Fecal Transplant cures Ulcerative Colitis

By Michael K Hurst
Text copyright 2013
www.FecalTransplant.org
All Rights Reserved

Table of Contents
Introduction........................................................................ 6
Part 1: My Story..................................................................8
The Beginning life before the flare...............................................8
First Colitis Flare and diagnosis..................................................... 10
The anti-biotic Cipro brings about my first remission............11
I try diets for IBS.................................................................................. 12
I try the drug Remicade / New Years Eve in the E.R................15
I poop my pants on a night out (literally).................................... 15
Skin infection sends me to the hospital for 4 days................... 16
Anti-biotics to the rescue, again, for a moment.........................16
Finally preparing for surgery.......................................................... 17
I first hear about Fecal Transplant................................................ 19
I cancel Surgery to pursue Fecal Transplants............................22
Success finding a doctor.................................................................... 22
I am introduced to a mentor............................................................ 23
Finding a donor................................................................................... 25
Starting the Fecal Transplants without a doctor....................... 26
I add Bupropion and other drugs to my treatments................29
Its Gone! Im cured!........................................................................... 31
A colonoscopy reveals further evidence that I was cured!.....32
Defeating the self-perpetuating cycle of Inflammation...........33
Continued good health and lessons learned............................... 35

Part 2: Making the decision you really want to be well.....37

Weighing the Pros and Cons............................................................ 37

The Benefits of being sick, the challenges of being healthy...41
What is really standing in the way of good health?..................45
Do you actually want to be healthy?.............................................. 46
An exercise to change your mind to lead you to health...........47

Part 3: Step by Step how to do Fecal Transplants................49

Find yourself a donor......................................................................... 50

Prepare Your Body............................................................................. 51
Gather Your Supplies......................................................................... 53
Conclusion...................................................................................................... 59

Part 4: Frequently Asked Questions........................................60

Why and how does Fecal Transplant work?...............................60

Why not just remove the bad or add good bacteria?.........61
Why dont anti-biotics permanently cure the condition?.......62

Why do immune-suppressing drugs help?.................................. 63

Why are some diets sometimes helpful?.....................................64
What do you think about the Specific Carbohydrate Diet?....65
Why does emotional distress appear to trigger a flare?.........66
What published medical articles support the use of Fecal
Transplant for Ulcerative Colitis?................................................................ 67
Can I do fecal transplants at home without a doctor?..............68
Is there a risk that Fecal Transplants could trigger a flare?. .69
How do I find an ideal donor?......................................................... 69
Do I have to test my donor for every possible illness?............70
Can my intestines really be damaged beyond repair?.............70
What if a flare starts while doing the fecal transplants?.........71
Should I take medications that reduce stomach acid?.............72
Should I change my diet during the fecal transplants?............73
Should my donor significantly change their diet?.................... 73
How long will it take before I start to heal?................................73
Why could it take longer for some people to heal?...................74
How do I get a flare under control so I can get started?..........77

Part 5: What causes Ulcerative Colitis?................................... 82

Bacteria imbalances, infections or other parasites..................82

Auto-immune disorders and the good hygiene theory...........82
Emotional Stress.................................................................................. 84
Nutrient deficiencies.......................................................................... 84
An combination of factors and a vicious cycle...........................84

Part 6: Treatment Options / Methods.....................................85

Mesalamine: Asacol, Apriso, Sulfasalazine etc...........................85

Prednisone and other steroids....................................................... 87
Immune suppressing Biologic, drugs Remicade etc.............89
Bupropion (Wellbutrin).................................................................... 90
Other anti-depressant / anti-anxiety drugs................................ 91
Anti-biotics / Anti-bacterial / Anti microbial drugs.................91
Types of Bacteria......................................................................................... 93
Pro-biotics............................................................................................. 95
Fecal Bacterial therapy / Human Probiotic Infusion...............96
Diet and Nutrition............................................................................... 97
Specific Carbohydrate Diet (SCD)......................................................... 97
GAPS or Elemental Diet............................................................................. 99
Gluten-free Diet......................................................................................... 100
Digestive enzymes.................................................................................... 101
Nutritional Supplements....................................................................... 101
Low Dose Naltrexone....................................................................... 102
Herbal Supplements........................................................................ 103

Helpful parasites Helminths / whipworms..............................103

Surgery................................................................................................. 105

Suggested treatment plan for a flare..................................... 106

What do I do if youre having a flare........................................... 107

Treatment options during a flare....................................................... 107

Fecal Transplant Donor Questionnaire................................ 111

References..................................................................................... 114
More Resources ........................................................................... 116

This book is dedicated to all of those who were supportive over

the years especially my parents, my brother and sister. Extra special
recognition to my Mom who was right all along that the root cause
was bacterial in nature and literally handed me the article that ended
up saving my colon, if not a quality of life worth living. I also credit
how she raised me to question whether established medical
treatments were the best options without any alternatives.
I also want to thank the many understanding women I dated
over the years, the doctors who tried their best using the knowledge
they were aware of and my mentor Sky Curtis who told me with great
certainty that Ulcerative Colitis could be CURED and encouraged me
to keep going with the fecal transplants when I was discouraged and
considered giving up. Thank you to my friend and donor who was
very helpful and willing to help me make this work in spite of the
somewhat unorthodox nature of the request. I can say he truly has
good shit.

Introduction
Digestive diseases including Ulcerative Colitis, Crohns Disease
together known as Inflammatory Bowel Disease (IBD) is one of the
five most prevalent gastrointestinal disease burdens in the United
States, with an overall health care cost of more than $1.7 billion.
Up until now the established medical community in the United
States considers this illness to be one without a medical cure and that
it commonly requires a lifetime of care. Each year in the United States,
IBD accounts for more than 700,000 physician visits, 100,000
hospitalizations, and disability in 119,000 patients. Over the long
term, up to 75% of patients with Crohns disease and 25% of those
with ulcerative colitis will require surgery (Gut. 1989;30(3):36770)
However it is also true that over the years the medical
communitys understanding of infectious diseases has continued to
become more advanced and many illnesses that were once attributed
to other factors are now known to have bacteria as a contributing
component including stomach ulcers.
Before I go any further let me clarify that I am primarily
speaking of Ulcerative Colitis in this book. To distinguish Ulcerative
Colitis from similar illness, UC is ulceration in the large intestine
which is not caused by:
Infectious colitis, caused by a known pathogen that is typically
detected on stool cultures. This includes Pseudomembranous
colitis, caused by an infection or overgrowth of Clostridium
difficile bacteria, which usually occurs following
administration of antibiotics.
Ischemic colitis, inadequate blood supply to the intestine,
which typically affects the elderly
Radiation colitis in patients with previous pelvic radiotherapy
Chemical colitis resulting from introduction of harsh chemicals
into the colon from an enema or other procedure.
While I treated myself of Ulcerative Colitis, the most common
and best known use of this treatment at the moment is for
Pseudomembranous Colitis caused and infection / overgrowth of
Clostridium Dificile bacteria. Others have successfully used this to

treat Irritable Bowel Syndrome and Crohns Disease as well, especially

if much of the inflammation is in the large intestine. There is also the
possibility of overlapping conditions such as indeterminate Colitis in
which case they cant decide which form of the illness it is and you
could also have Irritable Bowel Syndrome (IBS) before developing
Crohns or Colitis. After the fecal transplants proved to be successful
for me, I am actually in better digestive health than I was before I
became ill with Ulcerative Colitis. In retrospect I think I may have had
undiagnosed Irritable Bowel Syndrome my whole life before Colitis
I wrote this book because I struggled with the impact of
Ulcerative Colitis for over 12 years. I was repeatedly told there was
no cure and that surgery was inevitable. After trying almost every
possible medical treatment my doctor told me surgery was my last
option.
However 3 days before my surgery date I found an article by
Dr. Thomas Borody Treatment of Ulcerative Colitis using Fecal
Bacteriotherapy that detailed the effective treatment of Ulcerative
Colitis using Fecal Transplant. Fecal transplants as I call them, are also
known as Fecal Microbiota Transplant, stool transplant, fecal enemas,
fecal bacteriotherapy and Human Pro-biotic Infusion among other
names. I had previously heard about their use to treat
Pseudomembranous Colitis caused by Clostridium Difficile bacteria
however this was the first time I had heard them being used to treat
Ulcerative Colitis.
I decided to pursue this course of treatment for myself and
ultimately resorted to administering this treatment to myself at home.
At the time of publication I have been free of symptoms without any
ongoing drug treatments or special diets for 15 months.
In this book you will see the course of events which lead to my
pursuit of this treatment option and what I did to make this work. I
have also included a step-by-step guide to performing this treatment
yourself, answers to frequently asked questions and some additional
background information on the illness and treatment options.

Part 1: My Story
Welcome to my story of how I successfully won the fight
against Ulcerative Colitis. This illness became serious enough that I
came within 3 days of scheduled surgery to remove my colon.
Specifically a full colostomy with restorative proctolectomy. As
anyone who has gone through Ulcerative Colitis or Crohns Disease
knows it can get to the point where it can really wear you down
psychologically as well as draining you physically from loss of blood,
malnutrition and more. After nearly 12 years of this, some without
health insurance, I was ready for it to all be over and I was told
surgery would offer that.
However I still had some nagging doubts as did my family. If
this were an autoimmune disease and not some sort of an infection
then why had it suddenly started after traveling to South Africa with
my family. Why did anti-biotics seem to help me? Why did immune
suppressing drugs seem to help sometimes but not other times? If
stomach ulcers could be caused by bacteria, then why would the same
not be true farther down the digestive track? Then questions
lingered.
Before I go any further let me start by giving an overview of the
course of my illness, treatments used and more.

The Beginning life before the flare

My first Colitis flare occurred in June 1999, about a month
before my 21st birthday, however life had never been entirely normal
for me in terms of diet and digestion.
According to my parents as an infant I was hyperactive, and at
times irritable. I spit up frequently, almost enough to be considered a
colicky baby. However I grew at an average to above average growth
rate and did not show any signs of malnourishment. At age 2 after
frequent sinus and ear infections and extended treatment with antibiotics I suffered a grand mal seizure with left a strong impact on my
parents, especially my mother and a desire to limit drug treatment
unless it was necessary. While an exact cause was not determined, my
Mom discovered an all-natural diet known as the Feingold Diet. She
fine-tuned this diet along with about two years of introducing new

foods one at a time while keeping a diet diary in an attempt to

identify and eliminate problem foods from my diet.
It was my mothers belief that along with specific behavioral
strategizes to manage a hyperactive child diet did appear to help.
Around age 5 I was also tested for food allergies to wheat and dairy,
using an elimination diet and various other tests. For nearly 6 months
I did not eat cows milk or wheat products. Rice cakes were the main
substitution for bread and goats milk in place of cows milk. However
wheat or milk allergies were ruled out and I ate these for the rest of
my childhood without identifying them as being a major source of
problems.
Although I did still have relatively frequent diarrhea or gas,
especially after eating foods high in fiber. I often did not always share
the details of everything, especially as I got older. It was just accepted
that some foods seemed to cause problems, but it was often hard to
say exactly which ones. Since I did not have any problems growing or
thriving, I just choose to ignore the problems and just keep going.
When I was approaching my Jr. year of high school I tried The
Zone Diet which attempted to eat roughly equal equivalent of calories
from fats, proteins and carbohydrates. The primary source of
carbohydrates was to come from fruits and vegetables dairy while
minimizing starches. I thought this could help me training for
swimming and ability to concentrate. In retrospect its hard to say
what difference it made, but I thought it was good at the time even as
the high fiber from nuts and fruits sometimes seemed to contribute to
urgency to go to the bathroom and frequent gas. I also had pretty bad
acne mostly on my back and shoulders, however I didnt go to the
dermatologist where the prescribed course of action would likely
have been the anti-biotic Tetracycline or even Accutane.
In college gastro intestinal symptoms continued to get worse
although I didnt think there was much I could do about it so I just
tried to make do as best as I could. Through my Sophomore year of
college I was very busy and stressed between a demanding course
load, volunteering in political campaigns and being rush chair in my
fraternity. By the winter I struggled with depression and ended up
self-medicating with St. Johns Wort and a lot of coffee and I had
frequent gas and diarrhea which I now think could have been
described as Irritable Bowel Syndrome (IBS) and not just related to
diet and dietary supplements.

First Colitis Flare and diagnosis

It wasnt until the summer of 1999 that I had my first flare of
Ulcerative Colitis, although I had never thought of the illness before. I
had traveled to South Africa to join the rest of my family that had
traveled there a few weeks before. At first I started to develop pink
eye and blurry vision. In South Africa a pharmacist can prescribe antibiotic drops to you, so thats what I got. However the eye drops did
not resolve all of the redness and blurriness. So I was also given
steroidal eye drops. This did help with the redness. While I had had
allergies in the past this was different. About that same time I started
to see bright red blood in watery diarrhea which was coming with
increased urgency, especially right after eating. At this point we were
about to travel back to the U.S. so I held out as best as I could with
Immodium.
I finally went to the Gastroenterologist as soon as we got back
home to Florida and he diagnosed Ulcerative Colitis. The doctor
assured us that to the best of their knowledge Ulcerative Colitis was
an auto immune illness. My Mom and myself told him about South
Africa, however he told us that travelers diarrhea was unlikely since I
had basically eaten the same diet as the rest of my family. However a
stool test was done and did not identify any know parasites. I was put
on 40 mg of Prednisone and 12 400 mg tablets of Asacol, 4 tablets 3
times a day, although I often had a hard time remembering to take the
mid day dose on time. I also took Immodium almost constantly to try
to slow down diarrhea.
In spite of the chronic diarrhea I continued to stick to a diet
called the Zone Diet, a lower carbohydrate diet included lots of raw
fruits, vegetables, nuts, meat and dairy. The doctors assured me that
diet had nothing to do the flare, although in retrospect a diet like this
that was high in fiber probably helped make the diarrhea and urgency
symptoms even worse. I also may have mistaken how spicy foods
appear in stool, specifically red pepper hot sauce, for blood. I also
continued to take St. Johns Wort for depression even though I
wondered if it might be contributing to this. Once again the doctor
assured me that it should not have a negative affect. I now think that it
contributed to diarrhea and might have contributed to making me
more susceptible to the bacteria.
Before the Colitis flare my plan had been to transfer to
American University in Washington, DC from Beloit College, a small
0

liberal arts college in Wisconsin. My parents questioned if I should

stick to my original plan when faced with this illness. However I was
stubbornly determined to carry so I moved to Washington, DC.
Once in DC, my new Gastroenterologist increased the
Prednisone dose to 60 mg a day to try to control the flare and yet the
symptoms continued. The Prednisone was definitely starting to affect
my mood and I started to develop chubby chipmunk cheeks even
though I have always been thin. Once again my Mom mentioned
traveling and the possibility of it being Travelers Diarrhea, and my
medical history of GI disturbances, how I had been on a restricted diet
as a kid, and stress. We asked werent these factors as well?

The anti-biotic Cipro brings about my first remission

A month after Prednisone at 60 mg had failed to work, he
added Cipro at 500 mg twice a day to the treatment regiment. This
finally brought the flare under control and I went off Cipro and then
tapered down the dose of Prednisone 10 mg per week until I was off
of it.
One of the next questions to my doctor was, if the anti-biotic
made me better didnt that mean that bacteria was a root cause of my
problems? The doctor said that while they thought Ulcerative Colitis
was an autoimmune disorder with heredity being a factor, in some
cases where Prednisone didnt work anti-biotics seemed to help.
Over the next year I would periodically have a flare, go back on
Prednisone at 40 mg and then taper back off of it. I had continued to
have eye irritation and noticed that starting a day or two before a flare
I would get redness and what I thought was an infection. However my
eye doctor realized that Ulcerative Colitis can sometimes produce
secondary symptoms including eye inflammation and ulcers in the
mouth. So I realized that the conditions were linked.
A year later I ended up finally going to the Dermatologist and
was prescribed Accutane, eventually up to 100 mg a day for almost 6
months. This did effectively treat the acne, and its not clear if it made
the Colitis worse or not. Years later I learned that Accutane was
attributed as the cause of Colitis in many patients. I now wonder if
there may be some sort of link to the bodys immune system function
or the kinds of bacteria in the body between those who get Crohns or
Colitis and those with severe acne. Is it possible that severe cystic
acne skin infections are caused by some of the same bacteria that
1

causes Crohns or Colitis?

After college I briefly worked on Capitol Hill and then after
leaving stayed on health insurance cobra as long as I could, however
eventually that ran out and I didnt want to have to deal with the extra
expense anymore than I had to. I tried to make as few doctors visits
as possible and just went on Prednisone every time I had a flare and
then tapered off again once it appeared to be under control. Once
prescription drug coverage ran out, I ordered Prednisone from
overseas pharmacies. Prednisone was relatively inexpensive and
seemed to help, while Asacol cost over $300 a month and its effects
were not as clear to me as Prednisone.
Once or twice I also used Cipro to help bring the illness under
control. Then another time I ordered Doxycycline. I figured if
Doxycycline could also be used to treat Anthrax then it could treat
sinus infections then why not? It seemed to help as well. Years later I
learned that Doxycycline was also used to treat some parasitic
infections that cause travelers diarrhea. I also learned that while
losing blood I could take relatively high amounts of iron to make up
for the blood loss without worrying about iron poisoning. This helped
and I got control of secondary sinus infections or colds by taking more
iron.

I try diets for IBS

At some point someone told me about diets for Irritable Bowel
Syndrome and I thought to give that a shot. Since doctors had told me
it was incurable and I could not control when I had a flare, I was
resigned to trying to treat the symptoms. I discovered a book called
Eating for IBS by Heather Van Buren, which was practical and
included the authors story.
Her explanations made sense, the way to control diarrhea was
to have a diet that included plenty of water-soluble fiber to soak up
excess water in the colon and foods that could calm the muscles or the
digestive track. This includes a complete cook book and also several
different breads. I bought some bakeware and made the brown sugar
banana bread, something I still do to this day simply because I like it.
She also included these enterically-coated capsules with
Peppermint, Fennel and Ginger oil in them. This was =because
peppermint especially was supposed to have a calming, anti2

spasmodic effect on the muscles in the digestive track. The enteric

coating made sure that more of the peppermint oil went undiluted,
straight to the colon instead of causing heart burn in the stomach.
Instead of going to business school however instead I ended up
moving in with my girlfriend and getting a job as a management
consultant. Fortunately she was very understanding about my
problems with Colitis. Although we did run into some additional
challenges, this included a bathroom with no fan! I continued to suffer
from frequent gas and bloating, poor girl.
She told me about how her manager had some success with the
Breaking the Vicious Cycle by Elaine Gottschall which was about the
Specific Carbohydrate Diet. It turns out her boss also had an openminded and well-published gastroenterologist who was open to
considering alternative treatment options to drugs.
I went to the Dr. and she told me about how the balance of
bacteria may play a role and how pro-biotics were helpful in
modifying immune system response. She told me about VSL #3, a
pharmaceutical-grade mixture of eight different pro-biotic strains in
very high concentrations.
I read the book and tried the Specific Carbohydrate Diet (SCD).
I was shocked that most of the food I had in my cupboard I tried the
diet, starting by eating nothing but home made chicken soup. I then
added home made yogurt as recommended by the diet, I fermented
the yogurt for nearly 24 hours to break down the lactose. I got vital
nutrients by making my own vegetable and fruit juice using an
inexpensive juicer I bought at Target.
Unfortunately the juice ran right through me and so did the
vegetables from the broth. It appears to me that water went right
through me. How could I slow down diarrhea and how could I soak up
excess water without eating bread? Then it occurred to me, what if I
added constipating foods to the mix. So I stripped my diet down to
cooked hamburger, the home made yogurt and fresh man fruit and
vegetable juice mixed with Benefiber water soluble fiber.
After about two weeks, I was starting to notice a positive
difference, however I had lost over 10 lbs and was feeling weak, not to
mention unhappy about missing foods. Ive always been pretty thin
with a high metabolism so there was really nowhere for the weight to
come from. It was also very tempting to take Prednisone and instantly
3

feel healthy and eat whatever I wanted long-term impacts including

to my bones be damned.
While some of the premises of the diet made sense, I also
questioned the reasoning behind the diet. Benefits included being
gluten-free, lactose-free and free of processed foods and starches.
However while it was generally healthy the SCD also included many
problem foods for those with active diarrhea which had always been a
problem for me even before I was diagnosed with Colitis. This
includes high fiber fruits, vegetables and nuts and also dairy. I also did
not like the sound of some foods being declared illegal on the diet
with the assertion that eating even a small amount of some illegal
foods could contribute to problems that would last for days or even
weeks.
This also included cases where people did not have a
measurable food allergies to the problem foods. In my mind, a
problem food could be bad but then it was out of your system and you
should get better. I also knew that with high doses of Prednisone an
almost immediate remission of symptoms was possible. If this diet
was going to work, shouldnt I start to see measurable results within a
matter of days to a week?
Once again I had gotten some results but couldnt stick with it,
Prednisone was so much easier and with that I could eat whatever I
wanted. So bit-by-bit I started to include other foods and over time
gave up on trying to strictly follow it while sporadically including
things like juicing and home made yogurt.
Then about 3 years later after years of trying to largely avoid
what seemed to be an insolvable problem, A life coach / business
coach I was working with encouraged me to confront the illness and
take it on once again. I went to another Gastroenterologist who was
covered by my health insurance plan and learned that Asacol had to
be taken 3 times a day for it to work most effectively, while I had often
been taking it twice a day. This was because Asacol only released
Mesalamine for 8 hours. Once again, lesson learned read the package
insert and know how the mechanism for how drugs that you are
taking work. I was given Apriso, a 24 hour release version of
Mesalamine and it seemed to make a noticeable difference.

I try the drug Remicade / New Years Eve in the E.R.

Then I was prescribed Remicade which is known as a biologic
drug and which was administered by IV. My first infusion seemed to
help a little, however the results did not seem to last much past about
one week.
After missing my 2nd scheduled appointment because I had a
cold, I ended up having two infusions spaced only about two weeks
apart, instead of the normal minimum interval of 4 weeks. At the time
I was also taking Prednisone, Apriso and VSL #3 pro-biotics. Suddenly
I had a normal bowel movement. Wow, it worked! But what a costly
and intensive regiment this was. I talked to my doctor and the
infusions were moved up to once a month. However it still only
seemed to help for about 7 10 days after the infusions before
symptoms, the flare, returned.
The next month I almost had a fit when a bill arrived for
$10,000! At first the insurance didnt cover it because I had two
treatments within the same month, but finally they did. I wondered
why this drug costs so much when its less effective than Prednisone.
However there were complications stemming from Remicade. I
developed a staph infection near my groin area a few days before New
Years Eve. After a failed attempt to lance the boil myself, I ended up
going to the ER in the middle of the night on New Years eve to have it
lanced and was given anti-biotics. The anti-biotics to help clear up the
staph infection seemed to help a little with my gut while I was taking
them.

