light, it has been calculated that nearly four-fifths of the antibiotics used in America are given to livestock. There is nothing wrong with these animals, the antibiotics are administered totally out of capitalist obsession with profits and naked greed. Thus, they are administered to force healthy animals to grow faster, and more pounds means more money at the supermarket. The trouble is this activity provides enormous opportunities for the spread of superbugs. (See, 'The Spread of Superbugs' in The Economist, April 2, p. 73).

Two of the most ravaging superbugs are MRSA, an especially nasty form of staphylococcus that is resistant to many antibiotics, and clostridium difficile, or "c. diff." which actually arises when too powerful forms of anti-biotic kill the normal bacterial flora in the gut leaving only this nasty form to proliferate. Both of these are generally picked up while spending time in hospitals (one reason people shouldn't get too comfy in a hospital, and need to do their level best to leave asap). But this isn't always the case.

My run up with a superbug occurred indirectly, back in December of 2006. At the time my wife had been suffering from a severe sinus infection which had already gone on for two weeks. I was also suffering from severe nasal and chest congestion. She suggested we both see the family doctor and get an antibiotic to knock the infections out, but I told her I'd prefer to fight it on my own. In another week, after lots of coughing up loads of nasty stuff and inhaling from nebulizers nearly every night, I was through with it. Meanwhile, she opted to go for an amoxicillin prescription, given her by the Nurse assistant.

Within three days of beginning her course of amoxicillin, she was going to the toilet nonstop. We aren't talking about normal movements and with normal consistency, we are talking about cholera-like episodes accompanied by agonizing abdominal spasms, with the stools bearing the consistency of watery gruel. And we won't even get into the odor! By the fourth day she was so dehydrated, after running 22-25 times to the toilet each day, she went back to see the family dr. He immediately took a sample and the lab report came back: c. diff. He prescribed the antibiotic flagyl to off it (I know this sounds counter-intuitive but once c. diff. gains traction in the gut the only way to knock it out is via more powerful antibiotics!) Alas, after nearly a week, it didn't work, she was worse than ever and I had to rush her into the ER again, where they immediately put her on a drip.

Now hospitalized, but forced to share a room with another, I questioned the nurse about this, pointing out she was probably highly infectious. (Indeed, hospital studies on the distribution of c.diff. show it's only controlled by continual cleaning of all surfaces with bleach, every day and all the advisories insist patients have their own rooms to prevent the spread of c. diff. spores.) But the most the nurse would do is prevent her from using the general patients' lavatory, and restrict herself to a tiny "porto-potty" instead. It was humiliating for her and totally wrong.

After much more intense lobbying and complaining she finally got her own room where she was able to recover in comfort. She was also placed on the only remaining antibiotic with the strength to knock out c.diff. - vancomycin- which is why the doctors always save it for last, the final arrow in their quiver of protection. As one doctor told me, "Once the vancomycin goes, a lot of people will die." Fortunately for my wife, she was out of the hospital in another four days.

But our work at home had only begun, including disinfecting all her bedding and clothing, and washing them in high concentration bleach detergent. Then, going all over the house and wiping all the surfaces down with nearly 80% bleach solution, including telephone, and tables, chairs, tv, and everything else with which she'd come into contact. This was done every other day for a week, under doctor's orders.

What frightened me about the incident is how close she came to dying. Most patients with c.diff. die because the intensity of the explosive bowel movements causes the large intestine to rupture (from severe colitis and toxic megacolon). This is partly owing to the fact the bacteria 'spike' into the gut lining to force it to release vast amounts of water accompanied by spasms, as they destroy the mucosal lining. But a smaller segment die from dehydration, as with cholera. She came close to the last and that was why I fought like a Tasmanian devil to see that not only did she get to the ER but was expedited through it after the initial antibiotic failed.

This is but one story, but I'd strongly suggest people - readers recall it the next time they're tempted to have an antibiotic prescribed. It might be better, in the end, to just tough it out! For more on the benefits of the latter, please consult the work of University of Antwerp microbiologist, Hermann Gossens and his trials of 2007. He found that those subjects exposed to throat streptococci and given only a placebo were the only ones showing no signs of drug-resistant strains of streptococcus. The others, taking azithromycin and clarithromycin, did. Go figure!