The People's Perspective on Medicine

An Effective but Extreme Diarrhea Treatment

When people are given certain antibiotics such as clindamycin they sometimes develop a devastating diarrhea that can become life threatening. Here are just a few of the scores of stories we have received about this problem:

“I am a 45 year old women. I went to the dentist to get a tooth extracted and they prescribed Clindamycin. Within about two weeks the diarrhea started. I did not think anything of it, but the days turned into weeks of daily diarrhea. I finally went to the doctor. A stool culture revealed I had a bacterial infection in my colon. The doctor prescribed the antibiotic Flagyl.

“After seven days I was feeling great but two weeks after stopping it the diarrhea started up again. I woke up one morning and discovered that I was bleeding from my digestive tract. That really freaked me out. I went back to the doctor, had blood work done and a variety of tests. He asked if I had any dental work done and whether they prescribed Clindamyacin. I said yes and he immediately told me I had a C. diff infection.

“He prescribed me Flagyl again for two weeks, so here we go again. On day eight I developed terrible hives everywhere on my body. It looked like I had been whipped with a cat of nine tails. The doctor took me off Flagyl, prescribed prednisone and now I am wondering what they are going to do about my diarrhea and C. diff infection.”

Gitte

“I wish I had found this site when I was going through HELL, and it was hell! I had a tooth infection and went to my dentist. He prescribed me clindamycin, but he didn’t warn me of the symptoms and I was in too much pain to read the leaflet. I couldn’t wait to get hold of the pills and start taking them.

“Biggest mistake of my life. I was supposed to take 6 a day the first day. As it was late I only took 4 but the following day I took the full amount. The next morning I woke with severe watery diarrhea. I lost count of the number of times I ran, and I mean ran to the toilet.

“After a few days I went to my local chemist (pharmacist for those in the U.S.); she was lovely and explained to me that these tablets can cause severe diarrhea. She gave me the support and help I needed.

“After a couple of weeks I went to see my doctor who said in a blunt voice that the tablets would not cause this. By the 4th week I had given up on life and was incredibly depressed. The diarrhea lasted 8 weeks. I was dehydrated and depressed and thought it would never stop, but gradually it did. These tablets should be banned as a health hazard.”

Debbie

Should you wish to read more such stories, you can visit these links:

Clindamycin Can Cause Disastrous Diarrhea

Drug-Induced Diarrhea Proved Fatal

So, what can people do when faced with this incredibly hard-to-treat condition?

Here is a Q&A that reveals an effective but extreme treatment:

Q. Many years ago, I developed a terrible Clostridium difficile (C diff) infection in my gut from antibiotic treatment for Chlamydia. Vancomycin did not cure the C diff, which was painful.

My elderly gastroenterologist remembered that it used to be common to give people “flora restoration” for this condition, washing out the harmful bacteria by enema and replacing it by flora taken from a healthy individual. A nurse friend of mine organized such a transfer. My pain disappeared completely.

At that time, I corresponded with Dr. Borody, a gastroenterologist in Sydney, Australia, and he now provides the transfer treatment there. I understand that the Swedes never dropped this form of treatment.

A. C diff infections are becoming harder and harder to treat. When antibiotics wipe out good bacteria in the digestive tract, C diff often takes over. It can cause serious or even life-threatening diarrhea.

An article in the journal Clinical Gastroenterology and Hepatology (online Aug. 24, 2011) described fecal microbiota transplant as “safe, inexpensive, and effective.” By re-introducing normal intestinal bacteria, the balance can be re-established.

This “poop transplant” can be done by way of a colonoscopy or an enema using bacteria from a healthy donor. The authors report that such transfers are successful in treating C diff more than 90 percent of the time. They suggest considering this treatment for C diff infections that have not responded to other treatments.

Brand new research just reported in the journal PLOS Pathogens suggests that a combination of bacteria in a fecal transplant might be the optimal way to restore the proper bacterial balance within the gut.

Think of your intestinal tract like a garden. There are good plants that can flourish when the environment is optimal. But if the weeds take over, the good stuff can get overwhelmed. That seems to be what happens when certain antibiotics kill off the good guys and the bad guys (the weeds) get a firm foothold. Reestablishing a healthy environment may require extreme measures.

The British researchers experimented on mice that were infected with C. diff bacteria (the weeds in the digestive tract). They grew bacteria from healthy mice feces. The scientists discovered a “super six cocktail” of good bacteria that reestablished a healthy ecosystem within the mouse digestive tract.

