Are you pro probiotics? – By Dr. Dave Hepburn

This column is only for billionaires, which… is all of you. You are rolling in veritable vault-loads of bacteria. You’re a bacterial billionaire. Some of your teenagers are extremely wealthy, as are their hockey bags. In fact, for every single cell in your body you have ten bacteria; on your skin, in your mouth, genital tract, your jockstraps and helmets.

Your colon, you’ll be thrilled to know, is the happy hellish home to most of these billions. But don’t be in a hurry to try and get rid of them courtesy of some primitive cultish practice like voodoo or colon cleansing, the latter which not only does no good whatsoever but may in fact be harmful. (For those gullible colon cleansing folks…you’ve been hosed…so to speak.) Stick to voodoo like my patients do, which may be the reason Dr. Dave bobbleheads are being snapped off the shelves and I have a constant pain in my prostate.

Your bowels are teeming with lovely, yet sensitive, bacteria with names like E.coli and Petunia. However, your bowels also contain a bowlful of nastier, tougher, bacteria with names like Clostridia and Kevin. All of these bowel beauties, good and bad, compete for your pop tarts. Millions of them eagerly waiting in the bowels of your bowels with saliva dripping from their wee bacterial beaks. Sleep well now, Billy.

Bowel Bacterias Dr. Dave Hepburn
Bowel Bacterias – Dr. Dave Hepburn

Normally, the Petunias and those of similar ilk outnumber the nasty fellas significantly, a good thing for keeping your bowel flora and fauna in balance, albeit an uneasy one. The good flora, as mentioned, are a sensitive lot and should they be insulted by say an antibiotic or a foreign invader, they get nervous, can’t eat and often faint. The hardier, evil bugs don’t care and so they take over the pop tart smorgasbord, and in so doing can cause some rather unacceptable symptoms like bloody diarrhea, pain, cramps and death and stuff.

So in this ongoing battle of the gut it makes sense to send in reinforcements from time to time. Welcome probiotics. Yes, you can deliberately add more of these sweet germy gems to that twisting cauldron of poop. That, in fact, is what a probiotic is.

The most famous probiotic is, of course, lactobacillus, found in yogurt. When I first learned of the enormous bacterial count in yogurt I was quite viscerally affected, which may explain the reflexive gagging sounds I make when I spot a roving Yoplait in aisle 6 at the Piggly Wiggly. It also explains why I reach for the soothing Snickers bars to make me feel better as no bacteria could ever survive in my Snickers bars thank you very much. But knowing what I do now about how great probiotics can be, I can almost tolerate a yogurt in the same room, as long as the lid is on and it doesn’t look me directly in the eye.

Lactobacillus - Dr. Hepburn
Lactobacillus – Dr. Hepburn

A live probiotic, taken at the same time that you might have to go on antibiotics, can restore the strength of the good bacteria, preventing the diarrhea often seen in those on antibiotics. Probiotics can also be useful in actually treating good old fashioned infectious diarrhea and possibly even irritable bowel syndrome. In addition to GI problems, probiotics are also considered in the treatment of vaginal, skin and respiratory infections and might even prevent tooth decay and periodontal disease.

Most probiotics are bacteria similar to those naturally found in people’s guts, especially in those of breast fed infants (who have natural protection against many diseases.) Probiotics are available as supplements but are also found in foods like fermented and unfermented milk, miso, tempeh, and some juices and soy beverages. The bacteria may exist in these foods naturally or be added during preparation. Isn’t that a lovely thought? “Bill, add a pinch more salt to that miso and, ummm, do we have any more baby poop left?”

What is important is that not all probiotics are created equal and the correct probiotic, be it bacteria, yeast or Edmonton Oiler, must be chosen for the proper problem or it is a waste of time and bowel, and don’t we all hate bowel waste. If you took the wrong probiotic for a gut problem you might be disappointed to learn that it was the probiotic used for vaginal yeast infections, particularly if your drivers license contains words like Charles or Gordon. So for most of you guys of the male species, it may be better to just inhale deeply… from a hockey bag.