I poop my pants on a night out (literally)

A few weeks later I was out coaching my dating coach class at a
bar near U Street in Washington, DC when as fate would have it I was
in the midst of a flare once again. I had already gone to the bathroom
once, however I needed to go again. I rushed away for my budding
Don Juans and a few women we were talking to. I got to the bathroom
door but it was locked. I desperately tried to do my poop dance to
stop it, but I couldnt. In spite of my best efforts to control my bowels,
it came anyway. The watery diarrhea came out in spasms and then
just dribbled out and ran down my leg into my shoes.
I kept trying to get into the bathroom, but I couldnt. Finally the
spasms stopped, however it was too late. A whole bowel movement
5

had gone done my pants leg and into my shoes. I went back to get my
friend and told him we needed to leave right away. He said a few good
byes while I went downstairs out into the February cold. The poop in
my socks felt cold as the other shit on my legs started to dry. My
friend came out and we got in the car. I had to drive him back to my
place to get my car and he headed back home through the city and
down interstate with the windows open to deal with the smell.

Skin infection sends me to the hospital for 4 days

Then in the summer 2010 I was still struggling with frequent
diarrhea, bloating and blood loss, I ended up going back on
Prednisone on a constant basis. After I scrapped my lower leg while
playing kickball, it got infected, swelled up to the point where I could
barely walk and once again I ended up going to the ER in the middle of
the night. They cleaned the wound, gave me anti-biotics and sent me
home. I took myself off the Prednisone cold turkey, thinking that going
off an immune suppressing drug would help me deal with the
infection. After initially starting to get a little better the swelling got
worse in spite of the anti-biotics, so I went back to the hospital
dragging my leg and an overnight bag just in case I was going to be
there awhile and was admitted on an inpatient basis

Anti-biotics to the rescue, again, for a moment

During this next trip to the hospital I was put on IV anti-biotics,
including Vancomycin. Within 24 hours I had a normal almost solid
stool! I suppose most people take this for granted, but this hadnt
happened in years except for a day or two after a Remicade infusion
or after being on high doses of Prednisone. However the skin
infection on my leg wasnt getting better yet. Then they added iron
supplements to my treatment regiment at the hospital and the skin
infection slowly started healing. They discontinued Vancomycin after
the 2nd day and the diarrhea returned slightly although not as bad as
before. I continued to slowly get better after that and ended up
spending 4 days inpatient at the hospital. This was my first inpatient
hospitalization since I was 2 years old.
The Vancomycin treatment by IV seemed to have very clearly
brought about an almost spontaneous remission, so I asked the
infectious disease specialist for a referral to another
Gastroenterologist who was willing to use anti-biotics to treat this. I
6

went to the new doctor and was given a prescription for Flagyl and
was also tested for known parasites and causes of travelers diarrhea.
These tests came back negative. I also wanted to give a maximum
dose of VSL #3 a try once again, (3.6 Trillion CFUs) perhaps at the
same time as Flagyl.
However the insurance declined to cover VSL #3, even the
prescription-strength version, even after my doctor wrote a note so
that I could appeal the decision. My out of pocket cost for VSL #3
would be nearly $700, so I abandoned that idea.
At about the same time, after 30 days of taking Flagyl I was still
not having any significant results. My doctor said my only option was
surgery. Based on the failure of almost every other known treatment
option his arguments made sense. However I still didnt want to do it
except as a last resort since I knew that sometimes the illness seemed
to get better. Maybe it would once again.
I then went on a cross-country book signing tour for another
book I had published, so I kept myself going using Prednisone.
However after I got back I was sick once again. My life was really
hectic when I got back, I didnt have a regular job, I had to move from
my apartment and my business as an author and speaker was at a
slow point.

Finally preparing for surgery

Then when I got back I went to the doctor and he told me that I
needed to go with surgery because clearly this could not be brought
under control with medications. He prescribed a capsule endoscopy. It
turns out my insurance had been discontinued for non-payment, so I
had to get that reinstated to cover the capsule endoscopy. The
purpose of this was to confirm that I did indeed have just Ulcerative
Colitis confined to the large intestine and not in the small intestine.
Basically that it was not Crohns Disease or Crohns Colitis.
I ran into financial difficulty once again. I had been
unemployed for several months now, had to move from my
apartment, I had moved in with my old college landlord, a widow
about the same age as my Mom.
I also had to get my insurance reinstated, so I talked to the
hospital billing person on the phone. To her credit she trusted me at
my word and allowed the $1700 procedure to go forward. The results
of the test confirmed that it was in fact Ulcerative Colitis confined to
7

my large intestine, which meant I was a candidate for surgery.

I was referred to a colorectal surgeon and he explained the
whole procedure to me and I started to feel a little more optimistic.
The procedure I going to have was called a full Colostomy with
temporary diverting Ostomy and restorative Proctolectomy.
There were going to actually be two surgeries. The first would
be a full Colostomy with temporary diverting Illeostomy and
restorative Proctolectomy. Basically this meant removal of the entire
colon and rectum (Colostomy), then temporarily diverting the stoma
the end of the small intestine - through my abdomen to a bag on the
outside of my stomach. Then the surgeon would construct the Illeoanal reservoir basically a substitute colon also known as a J pouch
from part of the small intestine and connect it to my anus. The surgery
would be done all at once using Lycoscopic surgery using small
incisions in the skin to perform the surgery. This meant that there
would only be a few small scars instead of larger cuts through my
abdominal muscles and skin.
Then after allowing about 8 weeks for the illeoanal reservoir to
heal. I would have a second surgery to reconnect the stoma to the
reservoir. After that I would have to train my bowel muscles so that I
could be able to learn how to go to the bathroom again, however I
would have to go about 5 6 times a day for the rest of my life, that is
if everything went well according to plan.
At first I was optimistic, surgery might offer me a new lease on
life without the side effects of drugs and elevated risk of cancer that I
might have if I kept my colon. I started to do some research on it and
still felt optimistic, it looked like there was a good chance it could
work.
I also spoke to the daughter of a longtime friend of my Mom
who was about my age and she sounded optimistic about how it
worked out. In her case she had had emergency surgery for an acute
case of Ulcerative Colitis that had developed in a matter of weeks
while she was in college and then she had emergency surgery. In her
case they had done the surgery in one step, so that she skipped having
the Ostomy bag for 6 8 weeks between surgeries, however the
Illeoanal reservoir had ruptured after surgery so she then had to go
back for emergency surgery. However since that time she said that
things had worked out well for her. While I got the idea that she
seemed like a pretty positive, cheerful, person I also thought that she
8

was making the best of what seemed like a pretty bad situation.
However while I was home at Christmas time my parents
asked about how this would work. I originally thought I could have
the surgery and then fly home to Florida. However while discussing
recuperation time with my parents I called the nurse at the Colorectal
surgeons office and when I spoke to the nurse I learned that it was
not advised to travel on a plane for up to 4 weeks after surgery, nor
lift any object weighing more than 5 lbs for fear of it causing the
stitches to rip. I realized that I would not be able to even care for
myself so I would need to move back in with my parents while I
recovered.
I also had some other concerns and questions, what if this
illness would never get better and only get worse? Why were there
sometimes periods of remission? There was also the matter of cost,
while I had found an individual insurance plan, there were high
deductibles and copayments. The two surgeries were listed at
$25,000. My father also spoke of going abroad to have surgery. Many
of our doctors are from India and they speak English, you might be
able to find a good one there.
Ouch! Although my parents were able to cover it, I had mixed
feelings, I still didnt feel good about having to rely on them while I
was an adult, and if I wasnt going to be able to care for myself while
healing it was like I was going back to being a child.
All of these questions kept swirling through my head, but it
seemed so hard to deal with all of this. I had also sought out doctors
that had graduated from top medical schools, and gotten second and
third opinions. Could it be that all of these doctors had overlooked
something?
Since a nurse in the surgeons office in the Washington, DC area
said I wasnt going to be able to fly for a few weeks after surgery I
decided to have surgery closer to home at Mayo Clinic in Jacksonville,
Florida.

I first hear about Fecal Transplant

I met with one of the two colorectal surgeons at Mayo Clinic.
He had very impressive credentials and at first I felt pretty good about
things, however I still wondered if there were other things I could be
doing. When I met him, he told me that he wanted me to taper off of
Prednisone and then from the blood work that my blood albumin
9

levels were low. Basically the amount of available protein I had to

rebuild damaged tissue was a little too low for the level they would
like to see for optimal recovery from surgery. He told me to get plenty
of protein and recommended I drink plenty of Ensure. Later when I
went to the store I realized that I would have to buy tons of cans of
Ensure. I also looked at the labels and it turns out there was more
than 3 times as much carbohydrate as protein in Ensure while other
protein shake mixes like Muscle Milk had much more protein per
serving and were available in powdered form. Those were all good
reasons, however I liked the sound of Muscle Milk more, it sounded all
manly while I associated Ensure with retired people playing shuffle
board. So I decided to use Muscle Milk instead.
For the next 8 weeks I successfully tapered off Prednisone in 4
weeks and continued to drink my protein shakes and take iron
supplements. I also mixed protein shakes with rice milk to make it a
meal replacement. I continued to recover my energy and the flare had
largely abated. I was starting to feel much better. In the meantime I
also read an article in Slate.com called The Enema of my Enemy is my
Friend. It was about how Fecal Transplants were being used to treat
Pseudomembranous Colitis which was caused by infection with
Clostridium Difficile bacteria. I wondered if it could work for Colitis
too, however I didnt find any information on it and was still
committed to going through with surgery. However my enthusiasm
for surgery started to wane now that I was feeling healthier.
Then when I traveled home to Florida the night before I was
going to go to a preliminary visit to the doctor in Jacksonville, my
Mom asked if I had read something she printed out for me: The
Wikipedia article for Ulcerative Colitis. When I was first diagnosed
Wikipedia had not been invented yet, and eventually I had stopped
looking for alternative treatment options, since everything I had been
told was that this was an incurable illness. I was sick and tired of
depriving myself of food when it didnt appear to offer any permanent
solution. I wanted to trust the doctors would take care of it and try to
forget that I was sick.
However when I saw this, it made sense. The Wikipedia article
referenced an article by Dr. Thomas Barody that had been published
in the Journal of Gastroenterology in 2003 Treatment of Ulcerative
Colitis using Fecal Bacteriotherapy. I found the article online and was
very excited. He had 6 case studies of patients whose cases of
0

Ulcerative Colitis were resistant to other known therapies and had

lasted anywhere from 5 to 20 years. The therapy worked in all of the
patients with COMPLETE REMISSION that had been sustained without
drugs for 1 13 years. Here an excerpt from the article:
Although these are case studies several observations can
be made. All patients had documented idiopathic UC with an
absence of detectable infective agents. Complete reversal of UC
was achieved in all 6 patients following the infusion of human
fecal flora. All patients ceased anti-inflammatory therapy within
6 weeks and did not require further treatment during the
extended follow-up period. After 1 to 13 years, patients remained
asymptomatic with a healthy colonoscopic appearance and
normal histology.
Though there is little doubt that UC can go into clinical
remission, chronic UC has not been known to spontaneously
resolve both colonoscopically and histologically without relapse
for up to 13 years, as observed here. To our knowledge, these 6
cases document for the first time the total disappearance of
chronic UC without the need for maintenance treatment. This is
an unprecedented finding that demands explanation through
further research... There is currently no definition of remission
that demands colonoscopic and histologic normality with no
recurrence after a prolonged period without maintenance drugs,
the result should be considered a cure".
Wait a second, for all intents and purposes these people were
essentially CURED! What else do you call it when an illness is resolved
and does not require ongoing treatment for that to continue to be
true? I was amazed. I didnt think this was possible, since every doctor
I had been to and every article I had read said this was incurable and
even sustained remission with drugs that did not produce intolerable
side effects was probably impossible.
Suddenly I was motivated I could do all of this and then be
done with this illness for good. I stayed up for hours in the middle of
the night reading as much as I could about bacteriotherapy and what
types of bacteria might cause this.

I cancel Surgery to pursue Fecal Transplants

The next day I traveled to Jacksonville for a pre-op
1

appointment with the surgeon however I expressed doubts about the

surgery once again. I was feeling much better now and asked why not
try the bacteriotherapy again, what was the urgency to do surgery
now?
The surgeon told me there was always the risk that the colon
could rupture and make it impossible to do a J pouch and that the
Ostomy bag was my only option. I was also told that continued
Prednisone use risked bone density problems, continued risk of other
infections and even diabetes. However in the short term I was already
doing better, could this continue?
The surgeon then did a quick flexible sigmoidoscopy
examination on the spot and said that the inflammation was severe
enough that my colon was basically burned out from chronic
inflammation and there was not enough left for it to recover. This
didnt make sense to me, peoples bodies recover from many different
kinds of injuries and problems as long as the original root problem
has been resolved. At this point I decided to cancel surgery, based on
Dr. Barodys article this appeared to be a very viable option.

Success finding a doctor

The next thing I did when I got home to Gainesville was call Dr.
Barodys office in Australia using Skype. However I was told by his
staff that he was not taking patients from outside Australia. I asked for
referrals to doctors in the U.S. however they would not provide any.
Next I called the doctors from the article in Slate.com. I made an
appointment with one doctor, however I would have to wait over 4
months to have an appointment. I then called another doctors office
and was able to talk to her. She had already done several successful
Fecal Transplants for c. diff Colitis but not yet for Ulcerative Colitis. I
talked to her for at least half an hour and she said that even though
she had never done it for Ulcerative Colitis she would give it a shot
and see if she could get her hospital to agree to it.
The procedure would follow Barodys protocol based on the
paper, a combination of anti-biotics, followed by prep for a colposcopy
and then one fecal transplant delivered by a colonoscope followed by
another 4 self-administered at home. The reason the following
enemas would be delivered by self-administration were that while the
first procedure could be billed as a colonoscopy since I was due for a
colonoscopy and one would actually be performed, the others could
2

not be. It was also thought that the first one might be the most
important one.
In the meantime while waiting for I got a questionnaire for my
would-be donor, most likely my brother. The questions were pretty
standard and were mostly looking to identify the likelihood that my
donor had certain blood-born illness or bacteria or other parasites in
stool that could be transmitted to me.
Illnesses that would be tested for included bacteria or
parasites known to cause travelers diarrhea and or food poisoning. In
most cases the presence of these such as cryptosporidia, microspora
and Clostridium difficile toxin would have presented very obvious
symptoms almost immediately.
Other illnesses to test for included the blood born viruses HIV,
hepatitis A, B, and C, cytomegalovirus, Epstein-Barr virus and syphilis.
While a complete battery of blood and stool tests would be
done, once I looked at what was being tested for and looked at the
questionnaire and likelihood of these illnesses I realized that for some
people like my brother the likelihood of having any of these illness
was almost non-existent. I will go into a little more detail later about
this topic, however suffice to say that I realized the risk of getting any
harmful diseases was very low and once testing was included could be
almost completely eliminated.
Next there was the matter of arranging to travel to have the
procedure done. This was not too much of a big deal however it was
still a logistic to be considered. This would be an undertaking
certainly but I had great confidence that this could work.

I am introduced to a mentor
Dr. Kelly gave me the contact information for a woman she
knew of who said she had successfully performed the procedure at
home. A day later I called and got to talk to Sky Curtis, a health
advocate who told me that her sons case of Colitis was cured by doing
what she called Fecal Enemas.
We spoke at length for a long time and she had obvious learned
a lot about this. I asked her what she meant by cured, the conventional
wisdom was that this was an incurable illness. She said he had no
symptoms for over a year, with no dietary restrictions, no pro-biotic
supplements and was not taking any drugs for the medical condition.
Her sons condition sounded like it had been much worse than mine
3

and included Crohns Colitis meaning that there was also some
inflammation in the small intestine.
Rather than 5 days she told me they had done them every day
for 3 months. Since he had been taking high doses of Prednisone, he
got used the anti-anxiety drug Ativan to help him get to sleep at night
and then gradually tapered down the frequency until they were down
to once a month and then were about to discontinue them since her
son had now been healthy for a year. I asked her about him now, and
she said he is enjoying life as a young man, I havent even heard from
him in a week.
I expressed dismay at having to do these every day for a few
months and then continue them after that for up to a year. She said we
thought we could do these for just 5 days, but that wasnt enough for
my son, it came back. So the second time around we didnt want to
take any chances. Is it necessary to do this many, I dont know, but Id
rather do more than necessary that not enough.
She kept encouraged me, I know this is going to sound kind of
funny coming from someone old enough to be your mother, but what
really bothered you the most about the prospect of having surgery. I
said to her, I know this may sound shallow, but I like being a bachelor
and dating and I take great pride in my body. How could I continue to
live this life with a bag on the outside of my body?
She said well there you have it, suck it up for a few months and
do this so you can get back to carousing with women, staying up late
at night until you crash on a couch somewhere.
What she said got through to me, and I began to wonder
whether 5 enemas were going to be enough. I also had read Dr.
Silvermans study that said low volume enemas that were selfadministered at home were just as effective. Ms. Curtis also told me
about using rectal syringes instead of an enema bag. The process she
described was much more simple than that of using an enema bag. I
asked what about waiting a few months for the doctor, she said you
could, but remember they are only planning to do the first one for you
anyway and Ulcerative Colitis could take many more fecal enemas
than c. diff Colitis. At that moment I decided, why not try this myself
first now, rather than wait 3 months.

Finding a donor
I wanted to continue to live in the Washington, DC area rather
than move home for several months, so I looked into other options.
Sky also told me that the donor did not need to be a relative nor even
the same blood type as me. She said just find someone who is healthy
and had good regular poop once a day. Also the stool did not
necessarily have to be used right away, it could be refrigerated in an
airtight container for up to 5 hours.
I started to think about who I could look for that might be a
good donor. Then it hit me, one of my clients from my coaching
program who had gotten some really great results. I knew him very
well and knew that he was pretty open-minded, so that he would at
least strongly consider what I was asking for rather than dismiss it
based on the ick factor alone.
I met up with him to go on a hike on the Billy Goat trail by
Great Falls and presented my plan to him. We would get an apartment
together and he would basically give me a stool sample a day. He
asked if anything invasive would have to happen, if there would be
any cost to him or if he would be responsible if I got sick for some
reason. I told him no.
I asked a little about his bowel habits and medical history and
then gave him the donor screen questionnaire, so far so good. In the
meantime we moved in together and I made the final preparations.
I also looked to see if I could find a lab to screen for illnesses.
Unfortunately when I called a lab they would not accept a specimen
from an individual. I called a testing company and was told that they
would only do tests upon the explicit request of a doctor.
So I asked myself the question, were tests really necessary to
determine if my donor was a suitable one? He had had an HIV test not
too long ago at a health fair, although his lifestyle did reveal him to be
high risk to begin with. He was a heterosexual white male, careful
with safe sex and no IV drug use.
I looked at the prevalence of illnesses like Hepatitis A, B, and C,
Syphillis, Epstein-Barr, very low and if someone had these illnesses
they would manifest soon after exposure. I looked at various stoolrelated illnesses, once again most of them were not found in the
United States and most of them would cause symptoms almost as
soon as detectable levels were found in stool.
So I concluded that even without tests, most of these illnesses
5

were very uncommon in a person with his lifestyle and medical

history and for almost all of the illnesses he would have presented
symptoms by now if he were infected. In my estimation this was a
good enough risk for me.

Starting the Fecal Transplants without a doctor

After 3 months of waiting I was impatient to begin the fecal
transplants and determine once and for all if they would work for me.
So I went to the nearby CVS to get my supplies:
1 box of hypoallergic latex gloves
1 blender
1 rectal syringe
1 box of plastic trash bags
1 box of Glad Ware containers
1 bottle of sterile saline
I was moving right through my shopping list when I hit the last
item. They refused to sell it to me. I threw a fit, what do you mean you
wont sell it to me? Its the same stuff as contact lens solution,
however in much larger quantities and without any preservatives or
other additives in it. I was told this was because they were worried IV
drug users would use it. I was still frustrated, why does everything
need to go through a doctor? Are people really going to do stupid
things where they are testing for the presence of illnesses of using salt
water?
Instead of continuing to argue with the clerks I bought some
distilled water and sterile salt packets used for a netti pot. How
complicated could it be to make salt water? All I would need to do is
look up the amount of salt I needed to mix into a given amount of
water.
I got home and told my donor that we would start the next day.
The first opportunity would occur at night. I got the stool and mixed
my sterile saline by boiling water and measured out the correct
amount of salt. I let the salt water mixture cool to almost room
temperature. Then I put the stool in the blender and poured in the
saline mixture.
Unfortunately I had not tightened the base on the bottom of the
6

blender cup tight enough. As I turned on the blender some of it leaked

out. The top wasnt on tight enough either and the volume of mixture I
had was a little too much as well. Poop squirted everywhere!
For some reason I didnt have the kind of ick response that I
think most people would have to poop flying all over the bathroom
counter top. At some point I had basically lost my sense of smell. I
think this could have been due to chronic nasal rhinitis since I was a
kid and also other possible inflammation. Also the illness itself was no
cupcake either. Over the years I had failed to make it to the bathroom
many times and had to clean up poop many times over the years,
especially in the last year. What most people would have found
disgusting was almost a routine event for me.
I quickly cleaned up while preparing to continue on with the
fecal transplant. I went to my bed and prepared that. I put a plastic
trash bag down on the floor over a pillow and then put a towel on top
of that. Then I put another plastic trash bag on the ground where I
was going to put my supplies. I poured the saline fecal mixture into a
plastic container. Then I squeezed the bulb of the rectal syringe and
slowly released my grip to pull the mixture up into it. Basically it was
like a turkey baster except the nozzle part is much narrower.
I then carried it over to my setup on the floor. I then lay down,
rolled over on my side with my hips elevated on the pillow. I had only
done an enema a few times before, using mesalamine enemas that had
been prescribed by my doctor. However this wasnt too bad. A little
weird at first and a higher volume than I was used to, however within
about a minute it was done. Now I lay there for a little while. I had a
book to read and realized that I had finally gotten started. Almost an
hour later I couldnt hold it any longer so I got up and sprinted to the
bathroom and barely made it in time.
Over the coming days and weeks I refined my process and also
ran into some problems that I had to resolve. Sometimes the mixture
would not come completely out of the bulb on the rectal syringe or I
would have to squeeze it really hard. I discovered that sometimes the
nozzle would clog. This was because of larger particles, so I started to
pour the mixture through a strainer from the blender cup to the
Gladware container.
I discovered that I didnt have to use as much water when
making my mixture. I discovered that using the end of a coat hanger to
clean the inside the nozzle was very helpful too. I made sure that I
7

took Immodium an hour before doing the infusions and also Gas-x to
help with gas.
Within the first few days I noticed that things were getting
better, however I kept going since I still had lots of gas. I thought this
might be because the bacteria was fighting to colonize in the colon
still. I thought I should keep seeding new bacteria until I could be
confident the new bacteria had completely established itself.
In the meantime I was working a job full time and sometimes
even entertained visitors at my place. One time I went off, prepped
and did the enema then walked back to the living room to brainstorm
with my roommate and a woman I was dating. Then an hour later
made my 10 foot dash to the bathroom.
I kept going with the fecal transplants, although after first
getting better things started to get worse once again with another
flare, blood in my stool once again. It had now been about 3 weeks. I
went back on Prednisone, and when that didnt help I increased it
back up to 30 mg. I was starting to get discouraged, however my
mentor encouraged me to keep going.
After another week or so I called my old Gastroenterologists
office for a refill, the one who referred me for surgery and l and was
told by the office that I needed to come in for an appointment. I
wondered how this was going to go. In addition to going to the
gastroenterologist I decided to continue to look for other options. I
searched on the Internet and found some more options including low
dose naltrexone and Bupropion among others. While there was a lot
of discussion about Low Dose Naltrexone (LDN) there was less about
Bupropion. Although I found a study for LDN as well as some
anecdotal reports on internet discussion forums.
I also found some discussion groups where people spoke about
successfully using Bupropion (Wellbutrin) to treat Crohns Disease.
Further research found a study for Bupropion for Crohns Disease that
made it to stage 3 trials without anything ever being published. I was
puzzled about this, were no results published because it didnt work?
Or were no results published because it did work and would compete
with other drugs for Crohns and Colitis like Remicade which cost
thousands of dollars per dose. In the absence of knowing one way or
the other I was left wondering.
I went in to my Gastroenterologist who was very displeased to
learn that I had gone ahead and done the fecal transplants myself in a
8

way that was unsupervised. I showed him the printed studies and told
him about how I had talked to a doctor as well. After talking to the
prominent doctor I had planned to do the Fecal Transplants with, he
did calm down a little, however he wanted me to immediately have
stool tests done. I fulfilled his request to have a stool test done and
have another Colonoscopy. The GI doctor also insisted that I stop the
fecal enemas right away and rapidly taper off of the Prednisone. I
complied with those requests, although I ordered some Prednisone
from an overseas pharmacy when I got home to have ready and also
planned to resume the fecal transplants at a later date too.
I also asked for a prescription for Low Dose Naltrexone, shown
him the study I had printed out and explained that had a 30-year track
record as being a safe drug. However he dismissed my request for a
prescription for Low Dose Naltrexone and did not want to look at the
study I had brought with me. It was his belief that LDN was largely
quackery without scientific basis to back it up. In all fairness I later
came to doubt LDN too even though I tried it for about two months,
however I was frustrated by the way my doctor dismissed it without a
specific reason.

