Handbook

DiffBiome Handbook

A 90-day programme out of recurrent C. difficile infection

A repeatable 90-day programme combining the oral DiffBiome FMT course with a structured lifestyle.

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topics
38
chapters
38 chapters · 6 parts

II. Phase 1 – The acute course and foundations (days 4–24)

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04

What is Clostridioides difficile?

You get to know your opponent: what *C. difficile* is, why its spore is so tough, and how its toxins cause your complaints. During your course it is precisely this pathogen that you are pushing back.

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Antibiotics and colonisation resistance

You understand why it is precisely the antibiotic that opens the door to *C. difficile*: it empties out the protective flora that had kept the pathogen in check. This protection is called colonisation resistance.

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Why does it return? Recurrent CDI

If this is not the first time you are battling *C. difficile*, it is not your fault. You understand why the infection returns so stubbornly, and why it is precisely the restoration of the flora that breaks this spiral.

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The gut microbiome and dysbiosis

You get to know the invisible ecosystem living in your bowel: what the microbiome is, why diversity matters, and what dysbiosis means – the loss of balance that is the real breeding ground for the return of *C. difficile*.

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What DiffBiome FMT is, and how it restores balance

You will understand what is in your capsule and how it works: the living, diverse gut flora of a healthy donor, which engrafts in your gut, restores balance, and pushes back *C. difficile*.

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Donor screening and the safety of the product

It is reassuring to know what stands behind your capsule: strict donor screening to international standards, blood testing done twice, an extensive pathogen panel and controlled manufacturing. Here you will get to know the full chain of safety.

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During the course: correct capsule intake and what to avoid

The how matters as much as the what. You will learn the perfect capsule intake – in the morning, on an empty stomach, with plenty of fluid – and you will get to know the pitfalls: antibiotics, probiotics and poor storage.

III. Phase 2 – Engraftment and lifestyle (days 25–60)

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Supporting engraftment

The FMT set recovery in motion, but the flora you have taken in must also find a home in you. In the next three days you learn what engraftment is, and how to help it with small daily decisions, so that the new bacteria truly stay.

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Fibre: the food of the good bacteria

The freshly engrafted flora needs food day after day, and its favourite food is fibre. In the next three days you learn what kinds of fibre exist, why they matter, and how to bring them into your diet gradually and gently.

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Plant diversity: the weekly 30

What counts is not how much of one thing you eat, but how many different plants you eat in total. In the next three days you'll meet the principle of 30 plants a week and start collecting diversity – the secret of a varied, resilient gut flora.

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Fermented foods

Fermented foods have been bringing live cultures to our plates for thousands of years. In the next three days you'll learn why they can be allies of your flora, and how to introduce them sensibly, in small steps – paying attention to what suits your healing gut.

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Protein and the gentle diet

Fibre feeds the flora, and protein feeds you: your muscles, your immune system, your healing gut wall. In the next three days you'll learn how to build enough well-tolerated protein into a gentle, recovery-supporting diet.

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Eating window and timing

Your gut and your flora both live by a daily rhythm. In the next three days you'll learn how to give them a rest with a gentle eating window, and why it helps recovery when eating and resting each have their own time.

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Fluid and electrolyte balance

The greatest hidden risk of recurrent C. difficile infection is not the pathogen itself, but the loss of fluid and salt. This chapter teaches you to count: how much you need to drink, what to put in your water, and how to recognise when your body is becoming dehydrated.

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Sleep and circadian rhythm

Sleep is not wasted time but active healing. Your gut flora has a daily rhythm of its own, and when you sleep well, the engrafting bacteria find better conditions too. This chapter shows you how to set your own body clock.

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Movement (Zone-2)

Healing doesn't need a gym and doesn't need exhaustion. Slow, comfortably paced movement – Zone-2 – improves gut motility, lowers stress and makes your gut flora more diverse. This chapter shows you how to start safely.

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Stress and the gut–brain axis

The gut and the brain are in constant conversation. When you are stressed, your gut feels it too – and vice versa. This chapter shows you how to calm stress with simple breathing and a daily routine, so that your gut flora is in a calm environment.

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What to avoid: antibiotics, PPIs, ultra-processed foods

Sometimes the most important thing is what we DON'T do. Unnecessary antibiotics, needless acid suppressants and ultra-processed foods all undermine the freshly engrafted gut flora. This chapter teaches you to recognise and avoid the three main traps.

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Reading the symptom diary and the Bristol scale

The diary is not bureaucracy but the compass of your healing. If you learn to read your own data – above all the stool count and the Bristol scale – you can see the improvement yourself and recognise in good time if something isn't right.

IV. Phase 3 – Stabilisation and prevention (days 61–90)

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Tapering: gradually stepping down the dose

Tapering is a sign of recovery, not an increase in risk. In this chapter you will learn why and how your doctor steps your daily DiffBiome dose down in stages, what to watch for as you go, and how your diary decides whether you are ready for the next level.

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What recovery looks like: response and remission

What is the difference between responding to treatment and becoming durably symptom-free? In this chapter you will learn to recognise the two stages of recovery – response and remission – and how your diary shows you where you stand.

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When it does not respond: non-response and retreatment

Not everyone responds in the same way and at the same speed. If symptoms stay longer than expected, it is not a dead end: there is a clear plan. In this chapter you will learn to recognise an inadequate response, and understand the logic of retreatment – from the maximum dose to switching to a different LOT.

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Recognising recurrence and what to do

The possibility of recurrence is no reason for fear, if you know what to watch for. In this chapter you will learn to recognise the early signs, to tell a passing upset from a genuine relapse, and you will know exactly what to do – from the diary to the doctor.

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Long-term microbiome restoration

The disappearance of symptoms is the beginning, not the end. In this chapter you will understand how a real, diverse and resilient gut flora builds up behind freedom from symptoms – and what you can do every day to keep this balance durable.

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Prevention: antibiotic stewardship and the environment

Holding on to your recovery depends on prevention. In this chapter you will learn the most important preventive tools – from conscious antibiotic use through environmental hygiene to lifestyle – so that you can keep the chance of relapse low for years to come.

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Special groups: older adults, immunosuppressed, IBD, pregnancy

The principles of the DiffBiome course apply to everyone, but a few life situations call for special caution. In the next three days we review what to watch out for if you are older, if your immune system is weak, if you have inflammatory bowel disease, or if you are expecting a baby – and why it is worth keeping closer contact with your doctor in such cases.

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When to seek medical help immediately – red flags

The DiffBiome course is largely safe, and most symptoms are mild and transient. There are, however, signs at which you should not be reading a book, but seeking medical help immediately. This chapter goes through these red flags once, clearly – so that you recognise them, and know what to do.

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Evaluating the 90 days and the next cycle

You have gathered ninety days of data – now it is time to read what it says. In the next three days you read your own trend from your diary, decide with your doctor whether the remission is durable, and clarify whether another cycle is needed, or whether you can move towards maintenance.

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Self-directed maintenance: a lifestyle system against relapse

The course ends, but your recovery does not. This final chapter helps you turn the habits built over the ninety days into a durable lifestyle system – one that feeds the engrafted flora and keeps relapse at bay. Antibiotic awareness, a diverse diet, sleep, exercise: the wheel comes into your own hands.

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