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Do not read this while eating- Dr. David Hepburn

WARNING! You might want to place this article in your “I-Wished-I’d-Dropped-My-iPad-Into-the-Hole-of-One-of-Those-Porta- Potti-Things” file.

I am forever paying attention to the word “transplants.” But this is one time, like accidentally opening Brett Favre’s text message, that I wish I hadn’t paid attention. It isn’t easy to revolt a doctor but this is so utterly repugnant that I really would like you all to share in my nausea, which, frankly, would be a far site better than sharing this particular transplant……feces. Yes, you heard correctly should your wife be reading this to you. She did not misread fleeces or fees please or fleas tease or freeze these or Jersey Shore.

Stool transplant. Not talking about a barstool, though that is probably where your keyster should be drooped over about now having availed yourself of the bar portion at least in order to continue reading about the stool portion.

Clostridium difficile is a bug that we doctors aren’t overly fond of, as opposed to ones we’re more partial to like ladybugs, butterflies and Latoya Jackson. Had we liked this bug we would have named it Clostridium facile or Clostridium Heidi Klum but no, we gave it a name like difficile to reflect the ease of which it is to deal with. A not uncommon colon infection, it has the potential to be diarrhea deadly in those who haven’t got a Prime A immune system. It is an opportunistic bug. Should a prolonged course of antibiotics happen to kill off the “friendly bowel flora” (which btw is a very cool name for a band or a child should you be raised in the wilds of Gabriola), then C. diff can overwhelm the colon kingdom.

C. diff - Dr. Dave Hepburn
C. diff – Dr. Dave Hepburn

Affecting primarily the elderly, this deadly beast is most often caught in hospitals or nursing homes. In fact, the longer your stay in hospital, the higher the risk of developing C. diff.  Cramping diarrhea with recent use of antibiotics (like Cipro), fever, and foul smelling stool (as opposed to the more common lilac/petunia fragrance), is an indication that C. diff has set up shop. Too much of this overgrowth and the body can go into shock. The bowel can even rupture, an event that has been known to ruin lunch at Zellers. Anti-diarrhea drugs can actually make it worse! Currently we treat C diff. with antibiotics, different ones than caused the problem in the first place. But this is not always terribly effective and can be very expensive.

So along comes fecal bacteriotherapy, known in some circles as… kindergarden. It involves infusion of fresh feces from a healthy donor into the hurtin’ bowel in order to reverse the bacterial imbalance responsible for the infection. The best choice for donor is a close relative who has been tested for a wide array of bacterial and parasitic agents and who is excellent at keeping secrets and avoids overindulgence in Lima beans.

Donor stool is collected in the AM and liquefied in your basic orange juice blender. (How about that for a slap chop commercial at a trade show. “ Folks, over here we have umm…well… a blender for your….well…your….poop. Umm…Ok on to the Sham Wow!”) The transplant is done via enemas and/or via an NG tube through the nose, and no… I am not kidding.

A modified form of fecal bacteriotherapy is being developed  which is more effective and easier to administer. A fecal sample, provided by the patient/victim before prolonged antibiotic treatment or hospitalization, is stored in a refrigerator, just behind the Limburger cheese. Should the patient subsequently develop C. difficile the sample is extracted, filtered, freeze dried and then formed into a capsule that can be taken orally with your Fred Flintstones. And just think of how proud if not vindicated the dog will feel as he watches you gulp down a poop pill, the ultimate probiotic.

stool transplant -Dr Dave Hepburn
stool transplant -Dr Dave Hepburn

Now there’s little doubt this treatment has a bit of an image problem, sort of the Kanye West of medicine. But this “transpoosition” may be something that saves your life because even though it is not being done everywhere just yet, it works and it works very well.

And most fascinatingly, some scientists feel that a disturbed gut flora might well be responsible for conditions like Parkinson’s, ulcerative colitis and even obesity. Furthermore, fecal transplant treatment apparently has shown a dramatic improvement in patients with so-called autoimmune disorders like rheumatoid arthritis. Very exciting stuff but it’s 2 AM and I’m poop…er…exhausted. So, before your husband or the dog reads this article….head to the Porta Potti.