Clostridium difficile, can cause serious illness and even death. It can also lead to IBS and even colitis, especially if recurrent. Here we look at the latest research on healing IBS, colitis and C. difficile infections.
In the USA, the CDC reports that C. difficile (or C. diff) sickens at least half a million people a year and contributes to 29,000 deaths, almost all in hospitals and healthcare settings, most usually following the use of antibiotics.
And the problem is growing. Deaths in 2012 were just 14,000.
C. difficile are gram-positive, spore-forming bacteria, ubiquitous in nature and especially in the soil. Consequently, this anaerobic bacterium is in most of us but it is usually kept firmly under control by our ‘good’ or commensal bacteria. However, when the diversity of gut bacteria is reduced by the drugs and/or antibiotics, C. difficile can overpower the system. If you have a C. difficile infection, you have a 1 in 6 chance of getting it back within 8 weeks.
It can cause symptoms ranging from diarrhoea to life-threatening inflammation of the colon, or colitis.
* C. difficile infection is involved in about 6% of colitis cases. But ulcerative colitis is worsened in cases of recurrent C. difficile.
* Post C. difficile infection, there is a much higher risk of developing IBS according to 2016 research from the Mayo Clinic (1). About one third of people develop IBS anyway after an acute infection (viral, bacterial or parasitic). But there is a high incidence of IBS after (an often undetected) C. difficile infection (5).
C. difficile infection, colitis and IBS can each be seriously debilitating diseases and, in the case of C difficile, life threatening.
Stool analysis and CT scans are usually required to assess the extent of the disease. After that, drugs such as Metronidazole and Vancomycin may be used. There’s a 20-27% chance of relapse. If you have had one relapse, there’s a 45% chance of a second.
Hospitals, Health care centers and C. difficile
Doctors are told to watch out for C. difficile in patients who have had antibiotics in the previous three months. A decade ago a more virulent strain of C. difficile emerged that can attack individuals after just one routine course of antibiotics. Cases have tripled since that time. This new strain produces up to 23 times more of the disease’s primary toxins than the common version. Like most strains of C-difficile, it also produces the heat resistant spores that can persist and lead to relapse.
The need for a better treatment is great and urgent. Up to 20 percent of infected patients suffer at least one recurrence; 35 percent of those go on to have a second; and 65 percent of those are likely to have even more. A few sufferers actually have their infected colon removed in order to “cure” the disease.
In 2022, Dr Paul Feuerstadt and his team at Yale University have now conducted a Phase III double-blind, randomized, clinical trial (2), involving patients who have had at least 3 recurrences. The trial used a probiotic containing purified Firmicutes spores against a placebo. The probiotic was dubbed SER-109. The researchers followed the patients over 8 weeks and showed that, of the 182 patients, 40% of those on the placebo had recurrence but only 12% on SER-109 had recurrence (2). The probiotic bacterium encourages bile acids that stop the germination of C. difficile spores. You can buy probiotics containing Firmicutes.
Healing IBS, colitis, C. dificile with fecal transplants
In the 1980s, an Australian doctor, Professor Thomas Borody (3), suggested that one way to cure patients of their serious gut conditions – be they colitis, irritable bowel syndrome or IBS, or even C. difficile, might be a faecal transplant.
The idea is something vets working on farms have known about for a long time. There was even reference to treating humans in America as long ago as 1958. The goal is to restore the ideal natural balance of intestinal flora and over-power the C. difficile spores.
What is a faecal transplant? It’s where you take a healthy stool from a health person and make it into an enema, although increasingly a tube passing through a nostril and down into the gut is used (4). This brings all the good and missing bacteria into the body of the patient, hopefully restoring the missing commensal bacteria and thus the original healthy balance. It has also been shown to work for both colitis and IBS. In the UK, NICE have confirmed that C.difficile infections are more effectively treated with Fecal Microbiome Transplants than drugs.
Clinical Trial on fecal enemas with C.difficile
In 2008, a double blind clinical trial commenced. One of the trial designers was Dr. Colleen Kelly, a gastroenterologist in Providence, Rhode Island. She first treated a patient with a faecal transplant in 2008. The patient was completely debilitated after having an operation in hospital, receiving antibiotics, and then experiencing six painful months of C. difficile colitis. “I tried every standard regimen of treatment. Nothing worked,” Kelly says. After the patient received a transplant of her live-in boyfriend’s stool, she was completely cured. Kelly had done more than 100 treatments by the start of the trial.