One of the visitors to The People’s Pharmacy website summed up one of the problems with fecal transplants:
“I know there is a yuck factor, but I would like to have more information on how this fecal transplant material is prepared. How is it prepared to prevent bad bacterial from being introduced?”

According to BBC News, professor of microbiology, Dr. Neil Fairweather at imperial College London admitted that fecal transplants have problems not the least of which might be transfer of harmful bacteria. He offered the following:

“There is the obvious benefit of not having to prepare an emulsion of human poo prior to transplantation – growing bugs in culture is far preferable and less smelly!

“One can imagine patients being offered a pill containing a number of defined bacterial species that will help restore the normal mix of ‘healthy bacteria’ in the gut.

“Other conditions that have been associated with imbalance of the gut microbiota include inflammatory bowel disease and it is possible that bacteriotherapy could have promise in such conditions.”

The Brits appear to be closing in on the optimal combination of healthy bacteria that could be swallowed just like probiotics to reestablish an optimal balance within the digestive tract. Until that day arrives, though, patients in dire straits may want to talk to a gastroenterologist who knows about the proper way to do a fecal transplant.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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For many years I regularly had urinary tract infections (utis) which necessitated the use of antibiotics, specifically Keflex (brand name). At the time I didn’t think anything of having such long-term doses of this antibiotic. However, in September 2012, not only did I have several utis, one after the other, but I also needed to have a tooth removed. Because I had been taking Fosamax some years before, the dentist said I needed to take Clindamycin before they would do the extraction. I was already taking Amoxicillin for general dental work which was taking place at the same time. The combination of all these drugs caused me to be very ill with what turned out to be c.diff. At that time I had never heard of it and I wonder if anyone would have ever told me what I had if my daughter-in-law had not overheard what the doctor said to my husband (who didn’t really take in what was being said to him because of the confusion of my being hospitalised with acute diarrhoea) and checked things out on her phone. My first stay in hospital was for 10 days, initially taking Flagyl 400mg, the Vancomycin 400mg when the Flagyl was deemed not to be working. I had four subsequent hospitalisations and the c.diff finally cleared. Two years later, having been given Augmentin Forte for a uti, and again towards the end of 2016, following taking Keflex, also for a uti, I once again found myself with c.diff infections. It is a very debilitating illness and is hard to shake. The antibiotics used have side-effects which are not pleasant. At the time of writing this, I have had six weeks of constant diarrhoea, accompanied by general weakness and ill-health. Once again I have been prescribed Flagyl 200mg, just in case the c.diff infection is still present, even though stool tests show it is not. I am nearly 77 years of age and have had a total colectomy with ileo/rectal anastomosis. I sometimes wonder what quality of life I have ahead of me!

Had the fecal transplant after 3 years of unsuccessful antibiotic treatment. Not just Flagy, Metrodiazinole, Bactrim, bottles and bottles of Vancomycin. The vanco collapsed my veins. To no avail. Months of diarrhea, 5 hospitalizations, I almost died. I was told to see a Shrink even.

Finally, finally, my dr. agreed to try the transplant. First one via a short version of the colonoscopy didn’t work but the second one did, via colonoscopy. This time they went all the way to my appendix with the donated poop of my granddaughter. No more c-diff.

Now a year later I face getting rid of H-Pilori. How exactly will that happen without getting c -diff again.? My heart stopped because of the Cipro that gave me the C-diff.. The Dr. wanted me to take amoxicillin 4x a day for 30 days. First, I am allergic to Penicillin, sulfa type drugs. Cipro is out. What the heck am I supposed to take that will have any effect on the H pylori? Wouldn’t it have killed it already with all that previous treatment?

For J. Bays — sounds like you need some gut healing. Gelatin is healing to the intestines–make and eat lots of bone based soups and find ways to add plain gelatin to soups and hot drinks or stir into yogurt. There is a book called Nourishing Traditions by Sally Fallon that has recipes and explains how to do these things. Also probiotics and properly fermented foods would probably be of great benefit. You may also want to investigate the Specific Carbohydrate Diet or the GAPS Diet (Gut and Psychology Syndrome) which are both healing to the entire digestive system. With these two books you will find lists of foods that will perfectly agree with your system and lists of foods you will have to avoid (probably temporarily) in order for healing to be accomplished. Lots of information is available online and most libraries have the books mentioned.