I add Bupropion and other drugs to my treatments

I was starting to get a little discouraged. What else could I do,
the flares were continuing in spite of my best efforts and the only
thing that had ever been able to consistently help me was now being
taken away. Then it occurred to me, was I really doing everything I
could possibly do to take care of this illness?
My roommate and donor told me about the class he taking to
become a hypnotherapist. In the class they discussed how chronic
illness or pain management centered on discovering the secondary
gain from the illness. That is people stay sick because while they
consciously say they want to change, there are other pay offs that they
are getting because they are sick.
I dont know if I believe this is true in all cases of chronic pain
or illness. However I thought about this and asked myself was there a
payoff for me being sick that encouraged me to stay sick? I thought
about this. Was my illness an excuse to not work a job, not take full
responsibility for myself? Was there a part of me that was holding
back from achieving full health? Was I using being sick as an excuse
and a way to get pity for myself?
9

I thought about this once again and decided to redouble my

efforts. I also looked at the picture I saw in one of the studies of a
colon that was healthy. I remembered a psychological technique used
to break a bad habit I had once heard about called the swish pattern.
The idea was to create a picture in your mind of the habit you want to
break and replace it with a picture of the new habit or result in your
mind. I decided to give this a try, in my mind imagined the picture I
saw of the healed colon and said to myself it will be like that one.
I made an appointment with a psychiatrist I saw over the years
for ADHD and occasional depression. Since I had been prescribed
Bupropion in the past I asked for another prescription. I told him
about sleep problems stemming from Prednisone and he prescribed
Silenor, which contained a lose dose of the off-patent anti-depressant
Doxepin. The doctor told me it would also help for the digestive
conditions as well. I later read that he was right in that antidepressant drugs had been prescribed for Irritable Bowel Syndrome
(IBS) for many years.
Then I mentioned my research about Low Dose Naltrexone and
how I was looking for a Gastroenterologist who might consider
prescribing that for me. He started writing a prescription for that too.
It cant do any harm, he said to me. That was true, from all I had read
in the one study I saw and in there were few to no side effects from
the Low Dose Naltrexone. He handed me the prescription for 50 mg,
which is the usual dosage for its FDA approved use of treating opiate
addiction and alcoholism. I saw the prescription and said, no I need it
for 4.5 mg instead of 50 mg. He gave me this really strange look of
disbelief as if I had two heads, which was. The drug was only made in
50 mg tablets, so his surprise was understandable. Then I explained
about the study and how it could be ordered from compounding
pharmacies. He shrugged and wrote one for 4.5 mg.
At this point I was ready to start with the low dose Naltrexone.
However I first needed to finish tapering off Prednisone before I could
start the LDN. However I could start the Bupropion and the Doxepin
right away. I went straight to the pharmacy and started taking my
new prescriptions right away.

Its Gone! Im cured!

By the evening of the next day I was amazed, I had a mostly
normal bowel movement. Once again this is something a healthy
0

person might take for granted, but for me this was truly amazing. In
my mind I remember saying to myself, its gone.
It couldnt be, really, could it be that this was finally gone? Over
the next couple of days I continued to get better and better while
finishing tapering off Prednisone, from 30 mg to 0 in 10 days. The
good conditions continued. I started taking Low Dose Naltrexone at
4.5 mg even though my condition was already much better. If nothing
else I thought it would at least help support continued good health.
The starting dose was 4.5 mg in the one study I had seen LDN for
Crohns Disease, so I went with that.
After another week I thought I was good enough to stop taking
Apriso, however a few days after I stopped that I started to have some
watery diarrhea and what I thought might have been blood in my
stool. In retrospect it might have been salsa or hot sauce, but I treated
it as a resumption of symptoms. I guess it was too soon to go off it so I
went back on Apriso and the mesalamine suppositories for a few days
until I went off it again and my stool promptly started to get more
solid.
Things were going well for about another 6 weeks, while I
continued taking the low dose naltrexone, along with Apriso,
Bupropion and Silenor. The LDN had some unexpected side effects
including severe insomnia when I took it at night. A couple of nights I
got absolutely no sleep, even though I had taken Ambien and Silenor.
Later I ended up switching my dosage into the morning. I was amazed
that 4.5 mg of this drug could have this much impact when the FDA
approved dosage was 11 times higher at 50 mg. I kept taking the 4.5
mg capsules until I read on a discussion forum that many people were
using lower dosages than 4.5 mg, however I could not find any studies
that had been done at those amounts. Nevertheless I ended up giving
it a try. Since I could not split the non scored tablet into 11 pieces, I
read about how what some people were doing was crushing the pill
and dissolving it in 50 mL of water 50 mL and used an oral syringe to
measure out the amount of water so that I had 1 mL per mg in a small
yogurt container.
then I had to prepare for a colonoscopy. I was worried this
might upset the delicate balance of my newfound health. However at
the same time this would give me some proof that it worked.

A colonoscopy reveals further evidence that I was cured!

In the third week of September 2011 it came time for my next
colonoscopy and the results I got astounded me. After more than 10
years of having pan colitis inflammation that extended throughout
the entire colon, the inflammation was now patchy. The doctor
speculated that it might be Crohns Disease, this was bothersome. He
had ordered a capsule endoscopy test to establish that it was
definitely Ulcerative Colitis and not Crohns Disease. Did this mean
that surgery would have been a mistake?
I looked at the colonoscopy images, sure enough there were
patches that now looked healthy where there had been solid
inflammation for years before that. How could that be, unless I was
actually healing? Symptoms had largely gone away over the previous
6 weeks. Maybe this was what things looked like as I started to get
better?
At that point I decided to consider myself cured of Colitis.
Since this was not something that the doctors or anyone else
considered to be able to happen he didnt believe it could happen. But
I did and these images matched my experience, no more illness. My
great, permanent remission occurred 7 weeks after I had started the
Fecal Transplants, 6 weeks after the end of the first week. While I was
putting this book together I realized that this was also how the
experience was described in Barodys article that I had first read, the
patients took about 6 weeks to get better.
About 3 months later I ended up stopping the Low Dose
Naltrexone (LDN) 4.5 mg. It was causing side effects including
insomnia that was resistant even to sleeping pill like Ambien and
Silenor. While I had read one promising study, I had a hard time
accepting its credibility once I realized that the people conducting the
study also owned a patent on LDN being used to treat Crohns or
Colitis. Within another month, just before Christmas I stopped taking
the Apriso as well once my prescription ran out.

Defeating the self-perpetuating cycle of Inflammation

One question I have been asked is why does it take so long to
make this treatment work? Why do treatments appear to work for a
little while and then stop again? My conclusion has been that there is a
self-perpetuating cycle of inflammation that is causing this I think the
2

reason why getting better can have some ups and downs is because of
a few reasons.
1) The lining of the colon has to repair itself after many years of
chronic inflammation. This means that the intestines will have
to heal ulcers and scar tissue which may have made the lining
of the colon have less elasticity. The damaged walls could make
it more vulnerable to various foods, especially those higher in
fiber and they may also be less able to absorb water. This could
also be a source of periodic muscle spasms and diarrhea as
well.
2) Bacteria that originally triggered the inflammation might come
back from spores or other sources to become active again.
However the new bacteria is now hopefully stronger enough to
keep it in check.
3) Diarrhea can be both a symptom of the inflammation and
inflammation-causing pathogen as well as a condition that
contributes to inflammation and inflammation-causing
bacteria.
I think that to become healthy all of these factors need to be
resolved. This might happen eventually just be treating the bacteria
alone, but I think a combination of approaches is the best way to go.
What finally got the symptoms under control for me in a very
noticeable way was when I started the drugs Silenor and Buproprion.
Silenor is a low dose of Doxepin, an off-patent (cheap) tri-cyclic antidepressant that was re-patented for "sleep maintenance" (ah, those
crafty pharmaceutical companies). Once the samples of Silenor ran
out I got a prescription for Doxepin 10 mg capsules and used about
half each time. Buproprion also known by the brand names
Wellbutrin and Zyban, is also available as a generic in all forms
including the Immediate Release form that I used initially and the
extended and sustained release forms I later used.
Bupropion was actually studied for use in Crohn's disease in a
study with results that were never published. Why were results never
published either positive or negative? Who knows. It couldn't possibly
be because if it were an effective TNF-a inhibitor, no one would spend
thousands of dollars on Remicade. You can also find some discussion
threads on the internet where people say they successfully used
Wellbutrin for Crohn's Disease or Colitis.
3

It is my belief that whatever bacteria are the root cause of the

problem favor watery stool conditions with faster bowel transit time.
Therefore slowing down urgency and muscle spasms through drugs
or even supplements like Valerian root extract could greatly speed up
the healing process.
Also adequate nutrition is important. The colorectal surgeon
who I was going to have surgery with told me my blood albumin levels
were low, so I needed to beef them up to prep for surgery.
Interestingly enough I was able to successfully taper off of Prednisone
while taking protein shakes and Apriso. Your body has to rebuild
much damaged tissue in the colon so you have probably burned
through your body's protein stores so you'll need lots of easy to digest
protein. Body-builder shakes are great for this, because they have
much more protein per serving than wimpy stuff like Ensure. The
shakes are also pre-digested nutrition, basically this means it can be
absorbed with little to no digestion, almost like drinking a feeding
tube except it actually tastes pretty good.
I used Muscle Milk mixed with some rice milk (no one can be
intolerant to rice) and flax seed oil as a liquid meal replacement. Other
things I would include B Vitamin shots (roughly $30 - 40 online for a 3
month supply) liquid iron supplements like Angstrom iron or other
gentle forms of iron including iron bisglycinate which is sold as
"comfort iron" at the Vitamin Shoppe.
Above all having a strong fighting spirit is essential. This
wasn't white light healing for me as much as it was a ferocious fight
for my existence. I took inspiration from video game violence, actionmovies and football as part of my motivation. I also wanted to go
back to hooking up with chicks, going out late and I wanted to prove
the doctors and any skeptics wrong! Also I actually continued to
enjoy life even as I was doing these enemas, it became a joke, don't let
Michael make you a milk shake and avoid the sausage in the
refrigerator!
All I can say is yes, THIS WORKS! It was hard for me to believe
at first even after I read Barody's study with the 6 patients who were
cured. It's amazing how something so simple and easy can have such
a powerful impact. I was kind of nervous and afraid before I actually
did it, but it was pretty simple once I got started. Within 3 months my
symptoms were much better, a colonoscopy revealed significant
healing and I could go back to getting better. So what are you waiting
4

for?
As a further note you don't need anyone elses permission to be
healthy. I know I was strongly discouraged from doing this by my GI
doctor and I have heard many stories from others who have contacted
me. Unfortunately many of the bad things they claim could happen
have no basis in reality if you know about the process and have read
the studies.
I know it sounds kind of bad to say, since presumably most
doctors and other people want their patients to be healthy, and many
have been very helpful to me. However doctors also need patients to
treat or else they don't have anything they can keep doing. Perhaps
this explains why they make unfounded claims about how this could
be harmful. So I encourage you to read up about this and realize that
the worst-case scenario from receiving an enema from a healthy
donor is that it doesnt work. However the positive benefit if the fecal
transplants work for you, as they have for many others, is that you
will be healthy and likely won't ever need to see a Gastroenterologist
ever again!

Continued good health and lessons learned

In the time since then I have continued to get better. Over time
I have continued to take protein supplements from time to time since
I have returned to lifting weights 3 times a week. I have continued to
be healthy and with better bowel health than I often had while I was
growing up.
I have discovered that anti-depressants are helpful for having
better formed stool. However in more recent times I have discovered
that Valerian root extract has turned out to be not only helpful for
calming down and sleeping well at night, it also has helped me have
regular well-formed stool. I think the anti-anxiety properties help
Irritable Bowel Syndrome symptoms, which can include indigestion,
which can lead to gas, diarrhea or constipation, muscle spasms
(urgency) and diarrhea.
I now question whether I needed to do the Fecal Transplants
for as long as I did. There are several things I think could have
expedited the healing process. If I had it to do over again I would have
started taking Prednisone at the beginning of the treatments even
though I was not in the middle of a flare, it might have helped. I also
think if I had taken the anti-depressants from the beginning it might
5

have helped too. Both preventing Ulceration and limiting muscle

spasms and diarrhea would have been helpful to control symptoms
and possibly speed up the rate at which this cure took place.

Part 2: Making the decision you really want to be well

Before I go into the nuts and bolts of how to do the fecal
transplants I want to briefly touch on how you prepare yourself
mentally for this. If you are at all like me, even as you have sought out
other treatment options it has always been from a mindset of let me
see if this works to make this incurable condition a little less bad or
appear to go away with the assumption that it will come back later.
Getting motivated to tackle a problem is much easier when you
have clearly identified benefits and clearly identified consequences if
you dont. For me it was easy to be motivated when after years of
denial the options presented to me were starkly starring me in the
face. So in this section I will lead you how I weighed the options I
faced in the winter and spring of 2011. I encourage you to actually
really weigh these options out, see how much you can relate to my
experience and then decide and act with courage once you have made
your decision.

Weighing the Pros and Cons

1) Surgery

While this option has worked out for some people there are also long
term risks and consequences which I thought would negatively impact
my quality of life. While at first it sounded good, the more I looked
into it the more real problems I saw. This was not a complete solution
where I would not have to do anything special for the rest of my life, it
seemed more like replacing one set of problems for another set. As I
saw if what is the point of a solution to improve your quality of life if it
diminishes it.
Advantages
- Doctor says I cant get colon cancer because you wont have one.
- Doctors say this is what I should do.
- My family will take care of me and I wont have to be responsible for
taking care of myself for at least a few months.
- There will be no need to take drugs with severe side effects
- Relatively consistent bowel movements, significantly less risk of
acute flares.
7

- Ability to possibly eat what almost anything I want within reason in

the long term.
Disadvantages
- Cost, it would have been $25,000 out of pocket for me to have the
surgeries without insurance. Even for those with insurance,
deductibles can easily be in the thousands of dollars for major surgery
like this.
- Lost wages from not being able to work time, at least several weeks
if not longer.
- It is really only a cure because it removes the organ and replaces it
with one with significantly smaller capacity.
- Surgery is irreversible and permanent, once my colon is gone I cant
put it back and try something else to make me well and still have a
colon. I also now have a smaller small intestine.
- If by chance the illness was misdiagnosed Crohns Disease and not
Colitis, the illness could continue to manifest itself in the J-pouch
and / or small intestine.
- The risk of future complications like bowel obstruction that could
result in the need for more surgery.
- Time: several weeks after surgery where you have to limit your
movement and how much weight you can lift while your body heals
from two separate surgeries. Basically you will need to stay with
family and have someone available to help take care of you.
- Lifestyle / physical body a few months of having an ostomy bag on
the outside of your stomach to collect poop, followed by having to
retrain myself on how to go to the bathroom.
- The limited but real risk that the surgery could make me impotent or
at minimum interfere with sexual function.
- Having to change an ostomy bag 5 6 times a day until a second
surgery to connect the J-pouch, after which I will have to use the toilet
5-6 times a day for the rest of my life.
- Having dietary restrictions to limit the risk of bowel obstruction and
limit bowel movements
- The need to be extra-vigilant about drinking water to avoid
dehydration, especially when exercising, drinking or spending time
outdoors in a hot climate.
- The need for B vitamin injections since the j-pouch procedure would
mean I have less of a small intestine.
8

2) Continued drug treatment

- Little reason to expect longterm remission even with continued

maintenance drugs since I had tried almost every treatment before
without success.
- Risk of loss of bone density from continued steroid treatment or
other absorption issues that would make me vulnerable to broken
bones.
- Secondary infections from immune-suppressing drugs.
- What doctors told me was a significantly elevated risk of colon
cancer.
- I would just be putting off the inevitable, since the doctors told me it
was incurable and the disease would only get worse.

3) Fecal transplants

This time I will discuss the disadvantages first, since there are
comparatively few. While I am obviously biased towards this solution,
because it very clearly worked me, you will see that my reasons make
perfectly good sense and can apply to your case too.
Disadvantages
- Ew, poop is icky. Come one really? If you are thinking this way ask
yourself can this really be any worse than cleaning up after crapping
your pants with bloody diarrhea, having to constantly clean your
bathroom or worse wearing a bag that you have to empty 5 - 6 times a
day for the rest of your life or adapt to a J-pouch where you have to go
5 6 times a day.
- Its not what my doctor wants me to do. Your doctor may say it will
make things worse, even if he cant support his assertions with any
published studies or even a single case study.
- People may think it is weird and wont be supportive.
- There is a very slight risk that you will get an infection from bacteria
that is missed in stool tests.
- There is a possibility a flare could occur which was either triggered
by the fecal transplants or was going to occur anyway.
- Depending on your case of Ulcerative Colitis you might have to do
these for a month or longer, which means that you should live with or
be able to easily see your donor every day during the course of
treatment.
9

- Worst-case scenario: no irreversible consequences, if it doesnt work

and you can go back to drugs alone or pursue surgery.
- Insurance may not cover all or even any of your costs.
Advantages
- Cost: Fecal transplant is a magnitude cheaper than surgery or
continued drug therapy for the rest of your life, along with the
treatment of possible secondary illnesses. This is true even if you
happen to have extraordinarily good health insurance coverage.
Insurance may not cover any or most of your costs, although doctors
might be able to bill a first fecal transplant through a colonoscope as a
colonoscopy.
If you do it at home less than $50 for supplies if any since most
of the necessary items are common household items except perhaps a
rectal syringe or enema bag. If you do it with a doctor you might be
billed for a colonoscopy. Getting your donor tested might also cost
you some money possible a few hundred dollars out of pocket.
- Time: For the procedures themselves 10 or 15 minutes a day or
however long it takes you to mix poop in a blender and then
administer it as an enema and then an hour or two to retain the
enema after that. Then you might have to do these for a solid month
or two at a time. For Ulcerative Colitis this is a commitment and you
may need to do these every day for a month and then maybe gradually
taper down the number of enemas you do after that. You may also
continue to take maintenance medications for 6 months to a year
while your body continues to heal and your symptoms are
consistently better. This compares favorably to the amount of
recovery time from surgery, however the stress and impact on the
body from fecal transplants is negligible compared to surgery, you can
continue going about your life. It also does not cause any irreversible
physical changes.
Note: you can continue to do other activities while lying down to
retain the enema like reading, watching TV, talking to people on the
phone, or even sleeping. You can also continue to work, provided you
make the time to do these enemas properly.
- You will actually be permanently cured once the benefits of the
treatment have fully manifested. Now, this is why I say cured instead
0

of just in remission.
After the treatment has effectively seeded a healthy bacterial colony,
your intestinal lining has healed and you are having well formed stool,
you will no longer need any maintenance drugs or highly restrictive
diet to sustain remission. It has now been 15 months since I stopped
taking Apriso and my digestive health has continued to improve, it is
now better than at any point I can remember in my entire life.
In Borodys paper he documented the treatment of 6 patients
who are now healthy 1 13 years later without any maintenance
drugs and with no signs of remaining illness. In his words since the
medical establishment defines the illness as permanent and incurable
it cant be cured. But why cant that way of defining the disease simply
be wrong? The history of western medicine is littered with past ways
of understanding illness that are now considered obviously wrong
and with treatment options that are now known to cause more harm
than good, sometimes even killing or maiming the patient.
Consider also if you choose to think of things this way, can you
ever say you have completely overcome an illness? Certainly doctors
have legal and ethical obligations in their profession, which limit their
use of language, and continued vigilance to treat potential threats is
part of their job. Speaking to you as a person who wants to be healthy
and get on with your life, then you will need to think differently.

