Fecal microbiota transplants, also called stool transplants, have been around since the late 1950s, but have had a hard time catching on. That may soon change. At the American College of Gastroenterology annual meeting, researchers reported that the therapy may successfully treat recurring C. diff and ease severe irritable bowel syndrome. In their study, 98 percent of patients saw improvement after one or two transplants.

During a fecal transplant, donor stool is transplanted into a colon, via a colonoscope or nasogastric tube. The donor is typically from a family member of the patient. Blood and stool is tested for transmissible diseases before the procedure.

Once transplanted, the healthy bacteria from the donor stool are thought to help restore healthy intestinal bacteria to the patient's colon.

What is Clostridium Difficile?

C. diff, is a bacterium that may cause mild symptoms such as abdominal cramping and more than three bouts of watery diarrhea a day to more severe symptoms signaling a severe infection. Those symptoms can indicate life-threatening inflammation of the colon, and include: severe abdominal cramping, watery diarrhea about 10 to 15 times a day, blood or pus in the stool, and fever.

Though the bacterium is found in the natural environment—and is present without problems in many healthy people's digestive tract—subsequent infections and most contact comes from hospitals and health care settings. In fact, approximately 20 percent of patients in hospitals acquire C. diff with 30 percent developing infectious diarrhea.

According to the Mayo Clinic, C. diff bacteria are passed in feces and spread to food, surfaces, and objects when people who are infected don't wash their hands thoroughly. This makes it the most common cause of infectious diarrhea in hospitals.

Healthy people can usually fight off C. diff infection thanks to their natural balance of intestinal flora, which keeps harmful bacteria in check. However, if a patient is taking antibiotics, it alters that balance and may put them at higher risk for complications. That's because antibiotics destroy some of the good and bad bacteria in the gut and allow C. diff to flourish. The resulting colonization of C. diff produces toxins that can damage the lining of the intestine and cause other complications, including death.

Treating C. Diff

A C. diff infection is treated with antibiotics and probiotics—and most patients recover quickly. However, about one-fourth of people with C. Diff suffer from recurrent bouts of the disease. If first-line treatments, such as antibiotics, fail to control the infection, fecal stool transplants may be considered.

The technique seems promising for hard-to-treat cases. Currently, only anecdotal studies have confirmed its success rates in the United States. Doctors in Australia have reported a 90 percent success rate in over 1,000 transplants and clinical trials are now underway in Norway.

 


 

Sources:

The Mayo Clinic
C. difficile: Treatments and drugs
http://www.mayoclinic.com/health/c-difficile/DS00736/DSECTION=treatments%2Dand%2Ddrugs

Medline Plus
"Fecal Transplants" Show Promise for Gastrointestinal Ills
http://www.nlm.nih.gov/medlineplus/news/fullstory_118194.html

Integris Health
The New "Superbug"—Clostridium Difficile
http://integrisok.com/cdiff

Medscape News
Stool Transplants Stop 90 Percent of C. Diff Recurrences
http://www.medscape.com/viewarticle/752770

C Difficile: Tracking the Rise of a Superbug
What Is the C Diff "Fecal Transplant" Therapy?
http://www.cdifficile.org/what-is-the-c-diff-fecal-transplant-therapy/

Medscape Reference
Clostridium Difficile: Background
http://emedicine.medscape.com/article/186458-overview