I am a 44 yr old woman. My diarrhea started FIVE YEARS ago, my doctor told me I had an H Pylori infection in my digestive tract. He put me on four very strong antibiotics (including clindamycin and flagyl, plus two others) for six weeks. I had to repeat this entire course three times to get rid of the infection. The diarrhea never stopped AND this treatment brought on severe nausea and daily, nightly, vomiting.
This diarrhea is like pure water and they also removed my gall bladder thinking it would help, but the vomiting is always FULL of bile or just completely bile. I mostly live on liquid now because it seems my stomach cannot digest solid food any longer. (solid food sits in my stomach for 6 to 12 hrs till it becomes rancid and makes me vomit). Immodium and prescription meds do not touch the diarrhea. Probiotics, yogurt and enemas have done nothing to help.
I have had countless blood, stool and urine cultures. I have had four endoscopies and three colonoscopies, no one can find anything wrong. But obviously something is!!!! I ALSO take hydrocodone 10/325, six a day and 20 mgs of methadone at night for chronic pain from breaking my back twice and neck once. These meds do not even touch the diarrhea, which is VERY odd.
I am always exhausted and my emotional state is slowly going downhill from these daily, sometimes up to 25 times, sitting on the toilet with it coming out BOTH ends!!! If anyone has ANY ideas, PLEASE let me know!!!! Thanks!!!

The idea of fecal transplants makes perfect sense to me coming from a wastewater treatment plant. And essentially a wastewater plant is simply a gigantic digestive system. It is our job as operators to provide the conditions to facilitate a vibrant and healthy population of bacteria and other microorganisms to “digest” the waste. I can think of no place where there is such a diverse population of different kinds of microorganisms living in such concentrated form as in the “mixed liquor” (actual scientific term btw) of a wastewater plant. It is in many ways completely analogous to the digestive system of animals and humans.
So what do we do when for some reason our mixture gets out of balance because of an upset or a kill-we go to another sewer plant that has a healthy mixed liquor and simply recharge our own with their mixed liquor. When some event kills off the population or more likely kills off a segment of that population, the only way to restore it back to health is a transplant.
Why not just simply treat the symptoms and try to nurse the existing population back to health? Because it is so complex that to achieve a healthy balance of members is just not possible. For one reason, because of the complexity, no one really knows what is missing, and also the good bacteria-the ones for example that nitrify and denitrify in the case of a ww plant- that have been killed off are many times are not able to reestablish themselves because of competition with the existing “bad” bacteria that might not have been killed off. Those bad bacteria in a normal population are held in check by myriad and many times unknown mechanisms.
I am pretty confident that in the case of a major kill of the microorganisms in the digestive system of a human, really the best treatment would be to simply find another population that is healthy and re-start the plant. For one is not having to wait for a stable civilization which contains all the prerequisite workers to grow itself from scratch or, from an abnormal state which can take a enormous amount of time and is fraught with peril. It makes more sense to simply transplant an existing fully functioning civilization and colonize the new intestine.
The idea of injecting poop into a fully cleaned out intestine to me is perfectly natural as one intestine is pretty much like another intestine, and more importantly without a functioning system, the consequences are pretty dire. In the case of humans, death and suffering. In the case of a wastewater plant, the degradation of the river by allowing untreated wastewater into a healthy system.
It is all well and good to try to understand how complex systems work from an academic point of view. But knowing that a system works without knowing precisely how it works does not mean one should not take advantage of the system.

Thank you. I, and probably the others that read these messages, appreciate your response. I, too, am adverse to antibiotics, and I always question them as some have made my gut sick. I’ve also read that humans also request antibiotics from physicians for whatever little cause, and many are prescribed for them. As you said “Over Prescribed”!

Dear Lou,
I really try to keep an open mind, but I was taught to question everything almost to the point of paranoia. In other words, any major claim should have major proof.
If you responded to probiotics positively, regardless of whether it was a placebo effect, then so what. You got better. It is no different than me saying that I used “transfaunation” to treat diarrhea, and 3 out of 4 got better. That 75% might have gotten better in spite of what I did in my veterinary practice. Only when double blinded-controlled studies (the scientific method) are performed can we say “yes” or “no” a proposed hypothesis exists.
The real problem in our world is that we use antibiotics without consideration of the consequences. No wonder we have all these “super bacteria” resistant to antibiotics. It does not matter if it is my profession, dentists or human physicians, we OVER PRESCRIBE. But don’t think it is the medical profession’s fault completely because you would not believe the number of people who not only ask but demand that their pet be given an antibiotic for cases that antibiotics are not indicated.
One other tidbit of information I will share with you. You know all this mess with pet chicken jerky treats (sickness, deaths and now lawsuits) made in China. In my practice I have seen several sick pets that have consumed these treats. The last case that I reported an adverse event to the FDA, in the documentation was not only positive cultures from the pet’s gi tract with C. difficile, but we also submitted portions of the treat for culture, and guess what? You got it, C. difficile. I will be the first to say that clostridial organisms inhabit our gi tracts normally, but what about that pathogenic strain that causes severe GI upset to the point of DIC.