The Benefits of being sick, the challenges of being healthy

To undertake this treatment, you do also need to think
differently about how you approach illness and have faith, act and
speak as if you are well before you actually become that way and be
bluntly honest with yourself as well. Why would people continue to
buy into a concept that offers them no chance of ever being well? It
really doesnt make sense sometimes when you stop to think of it that
way. So to answer this question let me briefly discuss some concepts
from hypnosis and also faith healing.
When my roommate and donor spoke to me of secondary gain
in treating patients with chronic pain it struck a chord in me.
Secondary gain in brief is the reason why attempts to change bad
habits are not successful even though there are clearly disadvantages
to continuing those habits. I had known of this concept for many
years, but I had never considered this to apply to me. I thought this
applied to weight loss and habits like smoking, whereas this illness
1

was something outside my control. Also the tools and actions to treat
this illness were not under my control, rather I was dependent upon
doctors to know what to do, to be able to prescribe drugs, tests and
procedures such as surgery.
So I thought what benefits did other people gain that I knew of.
I remember a story my father often told about my maternal
grandmother (his mother in law) who seemed to constantly complain
of being sick. While the natural response that most people will give to
a sick person is sympathy, some of my grandmothers friends knew
that dealing with her required a different approach. One time when
she was sick in bed, her friends stopped by, its too bad youre sick,
because youll miss such and suchs party tonight, you wont believe
what they are going to be doing. Well, its time to go, we cant be late.
What happened next? While, there were some legitimate reasons she
could be feeling bad including cancer, a bad back, after effects of
having Polio at college age, she got herself dressed, make-up on and
went to the party with her friends.
Basically my fathers conclusion was that while my
grandmother did have health problems she often overemphasized
being sick to gain sympathy and attention and as a way to gain and
exercise control over a situation. However when acting sick meant
missing out on life and not having fun, she would find a way to rise to
the occasion and carry on in spite of being sick.
So I challenged myself, what advantages did it offer me? How
often was I using this illness as an excuse for not being where I
wanted in life professionally, financially? Was I using this an excuse
for not taking full responsibility and to gain sympathy? In my honest
assessment, yes I was doing this. I was not always as compliant as I
could have been with medications, diets and other treatments. I
thought do I really want to gain attention and some degree of
happiness from other people in the form of pity and sympathy? Or do I
want to gain it from having a positive impact on others and by doing
great things and by being self-reliant.
If I had gone through with surgery, it would have essentially
lead me back to being fully dependent on my parents since I could not
afford the cost of surgery and other medical expenses or to not work
for a significant period of time. Even though they said they would
help me and do everything necessary to pay for medical treatment. As
an adult why should they have to be responsible and pay for this and
2

not me? While all the answers I got were, youre sick and you cant be
responsible for making yourself well, thats the responsibility of the
doctors.
Was surgery really the only option then at that time, no it
wasnt. But, had I even been doing the fecal transplants as well as I
could have, by not taking drugs like Prednisone and Apriso and
seeking other options to add to my treatment regime? So, no there
was more I could be doing to take responsibility and act in a positive
manner. I also chose to renew my focus on health and switched the
pictures in my mind. I reaffirmed my decision, to rid myself of this
illness in the fastest, least expensive most powerfully effective way
possible or die lead me to health. I decided not listen to those who
said it couldnt be done, I simply couldnt afford to. I couldnt ask
questions whose answers would not help me get healthy. So the over
arching question became how can I make this work instead of lets try
to make this work? So, I did that and within 10 days the illness was
gone
Was my sudden shift to good health because of the power of
my mind alone? No, I did many things in the physical world, drugs,
nutrition, which enabled me to make permanent the changes that the
fecal transplants had already helped set in motion by changing the
bacterial in my colon and contributed to getting better. However this
single-minded focus on health was what led me to make the physical
decisions.
So I challenge you as a patient with Ulcerative Colitis and / or
Crohns Disease to be brutally honest with yourself. I say this not as to
blame or feel bad about yourself, but to enable you to take full power
and responsibility for your life.
- Am I really doing everything that I can to make myself well?
- Is there more I could be doing to make myself well?
- What advantages does it offer you to continue to be sick,
emotionally, monetarily, in life in general?
- Do you believe you need permission from others to be well?
- In what ways are you rewarded for being sick, in terms of gaining
attention, having an excuse to avoid doing things you dont want to do
or are afraid of doing?
- In what aspects of life do you gain power, or having to take risks?
- What would you lose if you were healthy?
3

- What advantages does it give to those around you, doctors, fellow

patients, family, friends?
- Finally do you have a problem with the notion of being cured?
I ask these questions because I have talked to hundreds if not
thousands of people who seek solutions but then dont follow through
or even actively sabotage the possibility of success when it looks like
things are going well. I have seen this as a dating coach, in answering
questions from my website and on discussion forums for chronic
illness. I spoke to a nurse who had a perfectly good donor in her son,
however she told me she was worried if she got better because she
would be required risked losing her disability benefits.
I spoke to a college age person who was living at home, not
working and not enrolled in classes full-time. Yet when she attempted
the fecal transplants she did not accompany them by taking the drug
therapies and gave up after a week while concluding that must not
work. Yet she continues to be active on internet discussion forums
sharing stories about how various treatment options did not work for
her and complains on her Facebook page often about being sick,
including posting pictures. I would argue that in that case she is
seeking to be a victim and is not looking to get better. This is sad
because she is young and has much to live for if she directs her
thoughts toward health and positive goals.
However this happens not just with patients who are
attempting to take responsibility but still find themselves stuck, it also
happens when doctors prescribe drugs to patients as well. Anti-biotics
clearly were effective for me, however they did not prescribe them
more frequently for a flare, but then again I did not insist upon them
as much as I could have. Remicade was not working for me except
maybe for a few days to a week after being administered, why
continue this treatment over and over again hoping that the same
thing will somehow get different results the next time?
Why does the assertion that you can permanently cure yourself
of this illness arouse significant protest and resistance from some
patients that are still ill, from doctors and even from people who
know relatively little about this illness. Why make excuses not to try
things based on an honest appraisal of the costs and benefits and then
attempt with full faith and determined effort to make it work. Instead
I hear excuses, where people dont follow all of the steps of a
treatment protocol or let challenges stop them instead of fighting to
4

overcome or seek alternative solutions to get past them.

What is really standing in the way of good health?

Why do some people continue to make excuses instead of
giving it every last ounce of effort to make things happen? There are
many possible reasons. Fear of failure, what if I give it my all and it
doesnt work for me? Ill look stupid or have tried and failed, maybe
Ill be worse off than I was before. Fear of success what if it does
work? My world will be changed, I will no longer have an excuse for
not taking responsibility, for gaining sympathy from others.
Just because you choose to consider yourself cured does not mean you
should not continue to monitor your health and take care of yourself
including your diet, exercise and state of mind.
Decide this is what you want to do for yourself. Realize that at
this point many people who know nothing about this, including most
doctors in the U.S. may tell you that you are crazy to do this. Prepare
yourself mentally to stick to your guns and make this work and tough
it out and adapt as necessary. Realize why you are doing this, other
therapies that promise remission for a period of time at best have not
worked and you face continued loss of time, money, psychological
stress and risks of potentially life threatening effects from many drug
therapies including secondary infections or even cancer.
One significant breakthrough that I had while doing the fecal
transplants came from taking a hard look at myself and having a
realization that my attitude and state of mind was keeping me sick.
Before I go any farther I realize that this doesnt make conscious
sense, what person would want to remain ill with this illness? What
benefits could someone possibly gain?
My friend and donor came home one day and told me that he
had covered treatment of chronic pain and chronic illness in his
hypnotherapy class that day. Part of what keeps people stuck with
bad habits such as smoking or being chronically overweight is a
concept known as secondary gain. Basically at a subconscious level a
person perceives there to be a greater benefit to continuing their bad
habit or even illness. This benefit reinforces the continuation of their
behavior in spite of any will power they exert to force change.
In the case of smoking, the bad habit can offer the benefits of
appetite suppression, as an anti-depressant, social opportunities and
an excuse to take frequent breaks from work or other tasks.
5

In the case of weight control common secondary gain benefits

outlined in the hypnosis class included physical safety for women who
had been sexually assaulted.
In the case of chronic pain or illness the reasons outlined
included getting sympathy or attention, having an excuse to not take
responsibility for themselves and deal with other challenges in their
lives. This struck a nerve in me. I asked my friend and donor, could
this be me, am I using this illness for my benefit? The hard truth for
me was that yes, I had been using it as an excuse. This was an excuse
to what was going on in my life in terms of finances and my career. In
truth by the end while I tried my best for many years to keep this as
private as I could by the end I was also choosing to be a victim and
was using this to gain sympathy and attention as well. While I did not
think I was going over the top to be a whiney victim it was true that I
would often talk of being sick.

Do you actually want to be healthy?

I thought about this, almost everyone deals with some sort of
challenge in his or her lives. Success people find a way to either solve
the problem or keep going in spite of it. By using this illness as an
excuse I was not gaining positive respect from others, if anything the
attention I was getting was sympathy and pity. Is this what I wanted
for myself, sympathy and pity for being a victim?
About that time I dusted myself off and kept searching with
renewed determination for a cure. Not just remission, which was
hard to motivate myself for and which I knew was possible with drug
therapy. About this time I realized that there was more I could do. I
could look for more alternatives to treat my condition.
I also considered this, what if I focused on being healthy in
such a way that being sick was not even a condition that existed for
me? About this time I ended up finding out about Bupropion as a
treatment for Ulcerative Colitis when I found a discussion thread on
HealingWell.com where people successfully used Fecal Transplant to
send their cases of Crohns Disease into sustained remission. It turns
out that this was just the treatment I needed and I went into an almost
spontaneous remission. About the same time I found out about this
treatment option I also read another study about using Low Dose
Naltrexone (LDN.)

An exercise to change your mind to lead you to health

While I cant be sure if LDN had any impact on me, I can say
some things that did help, the study did not end up making a huge
difference for me: I did notice a before and after picture of a colon.
The difference was amazing. The colon in the picture was now
relatively healthy even though it had some remaining scars in the
lining after only 30 days.
So I decided to try an exercise that had worked for me to break
my habit of biting my fingernails. I pictured the inflamed large
intestine in my mind as if it were my own and then in a lower corner I
made a picture of a healthy colon much like the one in the study. This
was kind of like those picture-in-picture TVs I saw advertised as a kid,
where you could see what was going on in another channel in a small
window while watching your main channel.
To further emphasize the emotional impact of the pictures I
took the big picture of the bad colon and made it even worse,
accentuating the colors and texture in it, while the other picture of the
healthy colon started out in black and white and a little fuzzy at first.
Then in one instant I imagined switching the pictures with a quick
swish sound so that the healthy picture of the healthy large intestine
completely replaced the picture of the unhealthy one. I repeated this,
taking the big picture of the bad and instantaneously replacing it with
the image of the good intestine over and over again. Then at a
certain point I stopped.
You might wonder how this would help. To any skeptics I can
say that it is hard to say that the power of the mind had anything to do
with me beating this illness. However if you have ever met anyone
who has overcome a major illness there is a certain fighting spirit that
they have, a certain purpose and reason for their lives and why they
must get past the illness.
I realized that by renewing my commitment to cure myself of
the disease rather than just make an incremental improvement to get
better I was giving myself a goal to move towards which while
impossible according to most doctors was profoundly positive and
motivating. This also reminded me of a story from the book The Four
Hour Workweek by Timothy Ferris. In the book he talks about how
when you set a goal it is actually easier to achieve a goal that seems
almost completely impossible than it is a goal that would appear to be
more easily obtained. The reason for this is leverage. The greater the
7

goal the more leverage you have to achieve the goal.

So to that end I recommend that you do several things to build
a tremendously powerful healthy state of mind. Read biographies and
books about people who have overcome great adversity. Read books
that contain specific exercises and positive stories including The
Power of the Subconscious Mind by Joseph Murray, PsychoCybernetics by Maxwell Maltz. Ask yourself is there a part of me that
is holding myself back? Am I really doing all that I can to make
myself healthy? If there is something that you are gaining by being
sick? If you can identify one or more benefits ask yourself is it worth
the costs of being sick? Is there another way to get the same needs
met or benefits gains while being healthy? It worth the what is a
better way to meet that need than being sick? Also how will your life
be without sickness, what will you be doing and how will things be
different?

Part 3: Step by Step how to do Fecal Transplants

Here is the process to do the Fecal Transplant or enemas at
home. Note that in most cases even if you do the first one with a
doctor using a nasal gastric tube or a Colonoscope you will probably
have to do follow-up ones at home. Based on some studies including
Dr. Silvermans (Success of Self-Administered Fecal Transplantation at
home) I dont think there is much added advantage to doing the first
one with a doctor, especially if they do not already specialize in this.
First I will give a broad overview and then follow that with more
detailed step-by-step directions.
- Decide this is what you want to do for yourself. Realize that at this
point many people who know nothing about this, including most
doctors in the U.S. may tell you that you are crazy to do this. Prepare
yourself mentally to stick to your guns and make this work and tough
it out and adapt as necessary. Realize why you are doing this, other
therapies that promise remission for a period of time at best have not
worked and you face continued loss of time, money, psychological
stress and risks of potentially life threatening effects from many drug
therapies including secondary infections or even cancer.
- Find a stool donor who is healthy and has good regular bowel
movements. The donor questionnaire can help you identify this.
- As an optional step, treat with anti-biotics to wipe out existing
bacteria which will make it easier for the new bacteria to become
established.
- Administer enemas made from healthy poop, continue until a strong
healthy colony is established or symptoms have made a noticeable
improvement. This could be anywhere from 1 2 weeks to a few
months for Ulcerative Colitis or Crohns-Colitis.
- Help the recovery process by getting et adequate nutrition, including
protein shakes, so the inflamed intestinal lining can repair itself.
- Slow bowel movements and muscle spasms to alleviate symptoms
and help the new bacteria become established.

1) Get an active flare under control as much as possible with

whatever can work, whether it's Prednisone, mesalamine enemas or
suppositories, anti-biotics, an all-liquid diet of meal replacement
shakes. All of those were helpful at some point, with Prednisone and
getting adequate nutrition usually yielding the fastest results.

Find yourself a donor

2) Find a donor that generally is healthy and whose blood and stool is
free of certain transmittable infections. When I did this, in 2011 in the
United States. I had to find my own donor by choosing from family or
friends, however this is rapidly changing as some medical clinics are
starting to come up with banks of donors. You may also be able to
find someone off an internet forum or Facebook group who has done
this before.
Use the donor questionnaires which includes someone meeting
these criteria:
a) Has good regular bowel habits, generally about once a day and with
well formed stool
b) Make sure they don't have or have never had blood born STDs like
HIV, Syphillis or Hepetitis. Fortunately this is not hard since these
illnesses are relatively uncommon in hetero-sexuals in most
developed countries that are not IV-drug users. While testing is
advised by doctors, in cases where you can trust the donors medical
and sexual history these tests are probably un-necessary. This
includes you longtime spouse as a donor or if you are the donor for
your children.
c) Make sure the donor does not have or has not had travel's
diarrhea or severe food poisoning or at least does not have any of
those bacteria active in their stool. While doctors can administer stool
tests for many specific parasites, most of the harmful bacteria they
test for would have caused noticeable illness including severe
diarrhea. If the potential donor has not had any illnesses that caused
severe diarrhea, then stool tests may be un-necessary, but are a good
0

precaution because some parasites that may not cause any noticeable
harm in a healthy person might impact a person whose health and
immune system has been weakened by Colitis.
d) Ideally your donor would live with you or practically next door so
you can get stool while it's fresh. Someone from your immediate
family would be ideal, however it does not have to be a family
member. I actually used one of my former clients from my dating
coach business and we got an apartment together.
e) Another consideration, pick someone who is relatively thin and
generally matches who you are as much as possible. At the time of
writing there has been some research showing that gut flora can play
a role in whether or not someone becomes overweight and even some
experimental research to see if Fecal Transplants could help people
who are obese.
It is also possible that gut flora might also impact many other
aspects of bodily functions including hormones and could potentially
impact autoimmune diseases as well. So finding someone who is free
of as many diseases as possible is key. Finding a person with a similar
body build as you would also be ideal although it is hard to say how
necessary this is. In my case my donor was a man with a similar body
build, tall and thin and about 5 years younger than me.

Prepare Your Body

3) Dr. Borodys treatment protocol included a course of anti-biotics,
immediately before starting the fecal transplants. This would
generally include an anti-biotic used to treat gastrointestinal
infections or a combination of such drugs. A course of anti-biotics
could help kill off most the "bad" bacteria back if there is an active
flare as well as clear space for newly transplanted bacteria to colonize.
While I did not do use anti-biotics immediately before starting
the Fecal Transplants, they were helpful for me for treating an active
flare at times in the past, so I think this could be valuable. As I
mentioned earlier in my story, my first Colitis flare was brought into
remission when Cipro was added to Prednisone and Asacol. Several
other times anti-biotics appeared to help me, including Vancomycin
1

the time I was hospitalized with a skin infection.

While I dont think it is necessary for the long-term success of
the procedure, I think it might have been helpful for me. However I do
think it is important to consider that anti-biotic use may have been
the primary cause of problems such as infection with Clostridium
Difficile and possibly many cases of Ulcerative Colitis. The reason for
longterm success of fecal transplants in my mind is that the newly
transplanted bacteria contains strains of bacteria that act as a
powerful anti-biotic / pro-biotic. However the reason the fecal
transplants continue to be effective after you stop doing them is
because the bacterial colony is self-sustaining.
4) If you have an active flare, consider using drugs like Prednisone to
get the flare under control first and continue on it. Even if you are not
having an active flare but there are even slight symptoms, I would
recommend going on at least10- 20 mg to keep down the
inflammation and help limit bowel movements while you are trying to
get the new bacteria established. Other drugs like mesalamine
suppositories and Apriso, a 24-hour time-release version of
mesalamine can be very helpful too.
5) Empty the bowels using a colon prep as if you were preparing for a
Colonoscopy. If you have had chronic watery diarrhea this might not
seem necessary, or you could switch to a diet of meal replacement
shakes for two days before you start. Another option is for the patient
to switch to an all-liquid diet of meal replacement shakes for 48 - 72
hours. This will help by giving the bowels a rest, which will help
reduce inflammation.
Once again I did not do a colon prep first, since my bowels
were already pretty much clear of any solid stool and I didnt want to
aggravate my colon any more than I had to. However it might have
been helpful by flushing some additional bacteria out of the colon. For
people who are having this done by colonoscope this would be part of
standard colonoscopy prep anyway so why not. However for those
using low volume enemas at home I dont think it would make too
much of a difference in the long run because the bacteria are going to
have to keep moving up the colon in spite of poop continuing through
the pipes anyway.

6) If you haven't already, start drinking protein / meal-replacement

shakes and continue this for a few months. This is because it takes a
lot of protein for the body to repair damaged or inflamed tissue. I
briefly tried a product Absorb Plus which was good but kind of
expensive and you have to order from online. I later switched to
Muscle Milk mixed with rice milk in a blender and then a tablespoon
of flax seed oil for a complete meal replacement. This was cheaper and
I could find it at any store. The pre-digested protein in Muscle Milk
and other body builder's or meal replacement shakes can be absorbed
with little to no digestion sort of like drinking a feeding tube except it
tastes better.

Gather Your Supplies

7) Gather your supplies all of which can be bought at any drug store,
including a basic blender, rectal syringe, KY jelly or some other kind of
personal lubricant, disposable gloves, plastic bags or garbage bags
and / or baby wipes, and sterile saline. If you are not going through a
doctor the drug store might not sell sterile saline to you without a
doctor's prescription.
That is ok, because sterile saline in very easy to make all you
need is distilled water and clean salt packets. When the drug store
refused my request I made my own using distilled water and sterile
salt packets sold for use in nasal rinses. I looked up the proportion of
salt to water on Wikipedia and mixed it.
Total cost of supplies: less than $40 retail
8) Give your donor a gladware type of container for them to take what
is basically a stool sample. A relatively wide container could be helpful
as it provides your donor an easier target to aim the poop.
I had my donor put a small stack of them on top of the toilet
tank or some other place nearby as a reminder. I actually reused
them by washing them out with hot water and dish soap to reuse.
Healthy, relatively dry poop is actually not that bad compared to the
foul-smelling poop that we often deal with in the midst of a flare.
9) Get a good stool sample from your donor. Solid or mostly solid
stool is ideal as well as a good-sized turd, for lack of a better term.
3

Eating a diet relatively high in fiber can be helpful to make sure your
donor goes on a regular basis. I dont think it is necessary to alter a
persons diet significantly while they are donating other than to
ensure regular bowel movements occur. If there are no problems I
dont see a need to change anything.
10) Use the stool immediately or close the air tight container and
refrigerate it for up to 5 or 6 hours. Do not freeze it as this could
damage the bacteria in the stool. I didn't want to have to put my life or
my donor's life on hold for this, so the fridge was our friend.

11) The recipient of the donor stool should take an anti-diarrhea drug
like Loperamide (Immodium) about an hour before the enema.
Loperamide is an anti-spasmodic which means it will help reduce the
feeling of needing to go the bathroom (urgency) and help you retain
the enema for longer. Anti-gas medicines like simethicone (Gas-x) can
also be helpful to reduce bloating.
While Loperamide is effective, based on my experience I now
think the addition of anti-depressant or anti-anxiety drugs is key
because they can work continuously to calm muscle spasms whereas
Loperamide only works for 4 hours. While I did not start using 5 mg of
Doxepin and 300 mg a day of Bupropion until after the end of doing
these transplants, I did have an immediate sustained remission within
a day after starting these!
12) Prepare an area where you will administer the enemas. This could
be the floor or even your bed covered in such a way as to protect it. At
first I would cover your mattress, a comfortable pad or even the
carpeted floor with a plastic garbage bag and then a towel and / or old
4

easily washable blankets.

As you get more experience with this, you will realize that most of the
time you can do this without spilling any of this.
13) Mix the stool with sterile saline (9 g of NaCl per liter of water).
While I have heard some people recommend recommend using as
much as 500 mL, I later used less saline, closer to 200 mL. Basically
you want enough to cover the stool so you can liquefy it relatively
well, however you do not have to be exact.
You might also consider mixing it with fiber like Phyllium
husks from fiber supplements to add some more bulk.

14) As an optional step filter the mixture through a soup strainer or

other type of strainer. The reason is to remove larger particles that
could clog the syringe nozzle. However it was my experience that this
was not always a problem even if I did not filter the mixture
15) Put the hole of the bulb without the nozzle attached to it into
the top of the mixture and then slowly release the bulb to draw the
mixture into it. Kind of like a turkey baster or syringe to draw the

fecal matter into the bulb.

16) Put the nozzle into the bulb and this is ready to use.
17) Carry your rectal enema over to an area on the floor covered in a
plastic trash bag. This way you can easily clean up any spillage later.
- Lubricate the tip of the nozzle with a little KY or other personal
lubricant, you may also want to lubricate your anus as well. Grab the
nozzle and get into a proper enema position, lying on your left side
with hips slightly elevated or on your back with your legs up squeeze
the mixture into your rectum until the bulb is empty or almost empty.

