19 Poop Pills

After April 13, Kaiser will no longer be my healthcare provider - THANK GOD. I've come to hate Kaiser and all of their doctors because of the poor care provided.

I approached by GI doctor looking for help with IBS and this was his prescribed treatment regimen for all patients with IBS. I went for it since I don't have much to lose.

1. Xifaxan (Rifaximin antibiotic for 2 weeks)

• Idea is to clear out some bacteria from the gut that may not aide in digestion
• It did nothing whatsoever so we didn't repeat another course
• No side effects

2. Elavil (Amitriptyline antidepressant for 1 week, then increased dose if initial dose does not work)

• Idea is to help the brain-gut dysfunction. Antidepressants reduce the uptake of neurotransmitters, which can reduce muscle spasms in the intestines
• This did have some effect on my gut. The feeling was a bit strange. I was still getting bloated and still had loose stool everyday, but it didn't feel as bad. It was as if my body still felt the pain and discomfort, but my brain did not.
• Some of my side effects were intermittent sleep with many dreams, dry mouth, and some drowsiness (though this overlapped Daylight Savings Time so I'm not entirely sure about the drowsiness)

After both treatments didn't help, I finally convinced the GI doctor to order blood tests in order for me to enroll in a clinical trial for fecal matter transplant (FMT).

Unfortunately the ONLY trial in the US that is investigating FMT for IBS is in Boston, and they plan to stop enrollment at the end of April. When I found this out, I had to come out to Boston so this morning I am writing from some random Boston university in the university cluster South of Fenway Park.

I will visit Beth Israel Deaconess Medical Center today for a screening, and I will be randomized into one of the four arms of the study. Wish me luck, and that I don't get the placebo. I'll have to swallow 19 poop (or 19 placebo) pills tomorrow or next week (if I'm in one of the antibiotic pre-treatment arms).

Arm	Intervention/treatment
Experimental: fecal microbiota transplantation fecal microbiota transplantation	Procedure: fecal microbiota transplantation fecal microbiota transplantation
Placebo Comparator: placebo fecal microbiota transplantation placebo fecal microbiota transplantation	Drug: placebo fecal microbiota transplantation placebo fecal microbiota transplantation
Experimental: FMT after antibiotic pretreatment v1 fecal microbiota transplantation after antibiotic pretreatment	Procedure: fecal microbiota transplantation fecal microbiota transplantation Procedure: FMT with antibiotic pre-treatment (v1) FMT with antibiotic pre-treatment (v1)
Experimental: FMT after antibiotic pretreatment v2 fecal microbiota transplantation after antibiotic pretreatment	Procedure: fecal microbiota transplantation fecal microbiota transplantation Procedure: FMT with antibiotic pre-treatment (v2) FMT with antibiotic pre-treatment (v2)

PS. I've been to Boston twice before, but my impression of Boston in my 2 hours here this time is that it's still so cold. People aren't as friendly as Californians, and they like their Beats headphones.