Dr. DCW: As one that has had success using probiotics, are you saying you believe the acidity of the stomach neutralizes 100% of the oral probiotic? If so, is my belief probiotics work a mind over matter thing? I’m not being facetious or a wise-guy; I just disagree that the stomach acid neutralizes it. If so, is it the same for all oral medications? I know when I was taking oral Methotrexate for Psioriatic Arthritis many years ago, after the doctor had me on the strongest dose, yet I still had problems, he told me probably half of the Methotrexate passed through the stomach so I needed to use the injection type. I did and it worked a lot better.
But your comment makes me wonder about all other medications we take orally. I realize you’re not an MD but you certainly treat animals in similar fashion, so I assume you are knowledgeable about medications. Thank you.

As a practicing veterinarian, I have been presented many cases of chronic diarrhea (yes, some caused by sterilization of gut with antibiotic therapy). In the last year and a half we have found that “transfaunation” of fecal material from a normal pet has effected a cure about 3 out of 4 cases.
Sometimes it takes performing the procedure more than one time. As I understand it, the “good” bacteria crowd out the bad bacteria or re-introduce normal flora of bacteria into the gut. I actually introduce the sample rectally as far as a soft 10 french soft catheter will reach.
I am not a big believer in probiotics since the acidity of the stomach neutralizes the effects of oral administration. The most important thing is that the sample transferred should not contain any harmful infectious agents.

My boss contracted MRSA while in the hospital being treated for a blood clot. He received an intense course of antibiotics in an attempt to deal with the MRSA, but as a result, his body began to react to the side-effects of the antibiotics. Not only was his strength slowly drained, he developed diarrhea that lasted for three months. It went from bad to severe and lessened the quality of his life. After consulting with an infectious disease doctor and a G.I. doctor, he was diagnosed with Clostridium difficile (C.diff) and was prescribed two new antibiotics that were expected to treat the condition.
But he did not get better, instead he grew worse. His immune system reached a dangerously low level. He had lost weight that he could not afford to lose. It was only through sheer grit and determination that he pressed on in his daily living. In desperation, he turned to alternative help – Phage Therapy. The PT doctors diagnosed that he did not have C-diff, instead, he had four superbugs: Staphylococcus Aureus, Klebsiella, Tseudomonas, and Proteus. The antibiotics that were used to help him, had also harmed him. They had eaten away all of the good flora in his intestines and had opened up a floodgate for the vicious superbugs. The loss of the good flora had reduced his body’s defenses, causing his immune system to be depleted. He received the Phage Therapy treatment and, long story shortened – it saved his life. Hope this helps someone.

Like others have reported, following hip and knee replacements, I was prescribed 600 mg. of Clindamycin to be taken 1 hour before each dental visit, for even teeth cleaning. Can this single dosage a couple of times annually raise the possibility of severe diarrhea caused by C. Diff? I do not tolerate penicillin, what other anti-biotics can be used to prevent the possibility of infections to joint replacement via dental visits?

In regards to developing c-diff after using Clindamycin, would you not think that the Doctors would quit prescribing it. Dah..
My girlfriend almost died from C diff, she was hospitalized for 2 weeks and would have diarrhea at least 30 times a day. She was scheduled to go to Minneapolis for the stool transfer. Her husband got her into clinical trials using defecid?? and after 2 weeks on this antibiotic. She has been well for over a year. I think we have some of the worst Doctors in the I U.S.They cannot diagnose anything. You better be an informed patient.