Admittedly all of this can seem a little (ahem) weird at first, especially
the positions. However remember why you are doing this, to cure this
illness once and for all so you can go back to living life in good health.
If not this, then you will probably relapse back to pooping your pants
or having an ostomy bag on the outside of your body.
18) Once you are done squeezing out the contents of the enema, put
your rectal enema onto the trash bag right side up if you can (this
means little or none of it spills out) or into a small bucket of soapy
water. Wipe gently with toilet paper or baby wipes. You may also pull
your pants back on because after wiping there should not be any
leakage unless you are ready to have a bowel movement. If makes you
more comfortable then you could always wear an adult diaper, but I
did not do this.
19) Retain the enema for at least an hour or as long as you can. If you
do this at night time before bed, you might even drift off to sleep for
awhile. Have something like a chamber pot nearby or do as I did and
make a quick 10 foot dash to the bathroom to expel the enema.
To retain the enema better and help it travel farther up your
colon shift from lying on your left side onto your back after a few
minutes and then onto your right side with your hips elevated with a
cushion. The reason this is helpful is that this movement will guide the
mixture as it travels through the contours of your large intestine.
7

Ideally the mixture will travel up through the rectum, then left
through the sigmoid colon, up through the descending (left-side)
colon, right through the transverse colon, then down the ascending
(right-side) colon all the way to the cecum and the Illeocecal opening
at the end of the large intestine.
The ability of the bacteria to travel all the way to the Illececal
opening either directly with the mixture or by colonizing their way up
from farther down the colon is key to making this work. While having
the mixture travel there directly might speed up the process, note that
the bacteria can and will also work their way up the colon especially if
diarrhea is limited and competing bacteria is relatively weak or
limited.
Whether or not this works for Crohns Disease in the small
intestine might be determined by the ability of the mixture or the
bacteria that it seeded making its way past the Illeocecal opening from
the large intestine. Other possibilities include using a medical device
traveled either through the digestive tract to the small intestine or up
through the Illeocecal opening. Or it is possible that Crohns Disease
confined exclusively to the colon might be successfully treated using
just the fecal transplants in the colon, or that the inflammation in the
small intestine is a secondary manifestation of the bacterial
imbalance / infection in the large intestine.
20) Clean your equipment by washing out the rectal syringe and
letting it air dry. If the nozzle starts to get a significant of poop drying
on the inside of it, then use a pipe cleaner or the end of a wire coat
hanger to scrape it out.
21) Repeat daily for anywhere from 5 days to a month or so if
necessary. While I did it everyday for 5 weeks based on the advice of
another person. Dr. Barody only did it for 5 days with his patients.
Other options include every day for I believe that if you can
effectively slow diarrhea and limit bowel movement down to 2 - 3
times a day or less then the newly transplanted bacteria will establish
themselves faster.
22) Take over the counter drugs like Loperamide (Immodium) to
treat symptoms like gas and diarrhea. Some amount of gas is normal
from new bacteria establishing and old bacteria dying off.
8

Conclusion
So there are the steps for the Fecal Transplants. Feel free to
contact me through my website http://www.FecalTransplant.org for more
information.
As a note even once the enemas have established the new
bacteria in the intestines it still could take some time for sustained
improvement without at least some relapses. In my experience there
were some dramatic breakthroughs where things got better and then
some relapses. However over time the relapses were not as bad and
now 18 months later I actually have better bowel movements, less
diarrhea and urgency than I did before I was diagnosed with Colitis in
the summer of 1999.
Also you dont have to do this perfectly per se for it to work.
The bottom line is you have to get a new bacterial colony to establish
itself which contains healthy bacteria that is more dominant than
inflammation causing bacteria. Once that has occurred it is also a
matter of time for the bacteria to adjust and balance and for your
bodily tissues to heal.

Part 4: Frequently Asked Questions

Here are some frequently asked questions that I have gotten
readers of my website.

Why and how does Fecal Transplant work?

If the problem is bacteria why dont anti-biotics
permanently cure the condition?
If the problem is bacteria why do immunesuppressing drugs help?
Why are diets sometimes helpful for reducing the
severity of Crohns or Colitis symptoms?
What do you think about the Specific Carbohydrate
Diet?
What research is available to support the use of
Fecal Transplant for Ulcerative Colitis?
Is there a risk that Fecal Transplants could make
things worse / trigger a flare?
Why does emotional distress appear to trigger an
outbreak of Colitis or Crohns Disease?
How do I find an ideal donor?
Do I really need to test my donor for every
conceivable illness?
Are my intestines damaged beyond repair so that no
treatment options would help me other than
surgery?
What if my symptoms get worse or I start to have a
flare while doing the Fecal Transplants?
Should I take Prilosec as part of my fecal transplant
protocol?
Should I change my diet significantly during the fecal
transplants?
Should my donor significantly change their diet?

Why and how does Fecal Transplant work?

This is a common question that I am asked. The short answer is
that in at least some cases the root problem stems from an
0

overgrowth of certain kinds of bacteria that might otherwise not be

present in a healthy person without adverse effects or can be found in
small quantities without causing any adverse effects. These bacteria
could overgrow because previous anti-biotic use killed off stronger
competing bacteria or diarrhea and improper digestion made
conditions more favorable for the inflammation-causing bacteria.
Fecal transplants work by restoring a healthy balance of
bacteria to the colon, which are necessary for preventing certain kinds
of harmful bacteria from taking over. This can also be thought of as
the ultimate pro-biotic. By seeding the colon with enough of these
good bacteria until they start to become established you can both kill
off the bad bacteria, or crowd out any room for them to grow and then
keep them from coming back. However once established the
transplanted bacteria it is more effective in the longterm than probiotics cultured from diary because the transplanted bacteria formed
a complete and self-sustaining colony in a healthy persons body.
If bacteria can cause travelers diarrhea and infections like
Clostridium Difficile which have similar symptoms why not Ulcerative
Colitis. If bacteria can cause problems farther upstream from the
colon such as stomach ulcers then why cant it be the cause of ulcers
in the intestines?
My first flare of Ulcerative Colitis came while traveling abroad
and was affectively driven into remission with the help of the antibiotic Cipro, after my doctor said it was sometimes prescribed when
the illness did not respond to anti-inflammatory drugs. While no
known pathogen was identified in stool tests I still find that
coincidence to be overwhelming.

Why not just remove the bad or add good bacteria?

This is a good question, stated another way, why do the gut
bacteria equivalent of tearing down the building and building from
scratch if you dont have to. Why throw out the good with the bad?
There are several reasons. While certain infections of bacteria like
Clostridium Difficile and some forms of travelers diarrhea have a
cause that has been identified, Ulcerative Colitis does not have any
bacterial strains specifically defined.
Killing bad bacteria is already done using anti-biotics and probiotic supplements can be used to introduce beneficial bacteria.
However at this point neither solution offers a lasting solution
1

that persists after you finish taking them. In the case of anti-biotics
even if they appear to work in the short term, they often create more
problems by also killing good bacteria. For example Clostridium
Difficile bacteria overgrowth usually occurs after treatment with antibiotics. After subsequent use of anti-biotics the bacteria often adapt to
form treatment resistant strains. It is also known that strains of c. diff
bacteria are also often found in healthy people without illness, which
could suggest that the bacteria itself may not cause illness as long as
other competing bacteria are present.
Adding in good bacteria can be done using pro-biotic
supplements cultured from yogurt. This can be helpful as long as you
keep taking the pro-biotics and this does seem to help some people.
However these bacteria are not native to the human digestive track
and cannot create a self-sustaining colony.
The course of Ulcerative Colitis, Crohns Disease and even
Irritable Bowel Syndrome is complex and medical doctors in the U.S.
have not agreed on any one definitive cause of this illness. There are
hundreds if not thousands of strains of bacteria that have complex
interdependent relationships most of which are not currently
understood and which may vary from one person to another. Until
this can be understood with more precision, a fecal transplant that
seeds the same colony of bacteria that is benefitting or at least not
harming the host can be an effective solution. I cover anti-biotics and
pro-biotics in greater detail in other questions and in the section that
discusses treatment options.

Why dont anti-biotics permanently cure the condition?

Once again this was puzzling to me. Anti-biotics appear to
effectively treat many illnesses without a relapse. However in recent
years anti-biotic resistant bacteria has become an increasing
challenge.
In my case, my first flare went into remission after the addition
of Cipro to my treatment regiment. Then other times the illness
appeared to become less severe while I was taking other anti-biotics,
however the Coltis kept coming back with periodic flares, not unlike
Colitis caused by a known bacteria like Clostridium Difficile.
The reason the Colitis inflammation came back after treatment
with anti-biotics could be because there was now or was previously a
lack of other competing bacteria to prevent or at least limit the
2

growth of other strains of bacteria. If the existing bacteria in the colon

are stronger than the bad bacteria that would take over then there
will be no room for the inflammation causing bacteria to grow.
For example nearly all cases of Colitis attributed to infection
with Clostridium Difficile bacteria happen after treatment using antibiotics. However clostridium difficile is also found in some healthy
people who are not suffering from Colitis. Maybe the mere presence
of Clostridium Difficile is not always a problem. Maybe the problem is
that an anti-biotic resistant strain has developed or the bacteria has
otherwise mutated.
Antibiotics often are able to drive c. diff Colitis into remission
the first time they are used and sometimes for the next several times.
However the infection often comes back either from some amount of
the bacteria that was not killed off or from a new introduction. Also
the effectiveness of anti-biotics tends to decline with each repeated
round of treatment to the point of becoming almost completely
ineffective.
For Ulcerative Colitis there is no known pathogen at this point
although it could be because the bacteria has not been identified as a
problem, or it is an otherwise harmless bacteria that has now changed
in response to anti-biotics or other factors.

Why do immune-suppressing drugs help?

This is also complicated and kind of counter intuitive. Why
would drugs that suppress the immune system (e.g. Prednisone,
Remicade, 6MP etc.) help if the root cause is a bacterial infection? The
simple answer is that at least in the short run, the benefits from
reducing inflammation outweigh any downside caused by suppressing
the immune system, at least for as long as you keep taking the
immune-suppressing drugs. But why and how? The reasons makes
sense when you consider that intestinal flora is in many respects an
ecosystem that operates both in conjunction with the immune system
and independent of it. Also if the bacteria cannot be killed off by the
immune system alone or the problem is an imbalance in the gut
bacteria then at a certain point the inflammatory response might be
causing more harm than good.
The benefits of reduced inflammation include decreased
diarrhea, possibly a result decreased ulceration of the intestinal walls
which results in better elasticity and ability to remove water from
3

stool. If frequent watery diarrhea creates conditions favorable to an

overgrowth of inflammation triggering bacteria, then does regular,
mostly solid stool with lower water content support healthy gut flora
and make conditions less favorable for inflammation-triggering
bacteria?
Another possibility is that the benefits of the immuesuppressing drugs are caused by impacts other than reduced
inflammation itself. This could include impacts to neuro-transmitters.
Prednisone certainly had a mood-elevating effect for me and seemed
to almost instantly calm bowel movements. Maybe this is another
reason why it helps.
So-called biologic drugs like Remicade inhibit TNF-a, however
in laboratory tests so does the anti-depressant drug Bupropion
(Wellbutrin.) However I am not aware of Remicade

Why are some diets sometimes helpful?

When I was first diagnosed one of the first questions my Mom
asked was about the role of diet in this illness. It makes sense that diet
would play a role, especially since some foods definitely appear to
trigger worse symptoms of diarrhea, urgency and gas/bloating. I have
seen posts by many people on the internet who believe that the
Specific Carbohydrate Diet and other diets like the GAPS diet have
helped them maintain long-term remission. The best explanation is
that the diet helps favorable bacteria and not helping unfavorable
bacteria. This does seem to be a valid explanation in many respects
there are several reasons why.
1) Pro-biotics - A staple the Specific Carbohydrate Diet also
includes yogurt rich in live active pro-biotic cultures. This
alone could be a very significant factor.
2) Eliminating trigger foods - The intestines might be more
sensitive to foods that are more difficult to digest due to an
existing level of inflammation. Eliminating these problem foods
helps relieve symptoms.
3) Psychological the mind-body connection has proven to be
very significant, such that drugs are tested against placebo to
determine effectiveness because the belief that a drug is
effective can actually make it effective. Digestive diseases
appear to be particularly susceptible to these affects. From a
4

purely physical point of view this makes sense because there

are a high number of neurotransmitters in the intestines. This
helps explain why digestive disease seems to be particularly
linked to a persons state of mind.
Since a diet can give a person the belief that there is something
they can actively do to address the symptoms a diet can help by
alleviating some emotional distress.
However special diets do not appear to help every person and
sometimes a one minor relapse appears to cause a problem that can
last for days or weeks before recovery. Why? It could be because the
original problematic bacteria is still there with little to stop it. It could
also be that the intestines are still suffering from a degree of
inflammation just below the point at which very noticeable problems
become obvious.

What do you think about the Specific Carbohydrate Diet?

I tried this at one point and it did seem to help a little bit.
However it was very difficult for me to strictly keep this diet and also
maintain body weight. I was also unhappy with how restrictive the
diet was. I also know of many people who swear by this diet and its
ability to help them. I also do believe that there are some concepts
from this diet that do make sense and believe it can help some people.
However based on the experiences I have read about even if
the diet works in the long term it has to continue to be strictly
followed for it to be effective ecause it has not eliminated the root
problem bacteria and good bacteria from yogurt cultures cannot form
a self-sustaining colony in the colon.
1) The starter diet of home made chicken broth helps provide bowel
rest. Also well-cooked chicken and vegetables are easier to digest.
This could provide nutrition that helps get you back on the right track.
Bowel rest has also been established and used as part of other diets
and treatment options to help get a flare under control.
2) The 24-hour fermented yogurt is lactose-free and also contains
many helpful bacteria which can help control pathogenic bacteria and
help modulate the immune system as well.
It helps starve pathogenic bacteria of food by limiting simple sugars.
This may be true, but it is hard to say if this actually happens or if the
5

3) pro-biotic bacterium is just keeping the other inflammation causing

bacteria under control. Especially if eating just one illegal food is
enough to set off a flare.
4) Many foods that people have allergies or intolerances to might be
eliminated using this diet. This makes sense, especially while the
intestines are in a state of inflammation.
5) It is also possible that some foods irritate the intestinal lining when
it is already inflamed but might not cause a problem when the
intestinal walls are ok.
6) Peace of mind. Psychological stress and feeling of being helpless
when it comes to managing the illness could actually help trigger a
flare by disrupting digestion or causing muscle spasms. By giving the
patient something they can actively do about the situation this could
alleviate some psychological stress and help the illness as well.
However I believe that any gains from this diet alone are un
necessary once other means such as Fecal Transplant have been
effectively used to eliminate harmful bacteria and / or effectively seed
a new bacterial colony that balances the other gut flora. While the SCD
diet appears to help some people it does not directly eliminate
pathogenic bacteria it does not offer a lasting cure beyond the diet
itself.
Moreover it can be very hard to follow this diet to the letter
day after day, year after year without somehow feeling deprived. I
grew up on the all-natural Feingold Diet as a kid and I still thought the
Specific Carbohydrate Diet was difficult to follow. I also dont agree
with the position that eating one illegal food even once in a month
should be enough to trigger a flare that could take weeks to get back
under control. This suggests that in those cases the original bacteria is
still there, and the underlying inflammation is also still there even if it
is not as bad.

Why does emotional distress appear to trigger a flare?

Emotional stress or change of seasons has often been identified
as a trigger for a flare. Here are a couple of reasons how it can do it.

1) Emotional stress can cause weaken the immune system which

weakens the bodys ability to fight infection.
2) Stress can cause the body to not effectively digest certain foods
as well. Improperly digested food can possibly rot and breed
harmful bacteria and trigger diarrhea which removes bacteria
that normally prevent certain inflammation-causing bacteria
from overgrowth.
3) Stress can both result from or cause an imbalance of
neurotransmitters such as serotonin, dopamine and
norepinephrine. Since the gastrointestinal track has high
amounts of neurotransmitters it can be very susceptible to
changing levels of these in the body.

What published medical articles support the use of Fecal

Transplant for Ulcerative Colitis?
At this point most of the supporting evidence comes from
documented case studies, including Dr. Borodys Treatment of
Ulcerative Colitis using Fecal Bacteriotherapy, however to date there is
more information for its use to treat infection attributed to
Clostridium Difficile bacteria. There are also some obstacles to doing
the kinds of large-scale studies that have been done for many drug
therapies.
1) It competes with existing treatments that make money for
doctors and drug companies.
2) Without a service or product that can be patent-protected and
make money, there is little money to be made.
3) Specific bacterial causes have not yet been identified for
Crohns Disease and Ulcerative Colitis as they have for
Pseudomembranous Colitis caused by c. diff bacteria, or
diarrhea caused by giardia or other kinds of travelers
diarrhea.
4) The course of the illness also appears to vary from one person
to another based on where the inflammation is most severe
and what treatment options have been effective if any. Such
that it can be hard to compare one case to the other.
7

Can I do fecal transplants at home without a doctor?

Yes, you can do the fecal transplant enemas without a doctor.
In fact right not it is hard to find a doctor willing to do this treatment
at all in the United States and the few that are willing to do it usually
will only use this treatment for Colitis caused by Clostridium Dificile
bacteria.
Even the few doctors willing to do this for Ulcerative Colitis
will usually only do the first fecal transplant, often using a
colonoscope with patients left to do follow-up enemas themselves, for
anywhere from one week to 1 3 months. Part of the reason is that it
can be hard to predict how long treatment will have to be done before
the illness gets better. So the question then becomes is the advantage
that you get by having the first transplant administered via
colonoscope worth the extra cost and effort?
The good news is that you can do it yourself and be successful.
In the article Success of Self-Administered Home Fecal Transplantation
for Chronic Clostridium difficile Infection (Silverman et al, Clinical
Gastroenterology and Hepatology 2010) the author concluded low
volume home administered fecal transplants were just as effective for
treating infectious Colitis caused c. diff bacteria. While there
currently is no similarly published article for home administered
treatment of Ulcerative Colitis there are a growing number of success
stories including my own. I do think there may be may be some
benefit to getting bacteria up into the upper reaches of the colon
faster, however in the long run it is hard to say how much it would
speed up the process of new bacteria colonizing.
However you will need a doctors prescription to have your
donor tested for illnesses and for prescriptions for drugs including an
optional course of anti-biotics before starting the fecal transplants
and prescriptions for drugs including Mesalamine, Prednisone, and /
or anti-depressants drugs such as Bupropion. You might already be
prescribed some of these drugs by your current GI doctor or you
might get prescriptions to treat other conditions you have like sleep
disorders or anxiety and depression from a psychiatrist or other
doctor.

Is there a risk that Fecal Transplants could trigger a flare?

I think that FTs are a very effective treatment option that is
worth doing, however yes it could trigger a flare. This is why taking
Prednisone or other drugs to treat inflammation and suppress the
immune response is very important and is part of most treatment
protocols. Borodys patients took maintenance drugs and while I did
not start with these drugs I ended up taking them after having a flare
myself.
Why is this necessary? One possibility is that because the gut
flora are undergoing dramatic changes and the immune system has to
adjust to this. Note that when people receive donated organs they
often are treated with immune suppressing drugs. When people
receive a blood transfusion, the blood types have to match up as well.
It is not known how much these bacteria have to match up for
someone however my donor was not a member of my immediate
family, although he was of a similar body build including height and
weight.
Another possibility is that a flare was going to occur anyway
perhaps because of a bloom in bacteria from dormant spores,
however since those pathogenic bacteria are active, the inflammatory
response is part of the solution as the newly transplanted bacteria and
your immune system fight the bacteria.

How do I find an ideal donor?

An ideal donor would be someone who is healthy, free of
certain diseases that can be transmitted through blood or stool and
has consistently good regular bowel movements. Oftentimes it will
help to have your donor be an immediate family member, spouse,
parent or child since they may already be accessible and you can trust
their medical history. I ended up recruiting a friend of mine to
become my roommate since I lived alone about 1,000 miles from
family.
See the questionnaire at the end of this book for specific
questionnaires, however there are many people who would be a
qualified donor. If the list of illnesses to test for seems intimidating,
know that the actual likelihood of a person having any of the those
illnesses is pretty low in the general population and can be largely
predicted based on a persons medical history, travel history and
9

lifestyle.

Do I have to test my donor for every possible illness?

Most protocols written by doctors recommend testing for a
variety of diseases that can be transmitted through blood or stool.
Most of the blood born illnesses include STDs like AIDS, Sypillis and
Hepetitis. While most of the ones that can be transmitted through
stool cause noticeable symptoms including severe chronic diarrhea
that usually needs significant medical treatment to get over.
While the doctors would say it is necessary as a way to err on
the side of caution, if you are doing this at home I would say this
depends and you should use your best judgment.
For example if you are the donor or recipient for your spouse
or long-term sexual partner it might be un necessary to test for
illnesses like AIDS. If you look at the likelihood of a person having the
illness you will see that it is often confined to a very specific segment
of the population.
Stool testing is advisable no matter what because it is possible
that some intestinal parasites that are not causing gastrointestinal
problems for the donor might cause them for the recipient.

Can my intestines really be damaged beyond repair?

Quite probably the answer is no even if that is what your
doctor has told you. If you have had multiple flares over the years
followed by periods of remission you know that you do appear to get
better while in remission, this is because when the inflammation is
effectively suppressed by drugs, the intestines do heal over time. Once
the bacterial root cause of inflammation has been resolved using fecal
transplant, healing can begin to take place. This healing depends on
adequate nutrition for the body to rebuild tissue, an absence of
inflammation and relative calm so that violent bowel movements do
not re-aggravate the ulcers that are healing.
My doctors including a colo-rectal surgeon told me my colon
was beyond repair because it had lost elasticity and had scar tissue
from repeated ulceration. This was given as another reason I needed
to have surgery. However after treatment and several months of
healing it worked as good as it had before I had ever gotten sick.
While Im sure it was true that my colon had lost elasticity, and this
was a major reason why I often had urgent bowel movements after a
0

meal, I now have it back.

However after the surgeon told me to take meal replacement
shakes to boost the amount of available protein I had in my body
(albumin) I was able to taper off of Prednisone and maintain a
relatively calm remission using Apriso and mesalamine suppositories.
I think that a combination of the illness and restrictive diets may have
resulted in a lack of getting adequate protein and this was what
created the problem.
Once the bacterial root cause of the inflammation was knocked
out, I was able to successfully heal over time and now often have only
one well-formed bowel movement per day. While I tried a number of
supplements to help ease inflammation, including Aloe Vera at one
point, I believe that the Muscle Milk supplement helped play a very
significant role due to the available proteins and amino acids
including L-Glutamine.
The same surgeon who told me my colon was damaged beyond
the point of being able to heal itself also told me my blood albumin
levels were too low for an optimal recovery from surgery and that I
needed to elevate my levels of available protein in my body through
protein shakes. Interestingly enough as I started taking these shakes
a few times a day my Colitis went into a very stable period of
remission.
While I cant medically prove this can happen for everyone I
am firmly convinced that if you stop the root problem caused by
bacteria, get adequate nutrition and calm muscle spasms in the gut
then your body can heal.

What if a flare starts while doing the fecal transplants?

This happened to me while I was doing the fecal transplants for
Ulcerative Colitis and I was encouraged to continue the fecal
transplants and Im glad I did. I also was not taking medications to
maintain remission at the time either which was not a good idea. Your
can limit the probability of a flare happening or affectively controlling
one if it does happen by doing a couple of things.
1) Get the symptoms of the illness under control before starting
using available drugs. While I was not in the worse point of a
flare I was still experiencing some symptoms like diarrhea. If I
had it to do over again I would recommend starting on
1

Prednisone even if you are currently off of it as a pre-emptive

measure. Mesalamine based drugs like Apriso or Canansa
Suppositories could also be helpful.
2) Use anti-spasmodic drugs like Immodium about an hour before
each enema to slow bowel movements. Another option
especially for night time is the use of tri-cyclic anti-depressants
or anti-anxiety drugs to further calm the gut.
3) Above all else either keep going or take a short break to get the
worst of the flare under control. By limiting bowel movements
you can speed the establishment of the new bacteria in the
colon. Most of the people I have heard about who have gotten
better from this who had Ulcerative Colitis needed to do
significantly more fecal transplants than patients who only
had Clostridium Difficile infections. This could include doing
them for at least a month to be on the safe side and also
including the use of drugs to limit inflammation and bowel
movements.

Should I take medications that reduce stomach acid?