According to the New England Journal of Medicine, the trial was a success with transplants beating the best antibiotic for returning patients to health. 43 patients were treated. 13 out of the 16 receiving the transplant saw their illness disappear immediately, compared with only four out of 13 in the antibiotic-only group, and three out of 13 in the antibiotic plus transplant group. (You can find more on this in Chris Woollams’ excellent book Heal your Gut – Heal your Body’.)
As always with these ‘natural beats drugs’ results, some ‘experts’ immediately talk about developing expensive pills (which will have to be approved by the FDA as drugs) instead of using the research results and simple enemas. Pills? First, you take healthy stools, remove the food and the waste and then give people just the active bacteria in a pill form.
The pill is ‘guaranteed’ to reach its destination and work. University of Calgary researchers reported a 100 percent success rate – none of the 27 patients who took the tablet-sized pills had a recurrence of C. difficile, even though all of them previously had had at least four bouts of the infection.
Patients ingested between 24 and 34 capsules containing faecal bacteria, often donated by family members. “Patients with C. difficile often have 20 or more stools a day, which seriously affects quality of life and so they are very open to this treatment,” said Ravi Kamepalli, MD, an infectious diseases physician at the Regional Infectious Disease-Infusion Center, Lima, Ohio, and lead author of the study. “Human beings are 90 percent bacteria and once that balance is altered with antibiotics, opportunistic infections can cause serious problems. All we are doing with this treatment is resetting the balance.”
Healing your gut
For the vast majority of patients, these enemas and super-probiotics seem a long way off. Chris Woollams who is often asked to rebuild a fallen microbiome and IBS or colitis by patients says that it is not simple, noting that all of the above, probiotics and Fecal Transplants, are only a step towards health. Fecal transplants are complicated, hard to perform, it’s often hard to find a healthy donor and they can be expensive. People can rebuild their gut and need to understand it’s not about just taking a probiotic pill!
Chris believes that there are four crucial steps:
- Heal your gut wall – butyrate can help
- Kill the bad – Oregano oil, artemisinin and other herbs help, depending on the problem. It may even require a full course of Para Free Plus.
- Add back missing good (commensal) bacteria, especially for C. difficile, firmicutes, B. infantis Lactic Acid Bacteria
- Heal the gut lining – mothers milk (for example, colostrum, or unpasteurized milk) is good for this
Healing IBS with B. infantis
For non-life threatening cases of Irritable Bowel Syndrome, or IBS, research from Illinois Medical Center in 2017 has shown that Bifidobacterium infantis, but only when used in a multi-strain probiotic with other Lactic Acid bacteria, can make a very big improvement and can even cure the disease. Chris Woollams has designed a Probiotic (Probio8 Max) with including this probiotic bacterium in the formula.
The probiotic contains 8 strains of bacteria – one, L.rhamnosus, is known to reduce leaky gut and holes in the gut wall, another is B. infantis. The probiotic contains absolutely no glutamate as this is known as a fuel source for cancer.
Chris Woollams has written a number of important self-help health books. ‘Heal your Gut – Heal your Body’ is yet another easy-to-read, easy-to-understand book covering illnesses such as Asthma, Autism, Alzheimer’s, Chronic Fatigue Syndrome, Cardiovascular Disease, Colitis, Cancer, Diabetes, Dementia, Fibromyalgia, IBS, Parkinson’s, strokes and many more – it explains the problem, and tells you exactly what you can do about it.
First you might go to his YouTube Channel and watch any of the 6 simple videos he has made about the microbiome and how to Heal Your Gut; Go to the first Heal your Gut video.
- Wadhwa A et al, Aliment Pharmacol Ther, 2016 doi:10.1111/apt.13737
- Paul Feuerstadt et al; New England Journal of Medicine, 2022 Jan 20; SER-109 An oral microbiome therapy for recurrent Clostridioides difficile infection – https://newworldinvestor.com/wp-content/uploads/2022/01/nejmoa21065161-1642897166.5243.pdf
- Dr Thomas Borody, Centre for Digestive Diseases, Sydney – https://centrefordigestivediseases.com/about-us/professor-thomas-borody/
- Fecal transplants and fecal enemas – https://chriswoollamshealthwatch.com/your-illness/gut-health/fecal-transplants-and-fecal-enemas-the-future-of-good-health/
- Clostridium difficicile-related postinfectious IBS; Cell Mol Life Sci, 2018 Apr 75(7), Fabbrio Bassotti et al