I am currently taking Augmentin as well as having received two injections of Rocephin for a severe infection from a dog bite. The redness and swelling are almost completely gone but some soreness remains. I still have 5 more days of the oral meds to go. I experienced some diarrhea this morning but got it under control with Imodium. Is there anything I can do to ward off coming down with c-diff and/or a yeast infection? Are these inevitable consequences of being on heavy duty antibiotics?
KMR

Makes one wonder what they are teaching in med school these days. Why do doctors think that harmful prednisone is the answer to everything, or another pill, like flagyl, with all of its side effects, will cure c-diff.
We must all be colonized with c-diff, or why would it be the opportunist bug left after all of our “good” bacteria are wiped out with a course of antibiotics like clindamycin.
It is obvious smart med students are not being given the tools to adequately treat sick patients. And what about dentists giving perscriptions for clindamycin with no instructions to take large doses of probiotics, in the billion strain along with it. Can’t they give a less destructive antibiotic? Not everyone gets Peoples Pharmacy.

Wonder whether using a multi-strain probiotic (NOW Foods has one with 10 strains) both orally and as a suppository would not accomplish the same effect?

Reference the terms mentioned about good and bad poop and the causes. I’ve taken probiotics for several years now and have had good regular bowel movements most of the time. Several antibiotics, mostly the “mycin” type, give me an upset stomach and/or diarrhea. The pain medication Hydroco sometimes causes constipation. Last month I had a GERD Endoscopy and Colonoscopy. I was diagnosed with a Candidal type infection in the esophagus and was given fluconazole for 14 days.
I although the doctor removed 2 polyps from my colon, he said my colon was in very good condition. The biopsies were negative on the polyps. I had no stomach problems with the antibiotic. I, as some here have stated also, am leery of antibiotics so I always tell the doctors and nurses of my problems with them. I believe I was given Clindamycin one time and had mild stomach problems. I probably would ask not to be given it again, if offered.

What about extracting your own fecal bacteria ahead of time? Sounds like it will store in a vial.

After 2 months of antibiotics and 2 months of diarrhea,
I am doing daily (3) stool samples for testing.
I took probitics and ate yogurt with active cultures,
still I had constant diarrhea…raw ‘bottom’, accidents
happening all the time, just a complete mess.
Hopefully the test will be complete and I can get onto
treatment for ‘whatever’.
People’s Pharmacy is great website and I also read their
articles in our local newspaper.
Leslie

My 93 year old mother has had C-diff several times after antibiotic treatment for UTI’s. She was on Vanco several times and also Dificid and finally Flagyl. She does ok while on these drugs but after she still has some form of diarrhea. She was given Florastor while on these drugs to add good bacteria back into her intestines and this seemed to help. She presently has a UTI that the docs will not give her an antibiotic for as they are afraid that another C-diff attack could be fatal.
It has been recommended by a urologist to give her Cranberry juice, 2 500mg of chewable vitamin C every night and lemon in water as well as Azo as needed. This won’t cure the UTI but seems to keep her comfortable and keep the bacteria from overwhelming her. I have also found that coffee and milk products, such as ice cream, whipped cream and cheese trigger diarrhea. So, the coffee and ice cream are definitely off limits.
When she has any dairy we give her Lactaid and this seems to help. The gastro doc said that these things can definitely be a problem after D-diff. Do you have any other things we might do for the UTI, just to keep it under control and keep her comfortable?
PEOPLES PHARMACY RESPONSE: Stay in touch with the urologist. We don’t have any cures for UTIs other than antibiotics, but the recommendations you’ve gotten seem reasonable.

My husband had a similar experience with C. difficile following antibiotics prescribed by a dentist. After six months of flagyl, antibiotics, probiotics, hives, and unremitting diarrhea, his doctor prescribed Questran powder. It’s a drug designed to lower cholesterol but an off label use is to bind bowel contents. He started with four scoops a day and gradually reduced the amount until finally, he made his way back to digestive health. We are so grateful that his doctor thought outside the box!

Following my hip replacement, my surgeon ordered clindamycin to be used when I visited the dentist in order to prevent infection to my hip. When the diarrhea began, I attributed it to the restaurant food I had eaten the same day. Fortunately, I did not report the restaurant, but the diarrhea (which lasted 2 weeks) was the worst I have ever endured! I now have that I am allergic to clindamycin listed on my health report.

Would a good probiotic with 10 probiotic strains restore to normalcy? I have a bottle that has 50 billion cultures per delay-released capsule (of both Bifico and Lacto). I had hopes I could get back to normal after taking these for two months.
In other words, is there an important difference between a good probiotic and the remedies mentioned above (fecal transplantation and a pill with “defined bacterial species”)?

I take a daily probiotic and this seems to alleviate some of the symptoms when I absolutely need to take an antibiotic. I also have taken Goldenseal Root as an alternative to the traditional treatment.

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