While I have seen some treatment protocols include this, I did
not take anti-acids myself. I also wonder how they would help good
bacteria colonize in the colon because stomach acid does not leave the
stomach and travel into the colon. However anti-acids can change
how drugs are metabolized in the body and how they work. Anti-acids
could also change how food is digested and which nutrients are
absorbed.
For example iron needs a more acidic environment for proper
absorption that is why supplements like Vitron-C combine vitamin C
and iron. These impacts could either be helpful or not helpful. I do
know that for cases of indigestion after eating raw foods like oysters it
is not recommended to take anti-acids because stomach acids could
help kill harmful bacteria in foods before it gets to the intestines.
I did have good results with my protein shakes using Muscle
Milk. This would help reduce acid levels since these shakes are more
basic, however they would do this in a more subtle way than antiacids.

Should I change my diet during the fecal transplants?

Once again I did not change very much, however my diet was already
2

pretty restrictive. I would avoid caffeine, as I noticed that triggered

bowel movements. Carbonated soft drinks and beer were also
problematic by causing lots of gas. Very spicy foods were also not
good, and I noticed that red pepper hot sauce would sometimes
appear in my stool and looked very similar to blood. Other than to
avoid foods that trigger diarrhea, bloating and cramping, I would
generally stick to the same diet you have already been following. Once
diarrhea and inflammation is more under control you can gradually
increase the amount of fiber in your diet from fruits and vegetables.

Should my donor significantly change their diet?

Other than to make sure they have regular well-formed stool
and regular bowel movements, there shouldnt be any dramatic
changes. Eating a well balanced diet of fruits and vegetables and
meats can be good to maintain regular bowel movements. It is also
possible that spicy foods could introduce irritants to poop as well.
However the base gut bacteria has developed over time based
in large part on the kind of diet they have generally been eating for
most of their lives, so specifically eating lots of pro-biotics will
probably not help much other than to help maintain regular bowel
movements.

How long will it take before I start to heal?

That will depend upon several different factors, including what
is causing the illness, how long you have had it, where the
inflammation is and how severe it is. It is also hard to directly
compare one exact case to another given the dynamic nature of this
illness.
That said in my case, 6 weeks after starting the fecal
transplants I had almost complete remission, 6 months later I stopped
taking any maintenance drugs and as of the time of publication I have
the best bowel health of my life 21 months after I started the fecal
transplants.
Faster or slower healing is also possible. For example
Pseudomembraneous Colitis caused by Clostridium Difficile can often
be treated with just one or a couple fecal transplants. For Ulcerative
Colitis this takes a little longer. The 6 patients whose healing of
Ulcerative Colitis is documented in Dr. Borodys article Treatment of
Ulcerative Colitis using Fecal Bacteriotherapy generally stayed on
3

maintenance drugs for about 6 weeks after pre-treating with a course

of anti-biotics and doing 5 days in a row of the fecal transplants using
a colonoscope.
My mentor who used the Fecal Transplants to help her son's
Crohn's Colitis. It was her belief that he needed to do many more of
these transplants for several months first every day and then tapering
down to less and less of them each week, and that doing them for less
time had not been effective in the past.
In my case I did Fecal Transplants every day for 5 weeks at
home using a low volume rectal syringe, and did not pre-treat with a
course of anti-biotics. A sustainable recovery for me did not occur
until almost 10 days after I had stopped the FTs, about 6 weeks after I
had started the fecal transplants. At this time I had also just added the
drug Bupropion (Wellbutrin) to my treatment regiment, along with
Silenor, Apriso and mesalamine suppositories.
In retrospect I think pre-treating with anti-biotics might have
helped speed up the process, doing the first transplant with a
colonoscope might have sped up the process by a few days and
continuing to take anti-inflammatory and immune-suppressant drugs
might have also helped speed things up. I also think it is a good idea
to continue the maintenance drugs for a while after you think
everything is completely cured, perhaps about a month or so. This is
because there are some noticeable ups and downs in the healing
process.

Why could it take longer for some people to heal than

others?
Based on my experience and others I have spoken to Ulcerative
Colitis does take a more lengthy course of treatment with fecal
transplants than infection with Clostridium Difficile bacteria. There
also appears to be some variation in treatment during for those with
Ulcerative Colitis and / or Crohns Disease as well. First I will list
some factors and then below that describe each one in slightly more
detail.
1) The kinds of bacteria that are involved as the primary trigger for
the illness.
2) How long the illness been active and how severe has it been?
3) How much tissue damage is there, where the tissue damage is
4

located and how deep is it.

4) Secondary illnesses or nutritional difficiences.
5) Average bowel transit time during the time the fecal transplants
are being done.
6) Psychological stress / distress.
1. What kinds of bacteria are involved as the primary trigger for
the illness?
The bacteria or other pathogens which appear to be the root
cause of Ulcerative Colitis are largely unknown at this time. It is also
possible that they are different from one person to the next. However
it stands to reason that this could be one factor effecting how
someone heals. While anti-biotics appear to help me get over a flare a
few times, they seem to make conditions worse for other people.
2. Where did the inflammation start and where did it spread
from there?
Is it in the rectum? descending colon? the whole thing? Is it
continuous inflammation or is it patchy? Is it only in the small
intestines, large intestines or both? Different areas could mean
different kinds of bacteria that thrive in different areas. Also if is it
farther up the large intestine or into the small intestine, treatments
like Fecal Transplant could take more time to work.
3. How long has the illness been active, how widespread is the
tissue damaged and how severed is the damage.
The longer the illness has been around the more chance for it
to become resistant to anti-biotics and become stronger and different
from the strain or strains of bacteria that first caused infection. It is
also possible that immune suppressing drugs, anti-biotics and more
have changed the nature of the bacteria that are in there as well.
Changing bacteria could mean changing symptoms, some areas could
get better while other areas become inflamed for the first time. A
longer course of illness could also mean that tissue is more badly
damaged and therefore take more work from the body to heal.
4) Are you lacking in any nutrients
Once I learned that my blood albumin levels were low (the
amount of protein available for your body to rebuild damaged tissue)
it made sense why I was not recovering between flares and why
5

Prednisone was not effective. My body was not healing because it was
low on resources necessary to make it happen. Digestive illnesses in
particular can be hard to heal because the illness can reduce appetite
or desire to eat. Damaged tissue can mean less nutrients are absorbed
at a time when the body needs higher levels of nutrition.
Unfortunately more inflammation and diarrhea might led desire to eat
and less ability to absorb nutrients which prolongs the amount of time
it will take to heal. Also some parts of the digestive track may take
longer to heal than others depending on where they are. Certain foods
might also aggravate inflamed areas that are trying to heal as well.
5) Average bowel transit time after the fecal transplants.
It stands to reason that it would be hard for new bacteria to
expand their way upstream through the colon when confronted with
a steady stream of watery diarrhea flowing through it. Its kind of like
swimming upstream. However continuing to the transplants would
force more bacteria in to seed its way in there which could be helpful.
Also helpful would be ways to limit the diarrhea through diet
and anti-spasmodic drugs. I believe this was the decisive factor in my
case. I believe the prescription drugs I took helped slow bowel transit
time which helped the new bacteria colonize and also calm muscle
spasms that may have upset areas that were trying to heal from
inflammation.
I believe it is also possible that continuing to do the Fecal
Transplants after the necessary bacteria have established themselves
could be counterproductive in that the excess bacteria causes bloating
and triggers continued unrest in the bowels which would not
otherwise exist. These symptoms of gas, diarrhea and urgency could
easily be mistaken for continued disease leading someone to falsely
conclude they need to do more or conclude that it isn't working.
6) Psychological stress / distress
It is relatively accepted that a person's state of mind can have
an impact on the course of any illness. Digestive diseases certainly
seem to fall into this category as stressful events or depression can
often trigger flares. But why and how do they impact the illness?
- Psychological stress can cause indigestion, or incomplete
digestion can cause problems because undigested food can start to
decompose in the digestive track. Stress can also weaken the immune
6

system and / or cause more stress hormones to be released in the

body. Once started it can be a tough process to break.
My Experience
In my case I had a relatively normal case of Ulcerative Colitis
which started as left-side Colitis in the rectum, sigmoid colon and
descending colon and gradually spread its way up the colon to become
pan Colitis. By the time I started the fecal transplants there had been
extensive inflammation throughout my entire colon for many years.
This means the surface lining of the colon had been pock marred with
scars from previous ulcers and there were others at various stages of
formation, rupturing and also healing.
While also taking longer to heal, a more damaged surface of the
colon could also provide more nooks for bacteria to stay as they
become embedded in the lining. This would include bacteria that can
reproduce from spores after being dormant. So the ulcerated lining
means that it is harder to kill all of the bacteria.
That said, 7 weeks after I started I hit complete remission and
never had another flare. 12 weeks a colonoscopy showed significant
signs of healing.
Conclusion
Variation in some or all of these factors can explain healing
time and how long it takes to see noticeable and ultimately permanent
impacts from these treatment options. This would explain part of the
reason why different treatment approaches seem to help some of the
time but not others.

How do I get a flare under control so I can get started?

A flare is the time when you are most likely to be motivated to
try anything to make yourself better, however like many other
treatments fecal transplants will start to take effect faster if you can
get the flare under control first. This might mean being on immune
suppressing drugs like Prednisone or Remicade at first to suppress
the worst of the inflammation. However know that this treatment is a
permanent cure. Below is my response to an email from a reader who
tried to start fecal transplants during a flare and a step-by-step
approach to dealing with a flare.

Here is an email from a reader and my response to them.

Q: How is it going? Are you still feeling better? I am having a
flare and am thinking about FT very soon.
A: Yes I am still doing much better, in fact better than before I
was first diagnosed with Colitis almost 14 years ago. As for the Fecal
Transplants, do it, you won't regret it once you are done this illness
and done paying medical bills!
Q: I tried it on Sat and only realized my donor, my son, only goes
once every 3 days! So through everything out of whack. I am actually
getting a colonoscopy on Monday at Mayo clinic. It's something I have
to do in order to get disability, otherwise I would just do the FT with a
new donor.
That being said, I do have a fever for the last couple of days and
my white blood count is up. I am not sure if that was from that one
transplant. My son has some potent stuff because I still smell it 5 days
later.
A: This is another condition to add to your donor, someone
who normally goes once or twice a day. If might also help to youre
your donor eat a diet with good amounts of fiber in it to keep things
moving as well.
That said that one transplant could be very potent. If you can
still smell it in your stool days later, that means the bacteria from it
are still active. If his bacteria takes over at a certain point it could start
you on the road to recovery. You could end up with the same bowel
habits as him too! It also could mean that your body is attempting to
fight the new bacteria at this point. This is why immune suppressing
drugs like Prednisone are usually a good idea and a possible reason
for pre-treating with a course of anti-biotics.
Q: The problem is that I am not doing so well. I started this at
the worse point in a flare. 15 bloody watery bm a day. Right now I am
back to that so i just don't know. i feel like i will probably takes some
meds on monday to calm things down a bit and try the FT again in the
future. Also, I think i should to the scd intro diet now because whatever i
ate yesterday has really killed me. What do you think?
A: The Specific Carbohydrate Diet is not really a quick fix for an
8

active flare, though the starter diet using broth and home made soup
is a good start since it will help provide rest to the bowels. It could
take days or even a week or two to work from the middle of a major
flare. Otherwise in my experience the high fiber foods in the diet made
active diarrhea that I had worse.
In the short-term if your flare is that bad I would go with
Prednisone and / or anti-biotics. Once a flare is past a certain point,
its hard for many treatments that could be beneficial to have much of
an impact. As you may have read on my blog I also had good luck with
certain anti-depressants to calm muscle spasms and slow diarrhea on
a more permanent basis than Immodium.
You might also try an all-liquid diet for 2 - 3 days. There is one
product I've used before called Absorb Plus meal replacement shake. I
later had as good or better results with Muscle Milk either pre-mixed
or powdered, mixed with rice milk and olive or flax seed oil. You also
should get good amount of iron and b vitamins to prevent anemia /
lower RBC.
Q: Thanks for the update. I just had a colonoscopy and Dr says I
am in really bad shape. He wants to put me on Remicade asap. Not sure
what to do.
A: Here is what I suggest:
1. In the short-term do whatever it takes to get the inflammation
down even if it includes drugs like Remicade and/or Prednisone. In
this case I'd go with your doctor on this one for now while you are in
the peak of a flare. Unless you are dealing with c. diff Colitis in which
case anti-biotics and / or Fecal Transplant should be the first-line
treatment. If you want to do Fecal Transplant for Ulcerative Colitis
you still are going to need to do additional things to knock down the
worst of the flare and keep the inflammation under control while you
start this.
In addition to immune-suppressing drugs that here are a few things
you can do on your own which can also help any other treatments you
are working with.
2. Get adequate protein from pre-digested protein shakes like body
builders drink. I used Muscle Milk for a variety of reasons including,
9

relatively inexpensive and available in retail stores and it mixes pretty

smoothly. Mix with some kind of oil like olive, canola or flax seed
and / or some rice milk for a complete meal replacement or consider a
product like Absorb Plus. When I had a flare that was not even
responding to prednisone this is what made it work for me again.
That was because my blood albumin levels were low - that is the
amount of protein necessary for me to repair body tissue. Our body
needs protein to repair tissue, so get some protein.
3. Consider bowel rest through an all-liquid diet of meal replacement
shakes and / or broth for a few days or a diet consisting of meal
replacement shakes plus a low residue or BRAT diet can help by
resting the bowel. This can sometimes get a flare under control by
itself without other treatment options, however at minimum it should
help.
4. Slow bowel transit time and add bulk to stool. I had very good
results with homemade banana break without nuts. I have found
Valerian root extract to be helpful for less diarrhea and more bulk in
recent times, post-cure. When I was still treating an active flare with
the fecal transplants a combination of Bupropion (immediate release
3 x 100 mg) and Doxepin (or Silenor 6 mg) almost immediately cured
the symptoms and I am convinced help speed recovery.
5. If you have been losing blood, take iron and B vitamin supplements
to keep up your red blood cell count. I recommend iron supplements
like liquid Angstrom iron, or capsules that contain Iron Bisglycinate or
other forms of iron that are supposed to cause less irritation. B
complex vitamins are good especially those in capsule form or liquid,
injections could be even better since that way it is absorbed directly
into the blood.
Q: Thank you for the information. I do start remicade on Wed
and I pray it gets this under control so I can try other measures again.
Just need my life back. I actually keep thinking living with "a bag" would
be nothing compared to this.
A: Hang in there, I know how you feel, I had gotten to the point where
the bag at one point seemed like it would be better. They even used
0

the term "cure." But then I learned that the surgery can have
complications from obstructions, a restricted diet, either changing the
bag 5 to 6 times a day or going 5 to 6 times a day if you have the j
pouch which is made from part of the small intestine. You would also
have to take B vitamin injections for the rest of your life since the
Ileocecal valve is removed and reformed into the j pouch and be extra
vigilant so that you do not become dehydrated since you do not have a
large intestine to help absorb water.

Part 5: What causes Ulcerative Colitis?

One mystery that has caused such confusion in the treatment
of Ulcerative Colitis is confusion over what causes this illness in the
first place. While it is pretty clear that a bacterial infection /
overgrowth of certain bacteria is the primary root cause of this illness,
I think it is also useful to explore the various theories of what causes
this illness. There are a variety of complex overlapping symptoms
and causes which can be part of a self-sustaining cycle. In this section I
will briefly outline a couple of theories.

Bacteria imbalances, infections or other parasites

Infectious bacteria could be a root cause of the inflammation.
An overgrowth of Clostridium Difficile bacteria often following
treatment with anti-biotics in a hospital setting is known to cause
Pseudomembraneous Colitis, however some amounts of this bacteria
can also be found in healthy people. This suggests that the mere
presence of this bacteria when balanced with other bacteria is not a
significant problem. Travelers diarrhea and various infections with
parasites can also cause similar symptoms to Ulcerative Colitis in
people.
While at this point a specific strain of bacteria has not been
identified for Ulcerative Colitis or Crohns Disease, and it may be
possible that the cause is more complicated. However the fact that
anti-microbial drugs sometimes help in the short term, pro-biotic can
help and fecal transplants work, suggestions that undefined bacteria
or parasites are at work. Also many illnesses that were once thought
to be caused by auto-immune disorders or emotional stress have now
been linked to bacteria. This includes stomach ulcers.

Auto-immune disorders and the good hygiene theory

When I was diagnosed with Ulcerative Colitis in 1999, this was
the primary theory which was used to guide treatment. I was told that
while the exact nature was unknown, one theory was that my immune
system was acting improperly and attacking my own body. This is
why I was put on Prednisone to attempt to suppress inflammatory
response. In brief an auto-immune disease means:

1. The bodys inflammatory response is malfunctioning and or

too strong. Substances in the body that signal the the immune
system to become active are not working the way in which
they should be. The assumption is that an over active or
improperly functioning immune system is the problem.
2. Treatment involves suppressing or modifying the immune
system response using drugs like Prednisone. Longer term
immune suppressing or immune modifying drugs like 6mp or
Remicade can also be used. This usually appears to work in
the short term , e.g. Prednisone, and biologics, however once
the drugs are stopped the illness and symptoms usually come
back.
3. The symptoms come back when treatment of immunesuppressing drugs is discontinued or sometimes while it is still
continuing because apparently suppressing the immune
system does not solve the root cause of the illness.
The Good Hygiene Theory
Why are auto-immune disorders becoming increasingly
common. A common theory is the good hygiene theory which
basically states that our bodys immune systems become hyper
responsive to various bacteria, dirt particles and fungi that are
otherwise benign because in our modern world because we keep
things too clean. Therefore the body over reacts to stimuli that area
not actually a problem.
Some of the bacteria which is eliminated by overly good
hygiene is actually beneficial bacteria that would otherwise fight off or
crowd out harmful bacteria are not present. Anti-biotics could have
disrupted the bacterial balance in the body and the imbalance is the
problem.
Proponents of this theory point to the fact that autoimmune
disorders and digestive diseases are not as prevalent in less
industrialized societies. This could be because the body is adapted to
fighting bacteria and parasites so that it is necessary for it to continue
fighting. If it has nothing to fight then it attacks itself.

Emotional Stress
Emotional stress is another commonly attributed cause to a
Colitis flare. There are several possible ways that it could trigger a
flare. It could cause the body to release chemical signals that trigger
an immune system response. This is one theory for how stress
contributes to many different illnesses considered to be auto-immune
disorders.
Emotional stress can also cause lower endorphin levels which
weaken the immune system and can trigger improper digestion and
lead to either constipation, or more commonly diarrhea for those with
Colitis. Stress / depression can also cause improper digestion or
diarrhea which disrupts the balance of gut flora in the intestines.

Nutrient deficiencies
Various nutrients are necessary for the body to regulate the
immune system, this could include iron and b vitamins. An absence of
these throws off the system. Lack of nutrients can also contribute to
emotional stress as well. This could also include a lack of protein
necessary to rebuild after inflammation.

An interdependent combination of factors and a vicious cycle

I believe it actually is a combination of bacteria, mood, nutrient
deficiencies as well as the diarrhea and ulceration caused by the
illness itself that contribute to the perpetuation of this disease. That is
the bacteria are a root cause, but then psychological stress helps make
it worse by triggering indigestion and diarrhea. Ulceration of the
intestinal walls further contributes to diarrhea which perpetuates
conditions that are more favorable for the bad bacteria and less
favorable for the good bacteria. Over time diarrhea and other
symptoms make a person likely to limit their diet which could further
contribute to nutrient deficiencies.
This is why I believe a treatment approach that addresses
bacterial composition, inflammation, emotional distress and nutrition
is the most effective approach. The fact that Crohns and Ulcerative
Colitis often have inflammatory affects outside the intestines, for
example ulcers in the mouth or eyes suggests that it is possible that
other disorders that involve inflammation might also be caused by an
imbalance of bacteria in the intestines.
4

Part 6: Treatment Options / Methods

There are many treatment options that have developed over
the years with the goal of achieving remission of the illness through
ongoing Prescription drug therapy and through diets and
supplements. However since medical doctors in the U.S. and most of
the industrialized world still consider this an incurable disease, curing
the illness is not considered to be an option or a goal.
My experience and those of others are beginning to show that a
sustained absence of symptoms without ongoing drug therapy is
possible through fecal transplants, however combining the procedure
with drugs before, during and for some time afterward as necessary
can be a good way to control symptoms and enable the enemas to
work effectively. Almost all of the therapies listed below could be
used in conjunction with fecal transplants in some way except
forsurgery.

Mesalamine: Asacol, Apriso, Sulfasalazine etc.

One of the most commonly prescribed medications is
Mesalamine, known by brand names such as Asacol, Apriso, Canansa
Suppositories and mesalamine enemas. Here is a quick outline of
some basic facts.
Mesalamine is a bowel-specific amino salicylate drug that acts
locally in the gut and has its predominant actions there, thereby
having few systemic side effects. As a derivative of salicylic acid,
mesalamine is also thought to be an antioxidant that traps free
radicals, which are potentially damaging byproducts of metabolism.
- Mesalamine is considered the active moiety of sulfasalazine,
which is metabolized to sulfapyridine and mesalamine
- It is available as a tablet as in Sulfasalazine or Asacol taken 3
times a day as well as Apriso (once a day time released capsule) as
well as suppositories and enemas.
- Sulfasalazine, from which mesalamine was developed has
anti-biotic properties, so that could be another mechanism of action.
- Sulfasalazine also helps ulcerated tissue to repair itself.
Mesalamine is well tolerated by most people, but some are
allergic, especially those with allergies to salicylates.

My experience:
I was prescribed Asacol 4 400 mg tablets 3 times a day during
my initial Colitis flare along with 40 mg of Prednisone. After Asacol
and 60 mg of Prednisone was not enough to drive the flare into
remission, the addition of Cipro helped me attain remission. Asacol
was going to be the primary drug for me to maintain remission. I felt
it didnt do much during a flare and I saw the tablets in my stool as if
they had gone right through me.
I was supposed to take it 3 times a day, however I often did not
do that because I would forget the mid-day dose. Therefore I started
to take 6 tablets twice a day and thought it would work just as well.
However almost 10 years later I learned that Asacol really is supposed
to be taken 3 times a day because the drug only actively releases from
the tablet for 8 hours at a time. This could have been part of the
reason it was not as effective as it could have been.
- I also took Sulfasalazine because it was cheaper than the $600
a months supply of Asacol would have cost me out of pocket. This
was the original drug before mesalamine, however drug makers
determined that Mesalamine was the active metabolite that was
helpful to reduce inflammation. Originally Sulfasalazine may have
helped because it has anti-biotic qualities too. However I think you
had to take this one 4 times a day. My doctors were also concerned
that it would be bad for my kidneys and I noticed it stained my urine
yellow.
Years later in 2009 I started to take Apriso, a 24 hour timerelease capsule and it was much more effective. The once a day
dosing was easier for me to remember, so compliance could have been
the primary reason.
I also later took mesalamine enemas and suppositories. I never
did the enemas very many times however the Canasa suppositories
did appear to help when I was not in the peak of a flare. I was told
that enemas and suppositories could help because the mesalamine
gets diluted by the digestive track. Since it appeared to help maintain
remission when I was not in the midde of a flare but was did not
appear to be as effective as treating a flare I think it could be because
it is more effective when bowel transit time is slower.
My Conclusion:
- Apriso seemed to be more effective for me than Asacol,
6

although this could have been due to better compliance since I only
had to remember one dose per day. During the peak of a flare these
dont appear to help much, however I think Mesalamine can if you can
slow bowel transit and the worst of the inflammation using
Prednisone.
The suppositories were also very helpful and of minimal
distraction compared to the enemas, since they could be taken during
the day if necessary. Suppositories release the drug for 8 hours, so I
got the most noticeable results during a stretch of time when I was
using them 2 and occasionally 3 times a day when I added the
suppositories to the Apriso capsules made them more effective and
helped beat a flare when I was preparing for surgery in January and
February 2010.
I think taking Immodium an hour before the suppositories was
very helpful too, because bowel movements within a hour or two
afterward sent the contents right into the toilet. The enemas were
supposed to be taken at night however once again Immodium would
have been a good idea too to retain the enemas longer.

