Fecal transplant restores gut flora

Q. Many years ago, I developed a terrible Clostridium difficile 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 with 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. Thomas Borody, a gastroenterologist in Sydney, 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.

A recent article in the journal Clinical Gastroenterology and Hepatology (online, Aug. 25, 2011) described fecal microbiota transplant as “safe, inexpensive, and effective.” By reintroducing 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.

Q. I have been diagnosed with Meniere’s disease. This causes dizzy spells that come out of nowhere and are totally disabling. They last from 30 minutes to four hours.

I saw a specialist who prescribed a diuretic. Unfortunately, the medication itself makes me feel rather dizzy. I tried reducing the dose to half a tablet, but the next day I had two episodes, one complete with nausea and vomiting.

I tried taking it at bedtime, and that was better, but still very uncomfortable. At this point I’m afraid to drive. When I go out, I have to hold onto my husband’s arm due to the lightheadedness from the medication. Any suggestions you may have would be most appreciated.

A. Ear specialists believe that Meniere’s disease is caused by an imbalance in the fluid of the inner ear. Symptoms include episodes of spinning dizziness lasting longer than 15 minutes accompanied by decreased hearing, pressure and ringing in the ear. Such attacks come and go.

Treatment usually involves a low-salt diet and the diuretic Dyazide (triamterene plus hydrochlorothiazide). Ask your physician if an even lower dose might be worth trying. When this approach is not helpful, some specialists recommend corticosteroids. They can be given orally or injected through the eardrum. When all else fails, there is a surgical procedure that may help eliminate the condition.

Q. My insurance company wants to switch my Lovaza prescription to fenofibrate. What do you think of this change?

A. Lovaza is a prescription-strength highly purified form of fish oil used to lower high triglycerides. Fenofibrate is a completely different type of cholesterol-lowering medication. Only your doctor should decide if fenofibrate would be an appropriate substitute for you.

2011 King Features Syndicate, Inc.