Prednisone and other steroids

Prednisone is a synthetic corticosteroid drug that is
particularly effective as an immunosuppressant drug. It is used to
treat certain inflammatory diseases (such as moderate allergic
reactions) and (at higher doses) some types of cancer, but has
significant adverse effects. Because it suppresses the immune system,
it can leave patients more susceptible to infections.
Prednisone is used for many different indications including:
asthma, COPD, CIDP, rheumatic disorders, allergic disorders,
ulcerative colitis and Crohn's disease, adrenocortical insufficiency,
hypercalcemia due to cancer, thyroiditis, laryngitis, severe
tuberculosis, uticaria (hives), lipid pneumonitis, pericarditis, multiple
sclerosis, nephrotic syndrome, myasthenia gravis, and as part of a
drug regimen to prevent rejection post organ transplant.
Short-term side-effects, as with all glucocorticoids, include high
blood glucose levels, especially in patients with diabetes mellitus or
on other medications that increase blood glucose such as tacrolimus)
and mineralocorticoid effects such as fluid retention.
Additional short-term side-effects can include
insomnia, euphoria and, rarely, mania (in particular, in those suffering
7

from bipolar disorder). It can also cause depression or depressive

symptoms and anxiety in some individuals.
Long-term side-effects include Cushing's syndrome, truncal
weight gain, osteoporosis, glaucoma and cataracts, type II diabetes
mellitus, and depression upon dose reduction or cessation.
My Experience:
Prednisone saved me from a flare many times, sometimes
without the use of other drugs, other times while I was also taking
Asacol and / or anti-biotic. I actually liked taking Prednisone, it
seemed like my miracle cure. It almost immediately sent my flare into
remission, my energy came back, I could eat whatever I wanted and it
seemed to make me a little high (or hypo-manic.) During times when I
was without health insurance I actually ordered some from overseas
pharmacies since it was cheap as well as being effective. As far as I
know I have not suffered any long-term side effects from the drug,
even though I used it for many years.
However the drug is not without its side effects. It seemed to
make my usual insomnia even worse, however it did seem to help me
when I was dealing with seasonal depression. While it did sometimes
cause weight gain for me (chipmunk cheeks or moon face), it did not
always do this. Doctors told me this was because the inflammation
was accelerating my metabolism in a way that offset the potential
weight gains.
I think it retrospect that there were many other factors too, my
body was burning more calories to rebuild damaged tissue and also
that I already have a high metabolism and am very physically active. I
was also taking stimulant drugs at times for ADHD that suppressed
my appetite.
Prednisone also contributed to some significant problems due
to immune suppression. This included 3 boils / staph infections my
upper thigh to groin area (seriously it was almost like having a 3rd
testicle) and a surface skin infection on my lower leg for which I was
hospitalized for 4 days. The last boil and the leg infection were also at
the same time I was taking Remicade and was bordering on being
anemic. I also had relatively frequent outbreaks of cold sores as well,
however I think low iron was also a contributing factor.
Another problem was its impact on blood sugar levels,
especially if I took it on an empty stomach. I would often start to feel a
8

bit light-headed or loopy like I had low blood sugar. Prednisone can
also lower seizure threshold and I believe that a combination of 40 mg
Prednisone, 400 mg Bupropion SR (12 hour) and Adderall 10 mg on
an empty stomach when I woke up caused me to have a grand mal
seizure in January 2011 which resulted in being taken to the hospital
in an ambulance. In truth this was actually a very dangerous, however
I had taken all of the various drugs in the past including sometimes in
combination. However all of the above drugs can lower seizure
threshold as can low blood sugar, so you do have to be careful.
Why does Prednisone work?
Prednisone, works primarily by suppressing the immune
system response which can cause ulceration. However why does it
help if the root cause is actually a bacterial infection in a significant
number of Ulcerative Colitis and Crohns Disease patients? Part of the
answer to this might be because during a flare the ulcerated lining of
the intestines and the watery diarrhea that speeds through the
intestines makes it difficult if not impossible for the immune system
to get the inflammation causing bacteria under control. By helping
slow bowel transit time Prednisone helps the good bacteria regain the
upper hand.
Also a result of the intestines beginning to heal and slower
bowel transit time, absorption of nutrients would also increase. Better
nutrition would also help the body, and the increased appetite would
also help since people may also not feel like eating during a flare.
While I have not seen this listed as an effect of Prednisone I
wonder if it might help calm the gut through its anti-depressant
effects. If anti-depressants can help calm the gut and Prednisone
appears to elevate a persons mood, maybe this is another mechanism
by which Prednisone is helpful.

Immune suppressing Biologic, drugs Remicade etc.

These drugs including Remicade and Humera work by blocking
inflammatory triggers that stimulate the immune system response.
These drugs are very expensive costing thousands of dollars per dose.
One time my insurance didnt cover it at first and I was sent a bill for
$10,000 for one dose! Biologic drugs are administered by IV, about
every 4 6 weeks usually in the outpatient infusion clinic at a
hospital. During my treatments I met patients that were being treated
9

for arthritis, psoriasis, aplastic anemia and cancer among other

conditions.
Biologic drugs seem to work for some people at least some of
the time, however they dont always work on a sustainable basis. This
was my experience, the one time it seemed to work for just over a
week was when two doses were only about two weeks apart.
Disadvantages include: It does not permanently address the
root cause of the illness if the root cause is in fact bacteria that is
contributing to inflammation, then suppressing the immune response
that would take care of the root cause of the illness.
By suppressing the immune system you leave the body open to
potentially dangerous infections like the one that sent me to the
hospital as an inpatient for 4 days and also a type of Lymphoma
cancer.

Bupropion (Wellbutrin)
Rather than list this drug along with other anti-depressant
drugs I want to give this drug its own section because of research that
suggests that it might act to inhibit TNF-a, the same inflammationtriggering chemical in the body that biological drugs like Remicade act
on. In my experience the addition of this drug to Prednisone, Apriso
and Silenor caused an almost spontaneous remission by the end of the
2nd day I took it.
I found out about Bupropion from a few discussion threads on
HealingWell.com where a few patients reported that it had
successfully treated their cases of Crohns Diease. I also found a study
called A Trial of Wellbutrin for Crohns Disease, where results had not
been published either positively or negatively even though the drug
showed enough promise in 1st and 2nd tier trials to merit a 3rd tier trial,
however no study results were published on ClinicalTrials.gov. This
seems kind of weird to me and actually makes me think conspiracy
theories of drug companies deliberately hiding results might have
merit.
In any event after I started taking a 100 mg tablet of Bupropion
in the immediate release form 3 times a day I had an immediate
improvement in symptoms by the evening of the 2nd day I took it,
about 30 hours later, including a normal bowel movement. This was
strange to me after almost chronic diarrhea for so many years. This
matched up with experiences I saw from other case studies posted on
0

HealingWell.com.
My advice is to definitely give Bupropion a shot, where you are
doing the Fecal Transplants or not I think this can help a great deal
even during a flare. While it is a TNF-a inhibitor I did not have
negative side effects such as secondary infections like I did when I
took Remicade. While there is a slight risk of the drug causing a
seizure in higher doses, this risk is not any higher than most other
anti-depressant drugs at doses up to 300 mg per day.

Other anti-depressant / anti-anxiety drugs

There has been some research using other anti-depressant
drugs besides Bupropion. Some of the ways that could help include:
Alleviating emotional distress so endorphin levels rise and
immune system becomes stronger. Reduced emotional distress
reduces the number of stress hormones which cause
inflammatory responses and cytokines that trigger
inflammatory responses. This may include why Bupropion
appears to be an inhibitor of TNF-a.
Another possibility is that an unidentified viral or bacterial
infection is at the root of the problem and the anti-depressant
fixes that.
They can also help by calming muscles in the GI tract which can
help calm muscles spasms and diarrhea which could be the
result of a lack of neurotransmitters or an imbalance of neurotransmitters. This further helps by allowing bacteria to
repopulate the gut.
Neurotransmitter imbalance makes sense because many antidepressants also act as anti-spasmodics, e.g. Doxepin
Reduced urgency / bowel movements give beneficial bacteria a
chance to populate in the bowels and this sets a positive chain
of events in action that is self-perpetuating.

Anti-biotics / Anti-bacterial / Anti microbial drugs

Antibiotic(s) include a broad range of antibacterial drugs in
antimicrobial compounds, including anti-fungal and other
compounds. When the term was first coined it was used to describe
any substance produced by a microorganism that is antagonistic to
the growth of other microorganisms in high dilution.
1

With advances in medicinal chemistry, most of today's

antibacterials chemically are semisynthetic modifications of various
natural compounds and are classified on the basis of
chemical/biosynthetic origin into natural, semisynthetic, and
synthetic.
As well as either bactericidal agents that kill bacteria, and
bacteriostatic agents that slow down or stall bacterial growth.
My experience with anti-biotics
My initial flare of Ulcerative Colitis happened while I was
traveling in South Africa with my family. However no one else in my
family got sick with anything. Stool tests came back negative for any
known parasites, however I was still skeptical. Finally my doctor
prescribed Cipro, because it was sometimes helpful in treating cases
that did not otherwise respond to medications. After the addition of
Cipro to the Prednisone and Asacol I was already taking the flare went
into remission.
It seemed obvious to me, if a drug that kills bacteria helped
make me better then the problem must somehow be bacterial in
nature. The doctor did not entirely disagree however while they were
not entirely sure how this illness presented itself, the said bacteria
might aggravate what was thought to be an autoimmune disorder.
Why anti-biotics can work
- Anti microbials work because they kill off inflammation
triggering bacteria. These bacteria could be producing toxins that
trigger inflammation. Or the inflammation could stem from the bodys
attempt to kill them off.
- This theory makes sense because Stomach Ulcers have been
proven to be caused by bacteria. Also Pseudomembranous Colitis is
caused by c. diff bacteria. Travelers Diarrhea also has many of the
same symptoms as well.
Why anti-biotics dont provide a permanent solution
- Anti-biotics drugs dont work when the bacteria is not
susceptible to the anti-biotic being used.
- Over time the bacteria in the body can develop mutate or
otherwise develop resistance to the anti-biotic that is being used.
- Anti-biotics are generally not accepted for use on a
2

permanent basis due to the risk of side effects or the development of

drug resistant bacteria.
- Good or otherwise benign bacteria are killed off that have
the ability to either kill off or prevent the overgrowth of some bad
bacteria, including Clostridium Difficile. The absence of these
beneficial or at least unharmful bacteria leaves the body more
vulnerable to future infections.

Types of Bacteria
- A mystery of sorts, but unidentified at this point, possibly
different kinds or combinations of different kinds of bacteria are the
cause.
- MAP Bacteria could be the cause since it causes a similar
disease in cattle called Johannes Disease.
- MAP and other kinds of bacteria that reproduce from spores
are especially difficult to get rid of. These bacteria cannot be killed in
their spore phase
- Some people might be more susceptible than others because
of a weakened immune system, or have more frequent diarrhea.
- For example Pseudo Membranous Colitis results from c. diff
infection usually when people have a weakened immune system and
when good bacteria have been killed off by anti-biotics.
Examples of anti-biotics used for Colitis or Crohns Disease
Among the anti-biotic drugs sometimes used to treat Crohns
or Colitis are Cipro, Vancomycin and Flagyl. A leading theory is that
MAP bacteria which causes a similar disease in cattle called Johannes
Disease is also a cause of Crohns Disease and Ulcerative Colitis.
Bacteria being a cause of this illness makes sense considering that
stomach ulcers are caused by bacteria as well as travelers diarrhea.
Cipro (Ciprofloxacin)
- Broad spectrum anti-biotic, in the fluoroquinolone family of
anti-biotics, kills off everything good and bad. So it is often used when
other anti-biotics fail or when the problem bacteria is unknown.
- Used to treat Travelers Diarrhea among other infections.
- Sometimes prescribed to Ulcerative Colitis patients when
Prednisone and other drugs have failed to bring the illness into
remission.
3

- Helped me bring my first Colitis flare into remission and was

helpful in bringing about remission on at least one other occasion as
well.
- It seemed to make me very irritable and a little depressed,
which makes sense since Fluoroquinolones are known to cause a wide
range of serious adverse psychiatric effects and may show depressant
activity on the CNS according to some animal studies.
- As of 2011, the FDA has added two black box warnings for
this drug in reference to spontaneous tendon ruptures and because
ciprofloxacin may cause worsening of myasthenia gravis symptoms,
including muscle weakness and potentially life-threatening breathing
problems. Tendonitis and other forms of tendon damage may
manifest during fluoroquinolone therapy, and long after it had been
discontinued. Fortunately I did not have any lingering side effects
from Cipro after stopping it.
Vancomycin
- Used to treat Pseudomembranous Colitis caused by
Clostridium Difficile bacteria.
- I had a dramatic improvement in Colitis symptoms for me
almost immediately when I was hospitalized for a skin infection in
which I believe immune suppressing drugs were a contributing factor.
- Often reserved as an anti-biotic of last resort to treat
infections.
- Often administered intravenously (IV) because of poor
bioavailability.
- If taken orally in pill form it is normally taken 4 times a day.
Flagyl (Metronidazole)
- Used to treat bacterial and parasitic infections that cause
chronic diarrhea. Mostly gram negative bacteria targeted. Used to
treat Clostridium Difficile bacteria which causes Pseudomembranous
Colitis.
- I tried Flagyl however I continued to have persistent
diarrhea. It might help somewhat in combination with other drugs
though.
Other Anti-biotics
- Almost any anti-biotic could have some effect, especially
4

those used to treat Travelers Diarrhea. I also had some degree of

improvement with other drugs as well including Bactrim and also
Doxycycline.
- I once ordered Doxycycline off the internet because it
appeared to help when it was prescribed to me to treat acne a year
after my diagnosis with Ulcerative Colitis. I also noticed that
Doxycycline was used to treat Anthrax like Cipro so I thought it might
be similarly helpful for Colitis.
Natural anti-biotics / anti microbials
- Many herbs and spices can inhibit the growth of or kill
harmful bacteria (anti microbial), viruses, (anti-viral) or parasites
(anti-parasitic.)
- Herbs include Oregano, garlic, Berberine among others.
- I have had good results using oregano oil in saline to treat
sinus infections.
- These herbs and spices may have fewer or no major side
effects as compared to anti-microbial drugs.
Possible downsides
- Most anti-microbials kill off good bacteria along with the bad
bacteria which disrupts the gut flora and leaves you more susceptible
to future infections both GI related and other.
- Some future infections include c. diff bacteria which causes
Pseudo-membranous Colitis.
- Pro-biotic supplements either need to be used concurrently,
spaced far enough apart from anti-biotics or need to be used to follow
the anti-biotic use.

Pro-biotics
Pro-biotics are bacteria that are believed to be beneficial bacteria that
help body processes like digestion and may either kill, inhibit the
growth of or displace harmful bacteria. Ideally some strains can
colonize in the colon.
A healthy colony of beneficial bacteria leaves no room from
pathogenic bacteria to take over because they are more dominant
strains.

- Replace bacteria lost to anti-microbials

- Beneficial bacteria help the body digest food
- Regulate inflammatory responses - cytokines.
- Protect the body from bacteria and viruses that can cause infections
in other parts of the body.
- The good bacteria may kill off bad bacteria/ have anti-microbial
action.
What to look for in a pro-biotic
- High amount of CFUs per serving
- Well preserved (refrigeration)
- Combination of strains of bacteria, at least 8 different strains
of bacteria
- VSL #3 and other blends have some research to support them
and some doctors recommend them as part of their treatment
regiment.
Why pro-biotics are not a permanent solution
In most cases for pro-biotics from live cultures in yogurt or
capsules with freeze-dried cultures to work they must be taken
continuously. When you stop taking them and are not continuing to
take something else to help you the illness will likely come back. This
is because many yogurt cultured bacteria are not native to the body
and cannot sustain themselves without constant boosters. This is why
fecal transplant is a more permanent solution.

Fecal Bacterial therapy / Human Probiotic Infusion

My experience
I was scheduled to have surgery in two days a full colostomy
to remove my colon and restorative Ileostomy when my Mom
handed me a print out of the Wikipedia article for Ulcerative Colitis. A
few weeks before that I had found an article in Slate.com called the
Enemy of my Enema is my Friend which used Fecal Bacterial therapy to
cure Pseudo-membranous Colitis caused by an infection of
Clostridium Dificile Bacteria. While this made perfect sense I didnt
6

know it could work for Ulcerative Colitis until I saw a Wikipedia

article. I decided to cancel the surgery so I could see if this course of
treatment would help me out.
After talking to Sky Curtis who was writing a book on the
experience with her son I decided to have a friend of mine be my
donor instead of someone from my family. She suggested that I pick a
donor with the most regular and well formed stool possible. I talked
to a close friend who I thought would be amenable to the idea, he
became my roommate and my donor.
I ended up not having any tests done for the donor.
Unfortunately many labs will not just allow individuals to send in
samples for testing. However I realized that the illnesses that would
be tested for were ones that my donor was unlikely to have based on
his medical history and also based on the epidemiology statistics I
found for the diseases that could be transmitted through blood borne
pathogens. Also most of the harmful bacterial infections or parasites
would have produced some obvious symptoms and illness.
I continued my course of treatment for a month before
deciding to stop for awhile because of a flare and significant bloating.
Another thing I did not do which could have helped was to start by
taking a course of anti-biotics to first wipe out the existing bacteria in
the colon. I also think it could have helped it I were taking an antiinflammatory like Mesalamine at the same time. It is also possible that
the inflammatory response is because the body is effectively fighting
the infection and maybe a bloom cycle of spores from a particular type
of bacteria like MAP.

Diet and Nutrition

Specific Carbohydrate Diet (SCD)
The Specific Carbohydrate Diet is based on the book Breaking
the Vicious cycle by Elaine Gottschall. I first heard about the diet from
my girlfriend whose manager had Crohns Disease.
Why SCD could work: Basic assumptions
- Digestive disease was not a problem when people lived on
fruits, vegetables, nuts and meat.
- People were not designed to properly digest grains and
starches this inability to digest disaccharides is at the root of a
7

vicious cycle that leads to inflammation.

- Undigested and improperly digested food can cause diarrhea
and help feed pathogenic bacteria.
- An unsettled digestive system with frequent diarrhea means
that beneficial bacteria leave the body while harmful, inflammation
triggering bacteria start to take over.
- The bodies immune response causes damage to the intestinal
walls, including ulceration.
- The damaged intestinal tract is now less able to digest food
and more improperly digested food enters the GI tract which feeds
more pathogenic bacteria, which triggers more inflammation.
How the diet works
- Start with bowel rest using the homemade broth. This liquid
diet period allows the digestive tract to rest and start to repair itself
while not feeding pathogenic bacteria.
- Eliminate foods that trigger and allergic response or that your
body cannot properly digest.
- Eliminating these foods stops feeding pathogenic bacteria
that are at the root of the vicious cycle.
- Pro-biotic yogurt brings in beneficial bacteria which colonize
and crowd out or even actively kill off other pathogenic bacteria.
- Beneficial bacteria also help digest food, cause cytokines to
stop signaling for an inflammatory response, control fungus, parasites
and more.
- Once the vicious cycle is broken and the gut barrier is
largely restored then you can eat more foods than you would might
have previously thought.
Why SCD might not work
- Very restrictive, difficult to maintain, can be hard to get
enough calories, can be hard to maintain proper nutrition.
- Bowel rest might need to be for weeks for proper healing,
depending on what state of inflammation the intestines. So continuing
to restrict your diet to home made chicken and vegetable soup could
make it difficult to get adequate nutrition, including enough protein
for your body to rebuild and recover from inflammation.
- Generally you have to prepare all of your own food, although
more options have become available in recent times especially in
8

health food stores in large cities. This is not necessarily a bad thing,
but if you are a busy person on the go and are not used to cooking all
of your meals this can be difficult.
- The whole problem is pre-supposed to be controllable from
the diet. However what about the bacterial cycle? What about the role
of psychological stress?
- Intolerances or other co-existing food allergies can further
limit your selection of available foods. For example dairy allergies.
Also raw fruits and vegetables that are high residue can make
symptoms worse including diarrhea, urgency and cramping.

GAPS or Elemental Diet

- Liquid diet causes bowel rest. This means that the bowels can
repair while not having anymore inflammatory triggers going through
them.
- Eliminate all foods that are not pre-digested. This means that
there is nothing for the body to not be able to digest.
- Fast way to get a flare under control without drugs like
Prednisone.
- If you are only consuming pre-digested food, there is no
chance that you will have undigested food contributing to the vicious
cycle. This is another way to break the cycle.
- Lack of improperly digested food which feeds bad bacteria,
means that it is starved to death.
- Nutrition in liquid form is able to be absorbed into the body
and support tissue repair and immune system function.
- Proper amounts of L-Glutamine can then help the body repair
the intestinal lining.
Disadvantages
- Relatively few other than the fact that on an all -liquid diet
you are not eating any solid food so it might be hard to keep to it
exclusively in the longterm. However you dont have to cook.
- Lack of solid stool. If you are only consumed liquids then this
is what you get.
- Cost: This can be expensive if specialty shakes are your only
source of nutrtion. I think commercial body builder weight gainer
meal replacement shakes are your least expensive alternative, but still
not cheap.
9

Gluten-free Diet
How / why it works
- Gluten intolerance or Celiac disease means that you cannot
digest foods containing gluten, this undigested food feeds the growth
of inflammation-causing bacteria. For more on this see see The
Vicious Cycle.
- Gluten may not be good for many people besides the ones
with obvious negative impacts due to the structure of the molecules.
- Eliminate gluten and many secondary illnesses considered to
be auto-immune disorders can stop. Part of the underlying theory is
that gluten and other particles are crossing the intestinal walls into
the blood stream when they should not be. Another possible
condition that is often described but not medically established as
leaky gut syndrome.
Disadvantages
- Gluten-free food was expensive and hard to get, but that is
rapidly changing.
- Hard to follow 100%. Even small amounts of gluten can be a
problem that takes days to fix. Foods could be contaminated
without your knowledge even if the food itself is a gluten-free food.
However its also possible that not everyone is hyper-sensitive so
compliance might not always be too much of a problem.
- Many of the problems that are believed to be caused by gluten
might not be a problem for a person with healthy intestinal lining. So
gluten-free might not definitely cure the source of inflammatory
bowel disease, it might just limit irritation while periodic flares still
occur.

Digestive enzymes
- digestive enzymes can be helpful because they help the body
digest food which could otherwise feed inflammation producing
bacteria.
- Proper digestion can also help because undigested or
incompletely digested food can trigger inflammatory responses when
it goes through the lining of the intestine.
- Supplements in pill or capsule form could be useful, or you
could also get them by eating a balanced diet of unprocessed foods.
00

- A problem with processed foods is that naturally occurring

digestive enzymes may be missing.
- Essential nutrients may be missing from processed foods or
in a form that is not easily digested or absorbed into the body.
- However if the underlying cause of inflammation is resolved,
food indigestion may persist anyway.

Nutritional Supplements
Adequate protein is essential to recovery from ulceration of
the intestines. Just like your body needs protein to recover from a
workout or from surgery, you need it to heal wounds. I learned this
when my colo-rectal surgeon told me the level of albumin (available
protein) in my blood were low and told me I should start taking a
meal-replacement shake to boost it. I learned that many protein
shakes including muscle milk are also high in the amino acid LGlutamine. I cant say whether it was just the L-Glutamine or all of the
protein that I got, however I was able to taper off Prednisone in 6
weeks while also going into remission.
Other nutrients that are important include iron and b vitamins
to prevent anemia. In my experience when I started to take iron or b
vitamin supplements my energy levels would increase, I could heal
faster from small cuts or scrapes, chronic sinus infection and cold
sores would heal faster. B vitamin supplements can found using
capsules, tabelts, liquid shots and injections. Injection kits are
relatively inexpensive when ordered online, approximately $35 for
the least expensive b vitamin supplements. For iron I would
recommend Angstrom iron, liquid supplement or Comfort Iron also
known as iron glycinate.

Low Dose Naltrexone

I found out about low dose Naltrexone (LDN) after I was
already doing the Fecal Transplants and did not start taking this drug
until a month after stopping the Fecal Transplants and after I had
already achieved significant amounts of remission by using
Bupropion.
Naltrexone is an endorphin blocker which is FDA approved at
50 mg to treat Opioid addition and alcoholism. It is supposed to work
by blocking the rush or high that an addict would get from the drugs.
However at lower dosage levels up to about 4.5 mg the amount of the
01

drug is metabolized in about 4 hours or so. After the drug is

metabolized the blocking of endorphins stops which then causes a
rebound effect where the body increases production of endorphins
and Opiod Growth Factor (OGF). The higher levels of OGF help
regulate immune system response and cell replication. While the
higher levels of endorphins strengthen the immune system. The
stronger immune system helps the body regulate and / or kill off
bacteria, parasites or viruses that are problematic.
This could help if this process does strengthen or modify the
immune system in a helpful way. However the science behind this is
very controversial. This could be in part because the doctors who
published the study also own a patent to use a low dose of Naltrexone
to treat Crohns Disease.
While it is hard to say it had much of an impact. I did have
some significant side effects including sleeplessness that resisted
sleeping pills if I took my dose at night. Its also hard to say what
impact it had since I had also already done the Fecal Transplants and
was taking Bupropion at the same time. However the greatest benefit
I might have gotten was I chose to visualize the healthy colon from the
before and after pictures in the procedure. Otherwise I was not
convinced that it did much, so I stopped after 3 months.
Possible downsides
- You cant take at the same time as Prednisone. This is because
it could counteract immune-suppressant drugs like Prednisone and
biologics like Remicade.
- Can counteract medications that act on the opiod system so
that drugs includinganti-diarrheal drugs like Immodium (Loporadine)
and narcotic pain killers might not work.
- Might be hard to figure out when it is getting results
depending upon the mechanism of action. This is also true with
immune modulator drugs too, like 6 mp.
- Can be hard to get a prescription for. Naltrexone comes in
tablets of 50 mg, so you have to get it from a compounding pharmacy
or dissolve tablets in water and then administer using an oral syringe.

Herbal Supplements
Many herbs / plants may have beneficial properties similar to
prescription drugs. However I would recommend care with which
02

ones you use as some may aggravate your condition if you are having
a flare. In my experience I was taking St. Johns Wort immediately
before and during the early stages of my initial flare. This appeared to
significantly aggravate diarrhea. Whether it caused any other
irritation is hard to say.
In my experience Valerian root extract has been very helpful
for reducing the number of bowel movements and helping to create
more bulky well-formed stool.
Several other herbs may have anti-microbial properties. This
can include oregano oil. I have had great success using a product
called sinu-orega to treat sinus infections. It is a mixture of saline and
bay leaves and oregano that has anti-microbial properties. I have also
had good results from a product called Stye Eye Relief made by
Similasan USA which lists sulfur as an active ingredient. The use of
sulfur makes sense considering that a whole class of anti-biotic drugs
is based on sulfur.
There are also many other herbs that may be beneficial for
reducing inflammation, killing bacteria, virus or other parasites and
for calming the digestive track. However the one that has made the
most noticeable positive difference for me has been Valerian.

Helpful parasites Helminths / whipworms

Trichuris suis has been shown in a randomized control trial
from Iowa to show benefit in patients with ulcerative colitis.[70] The
therapy tests the hygiene hypothesis which argues that the absence of
helminths in the colons of patients in the developed world may lead to
inflammation. Both helminthic therapy and fecal bacteriotherapy
induce a characteristic Th2 white cell response in the diseased areas,
which is somewhat paradoxical given that ulcerative colitis
immunology was thought to classically involve Th2 overproduction.
[71]
Alicaforsen is a first generation antisense oligodeoxynucleotide
designed to bind specifically to the human ICAM-1 messenger RNA
through Watson-Crick base pair interactions in order to subdue
expression of ICAM-1.[72] ICAM-1 propagates an inflammatory
response promoting the extravasation and activation of leukocytes
(white blood cells) into inflamed tissue.[72] Increased expression of
ICAM-1 has been observed within the inflamed intestinal mucosa of
ulcerative colitis sufferers, where ICAM-1 over production correlated
03

with disease activity.[73] This suggests that ICAM-1 is a potential

therapeutic target in the treatment of ulcerative colitis.[74]Helminic
therapy using whipworms.

04

Surgery
As I have already expressed in this book I believe that surgery
should be a last resort option after every other possible option has
been fully explored. This is because the physical affects of surgery are
permanent and irreversible. While you can try most other treatments
and if necessary try something else later this is not the case with
surgery. That said it does seem to be helpful for some people. If a
person has colon cancer or perforation of the bowels happens this
could be a life saving procedure.
Surgery for Ulcerative Colitis can one of 4 different procedures
including The surgical choices are:
1. Proctocolectomy and Brooke ileostomy.
2. Abdominal colectomy and ilcorectal anastomosis.
3. Proctocolectomy and Kock pouch.
4. Restorative proctocolectomy with ileal pouch-anal
anastomosis (IPAA).
IPAA is currently the most commonly used surgery for those
healthy enough and was the procedure I was going to have. It involves
removal of the large intestine (colectomy) with or without the
construction of an ileo-anal pouch or reservoir with a two or tree step
procedure. The surgical option I was given was going to be a two-step
procedure, first removal of the colon and rectum except for a small
stump of the rectum. Then construction of the pouch from part of the
small intestine with a temporary diverting ostomy. The new end of
the small intestine would divert through the side of my abdomen to
the ostomy bag for about 6 months. After six months or so I would
then have a 2nd surgery to connect the stoma to the pouch and the
rectal stump and anus.
Benefits
Doctors call it a cure for Ulcerative Colitis. Once the colon is
gone there can no longer be inflammation in it. After that an ostomy
bag on the outside of the body or a J-Pouch created from part of the
small intestines can be used to collect stool. The risk of colon cancer
is eliminated because there is no colon to get cancer. Drug side effects
are eliminated because the colon is no longer there to get inflamed.

05

Disadvantages
The disadvantages are very significant, especially considering
that with fecal transplants a permanent cure that leaves your body
intact is available. However in my experience brochures from doctors
and surgeons understated these disadvantages. Of course this makes
sense if this is what they believe you should do.
- Permanent and irreversible. Since it is permanent you cannot
attempt other treatments or take advantage of future medical
developments.
- Pouchitis a bacterial infection and inflammation of the JPouch. This often has to be treated with anti-biotics.
- Blockage or obstruction of the stoma, diet needs to be
monitored for this reason.
- The body loses some ability to absorb water, the primary
function of the large intestine, so you have pay extra attention to
staying hydrated, especially if exercising outdoors in the heat.
- You may need to take injections for B vitamins because part
of your small intestine has now been turned into a J-pouch.

Part 7: Suggested treatment plan for a flare

The following comprehensive treatment plan for Ulcerative
Colitis is based on my research and 12 years of experience as a
patient. This includes treatment by many doctors who graduated for
highly respected medical schools, as well as my own research and
experience over more than 12 years. This can be used to get a flare
under control before starting fecal transplants and may be continued
for weeks or months until after the transplants have been stopped.
The course of the Ulcerative Colitis, Crohns Disease and
Crohns-Colitis illness and its symptoms can vary somewhat from one
patient to another. However there are often many similarities as well.
My case was described by doctors as a classic yet severe case of
Ulcerative Colitis. It started in the rectum and lower colon and spread
up through the colon over the years until it was diagnosed as pan
Colitis. After 11 years 3 different doctors verified that it was a
treatment refractory case for which surgery was recommended.

06

What do I do if youre having a flare

When you are having a flare and you have a severely damaged
intestinal lining and frequent diarrhea many treatment options that
would otherwise be helpful are not effective. This includes diets and
other anti-inflammatory drugs such as Sulfasalzine or Mesalamine.
Mesalamine comes as Asacol (tablets 3x a day), Apriso (capsule with
beads, once a day), suppositories or enemas.
This is because inflamed intestinal lining loses elasticity which
can increase urgency and bowel transit time. Drugs that are absorbed
in the intestine face rapid transit time from diarrhea which means
they have limited time to work.
Nutrition can also be a problem because of the loss of blood
and electrolytes. This body also has a higher need for protein to repair
damage to the intestinal walls. In blood work this can show up as
below normal Red Blood Cell (RBC) count, hemoglobin and hemocrit.
B vitamin and iron supplements can be helpful for this. Also white
blood count (WBC) might be elevated as well.

Treatment options during a flare

Oftentimes I have been asked can I start the Fecal Transplants
in the middle of a flare. Of course a flare is the time when we are most
likely to try something, anything to get it under control. If you are like
me, other times I just didnt want to bother thinking about being sick
since doctors had told me this was an incurable disease. If you are
attempting fecal transplant or other treatment options I would
strongly recommend combining them with other options for first
treating a flare.
Prednisone
- Prednisone often works to get a flare under control. It usually
works fast to get blood loss and watery diarrhea under control, can
also helps other allergy symptoms, elevate mood and its relatively
cheap. For those reasons I learned to like Prednisone, especially when
I didnt have health insurance.
However doctors are often reluctant to prescribe it for
extended periods of time due to side effects such as weight gain,
irritability, difficulty falling asleep and in the long run problems like
loss of bone density. Ultimately my GI doctor said he would not
07

prescribe any more Prednisone after awhile.

For fecal transplant I would recommend getting on this if you
have any Colitis symptoms and then attempt to taper off of it after you
notice a sustained improvement.
Anti-biotics
Anti-biotics can help too, alone or in conjunction with other
drugs such as Prednisone or mesalamine. During my initial flare in
1999, Cipro brought my flare into remission. In later years I noticed
improvements when taking other anti-biotics as well. While in the
hospital I also had a dramatic improvement from Vancomycin.
For fecal transplant I think a course of anti-biotics before you
start can be helpful. However you will want to stop about a day or two
before you start the fecal transplants. In my case I did not use antibiotics immediately before starting the fecal transplants. So they are
not necessary to have success, however most doctors will prescribe
them and I think they could be helpful.
Liquid meal replacement / bowel rest
A liquid diet of broth, yogurt or meal replacement protein
shakes can be a very helpful treatment option. This is because it rests
the bowel to not have any solid foods in there. In a liquid diet predigested nutrition does not need any addition digestion before it can
absorbed. Basically its similar to drinking a feeding tube. This will
increase the amount of nutrition to help speeding healing, especially
protein. For meal replacement and protein supplementation I used
Muscle Milk mixed with rice milk or Cyto Gainer (maltodextrin) and
mixed with flax seed oil. I think it was effective because it provides
high amounts of the protein amino acid L-Glutamine which is
necessary for your body to repair tissue which is why body building
supplements contain high amounts of it.
When I was scheduled to have a full colostomy in March the
colo-rectal surgeon told me I had to take protein shakes to boost my
blood Albumin levels so I could recover from surgery. However I was
able to taper off of Prednisone while taking the shakes and I then
decided not to have surgery. Now I continue to take at least one shake
per day to make sure I have adequate nutrition.

08

Low-residue diet
In addition to that a low-residue diet, often known as the bland
or BRAT diet includes foods that add bulk to your stool can also be
helpful for making stool less watery and reducing the frequency of
bowel movements. This includes white bread and banana bread
without nuts. In addition to having to go to the bathroom less often
this may also increase the effectiveness of anti-biotics, fecal transplant
and also drugs like mesalamine.
Based on experience I would NOT recommend starting a diet
high in insoluble fiber from raw fruits, vegetables and nuts while
suffering from active diarrhea. For me it made diarrhea and urgency
much worse. While it could be quite possible that allergies or
intolerances to certain foods can cause problems, too much rough
fiber will cause very noticeable problems from increased urgency and
more frequent bowel movements. This is also true of vitamin C and
other highly acidic foods.
From the specific carbohydrate diet I think the home made
chicken soup and home made yogurt which has been fermented for 24
hours is very helpful. However in my experience after completing the
fecal transplants and having my gut heal, even problem foods will not
trigger a flare. In fact the addition of supplements like Valerian root
extract that have calming / anti-anxiety properties seem to reduce
indigestion and occasional diarrhea as well.
Anti-inflammatory drugs / Mesalamine
- Take mesalamine in tablet or capsule form and by
suppository and enema unless you are absolutely sure that you are
allergic to it. I recommend Apriso capsules once a day over Asacol
tablets 3 times a day or sulfasalazine. I found it very difficult to
remember to take Asacol 3 times a day at regular intervals and after
years of treatment I learned that taking it at regular intervals is an
important part of making it work.
The mesalamine suppositories and enemas also help although
they only release mesalamine for 8 hours, so take them 2 or 3 times a
day for maximum effectiveness, at least until you get the flare under
control.
Anti-depressant / anti-diarrhea drugs
- Consider anti-diarrhea also known as anti-spasmodic drugs
09

to reduce urgency. These include over the counter drugs like

Loperamide. I also had good results with Silenor, 3 - 6 mg of the antidepressant Doxepin, although other drugs might be helpful too.
Peppermint oil capsules are also effective as an anti-spasmodic.
Additional vitamins and minerals
Certain vitamins and minerals can also be important especially
during a flare so you can counter blood loss. This includes b complex
vitamins and iron which are necessary for the formation of red blood
cells.
Consider additional vitamin supplements including liquid iron
supplements like Angstrom Iron with small enough particle sizes that
they can be directly absorbed directly into the body without having to
be digested. Other forms of iron supplements that are easier to digest
include iron bisglycinate.
For b vitamins consider liquid vitamin shots or injections.
These are available for relatively little money with a 3 month supply
of injections plus materials so you can do it yourself for less than $40.
Different forms of vitamins and minerals can be easier to
absorb and have fewer effects on the digestive system than others and
they will need to be in liquid form while you are having frequent
diarrhea or else you won't absorb them and they could contribute to
irritation.

10

Fecal Transplant Donor Questionnaire

This questionnaire is meant to evaluate any risk factors to
determine how likely a person is to be a safe donor for Fecal
Transplants. This questionnaire is not meant to be a substitute for
blood or stool testing of a donor, however it can help determine the
likelihood that a prospective donor might have an infectious disease
that could be spread through blood or fecal matter.
While having tests done is recommended as a precaution use
your own judgment on the likelihood that your donor has HIV,
Syphillis, Hepetitis or bacteria that may cause travelers diarrhea. A
quick study of these illnesses from an encyclopedia and the likeliness
of your donor having it based on their medical history and lifestyle
might be enough to reassure you.
Please Circle Yes or No
Are you:
1. Feeling healthy and well today? Yes/No
2. Currently taking any medication for infection?
Yes/No
Have you:
3. Taken any antibiotics within the past 6 months? Yes/No
4. Had any fevers, vomiting, diarrhea or other symptoms of infection
within the past 4 weeks? Yes/No
In the past 8 weeks have you
5. Had any vaccinations or other shots? Yes/No
6. Had contact with someone who has had the
Smallpox vaccine? Yes /No
In the past 12 months have you:
7. Had a blood transfusion? Yes/No
8. Had a transplant (organ, tissue, bone marrow)? Yes/No
9. Had a skin or bone graft? Yes/No
10. Come into contact with someone elses blood?
Yes / No
11. Had an accidental needle stick? Yes/No
12. Had sexual contact with anyone who has HIV/AIDS? Yes/No
11

13. Had sexual contact with a prostitute or anyone else who takes
money or drugs as payment for sex?
Yes/No
14. Had sexual contact with anyone who has ever used needles to take
drugs or steroids, or anything NOT prescribed by their doctor?
Yes/No
15. Had sexual contact with anyone who has hemophilia or has used
clotting factor concentrates?
Yes/ No
16. Female donors: Had sexual contact with a male who has ever had
anal sex with another male (male donors circle I am male)?
Yes/No/I am male
17. Had sexual contact with a person who has hepatitis?Yes/No
18. Lived with a person who has hepatitis? Yes/No
19. Had a tattoo?
Yes/No
20. Had an ear or body piercing? Yes/No
21. Been treated for syphilis or gonorrhea? Yes/No
22. Been in lockup, jail or prison for >72 hours? Yes/No
In the past three years have you
23. Been outside the United States or Canada? Yes/No
List location/time spent:_______________________
From 1980 through 1996,
24. Did you spend time that adds up to three (3) months or more in
the United Kingdom? (is there a chance you were exposed to beef
from cattle with mad cow disease)
25. Were you a member of the U.S. military, a civilian military
employee or a dependent member of the U.S. military? Yes/No
From 1980 to the present, did you
26. Spend time that adds up to five (5) or more years in Europe?
Yes/No
27. Receive a blood transfusion in the United Kingdom or France?
Yes/No
From 1977 to the present, have you
28. Received money, drugs, or other payment for sex? Yes
29. Male donors: had anal sex with another male,
even once (female donors circle I am female)?
Yes
I am female
12

No
No

Have you EVER

30. Tested positive for HIV/AIDS virus? Yes/ No
31. Used needles to take drugs or steroids or anything NOT
prescribed by your doctor?
Yes/No
32. Used clotting factor concentrates? Yes/No
33. had viral hepatitis?
Yes/No
34. had any type of cancer (including leukemia)?
Yes/No
35. Had sexual contact with anyone who was born or lived in Africa?
Yes/No
36. Been in Africa? Yes/No
37. Had sex for drugs or money? Yes/No
38. had any of the following gastrointestinal diseases or problems?
Irritable bowel syndrome? Yes/No
Crohns disease? Yes/No
Ulcerative Colitis? Yes/ No
Chronic diarrhea? Yes/No
Gastrointestinal cancers? Yes/No
Celiac disease?
Yes/No
39. Received a dura mater (brain covering) graft?
Yes/No
40. Received growth hormone made from human Pituitary glands?
Yes/No
41. Have any of your relatives had CreutzfeldtJakob disease? (human form of mad cow disease) Yes/No
General Medical History
42. Have you had any gastrointestinal surgery (for example:
appendectomy, gallbladder surgery, gastric bypass)
Yes/No
If yes, please list: ________________________
43. Do you have any autoimmune diseases (for example: Rheumatoid
arthritis, Multiple Sclerosis, Lupus)
Yes/No
If yes, please list:_________________________

13

References
Here are just a few of the references I used
Treatment of Ulcerative Colitis using Fecal Bacteriotherapy,
Thomas J. Borody, Eloise F. Warren, BScM,
Sharyn Leis, RN, Rosa Surace, and Ori Ashman, MA
Dr. Thomas Barody, et al. J Clin Gastroenterol. 2003; 37(1):4247.
PMID: 12811208
Available through Dr. Borodys Website:
http://www.cdd.com.au/pdf/publications/paper17.pdf
This article which detailed 6 cases where Ulcerative Colitis effectively
drove Ulcerative Colitis into remission was what prompted me to
cancel surgery and explore fecal transplant as an option.
Success of Self-Administered Home Fecal Transplantation for Chronic
Clostridium difficile Infection,
Michael S. Silverman, Ian Davis, Dylan R. Pillai
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY 2010; 8:471
473 PMID: 20117243
- The article helped form the basis for my treatment protocol and
confidence that self-administered Fecal Transplants at home were a
viable option for me.
Bacteria as the cause of ulcerative colitis
MASSIMO CAMPIERI, PAOLO GIONCHETTI Gut 2001;48:132135
PMID: 11115835
- Self explanatory with some additional evidence and reasoning for
why this is an effective treatment option.
A Trial of Wellbutrin for Crohn's Disease
ClinicalTrials.gov Identifier: NCT00126373 Sponsor:
Altschuler, Eric, M.D. Collaborator: GlaxoSmithKline
Information provided by (Responsible Party):
Altschuler, Eric, M.D.
The existence of this study even though no results had been published
14

increased my confidence that case studies I found posted by patients

on internet discussion forums and by doctors had merit. I still
wonder why no results were published.
A new chapter opens in anti-inflammatory treatments: the
antidepressant bupropion lowers production of tumor necrosis
factor-alpha and interferon-gamma in mice.
2006 Jun;6(6):903-7. Epub 2006 Jan 25. PMID:16644475
- More evidence for Bupropion combined with the existence of a study
using people and various case studies.
Eating For IBS
Heather Van Vorous
- Some very helpful tips for a low-residue diet. The brown sugar
banana bread recipe alone is worth it. It actually helped me many
times during a flare.
Breaking the Vicious Cycle
Intestinal Health through Diet (Specific Carbohydrate Diet)
Elaine Gottschall
- A very interesting theory, that digestion and gut flora are
interdependent. I have heard many positive reviews about the diet,
and the pro-biotic yogurt did seem to be very helpful to me, however I
found the diet very restrictive and hard to consistently follow 100%
while still eating enough food to maintain body weight. However
while I think diet including this one can help, I think calming the gut
and repopulating it using Fecal Transplant is a much more effective
alternative.

15

More Resources
More and resources are coming online each day, however
here are a few.
My website http://www.FecalTransplant.org post
questions or comments or even ask about personal coaching.
PowerOfPoop.blogspot.com
One of the biggest websites out there and a great source of
information and links. Also ask about the Facebook group.
Guide books by Sky Curtis. My mentor in this process, and
an invaluable source of information and encouragement
http://fecalinfusions.com/
http://www.IhaveUC.com Another website with tons of
resources and discussion threads.

16