Fecal transplant: A new option to cure severe Diarrhoea, better than Antibiotics (Study)

Severe recurrent diarrhoea-Fecal transplant

‘Gross’ ‘Grotesque’ ‘Disgusting’ ‘Yuck’ ‘Appalling’ ‘Impossible’ … make your pick after this read.

Quickly glossing over the sound of the caption above, a new small study has shown that a healthy person’s feces inserted into the gut of someone with severe diarrhea caused by Clostridium difficile may be a more effective treatment than antibiotics!

A group of researchers published these findings of their study early this year in the New England Journal of Medicine. The study specifically involved patients who had severe cases of diarrhea caused by the bacterium, Clostridium difficile.  Bacterial infection by Clostridium difficile is particularly troublesome because it most typically occurs due to prolonged use of broad-spectrum antibiotics which also clears the normal flora in the colon; and it can be life-threatening. Generally, antibiotic therapy becomes less effective for most patients when the condition reoccurs. Although the use of probiotics e.g. from Yogurt may come in handy, the idea of “fecal transplant” has been around as an unpopular procedure for intestinal normal flora replacement by donor stool. This study officially concludes that it is best and most effective resort after the second or third relapse.

One transplant of fecal material from a volunteer – with its mix of healthy bacteria – resolved severe diarrhea in 13 out of 16 volunteers. In comparison, standard treatment with an antibiotic worked in only 4 out of 13 patients. 

According to Reuters Health, a senior author from the University of Amsterdam said it is the first hard evidence that has been provided for this sort of treatment. This is because the use of feces in the treatment of diarrhoea dates back to 4th century China when people with food poisoning ingested body waste. It was then described as a treatment for food poisoning and severe diarrhea by Ge Hong, a physician.

The study team randomly assigned patients to receive one of three therapies:

  • 13 volunteers with Clostridium difficile infection received Vancomycin, the standard antibiotic treatment four times a day for 14 days.
  • Another group of 13 patients had the same drug therapy after a Bowel lavage -drinking a solution to clean out the bowel (is similar to the kind of effect seen if they are getting a colonoscopy).
  • The last group of 16 volunteers had a brief treatment with vancomycin, combined with bowel lavage, followed by the infusion of 500 milliliters of diluted donor feces through a Nasogastric Tube (a plastic tube that passes into the nose, down the throat, past the stomach and into the small intestine.

Result Summary: 4 of 13 (31%) people were free of bacteria-related diarrhoea in the Vancomycin-only group; 23% (3 of 13) worked in the Vancomycin + bowel lavage group while 13 of 16 were cured on their first fecal infusion making donor fecal transplant 94% effective.

It is worthy of note that among the 3 cases trials where the feces treatment failed, the doctors re-treated patients with fecal material from a different donor and it worked in all but one case.

The researchers concluded with this interesting noted: “No significant differences in adverse events among the three study groups were observed except for mild diarrhea and abdominal cramping in the infusion group on the infusion day. After donor-feces infusion, patients showed increased fecal bacterial diversity, similar to that in healthy donors”.

So now, what do you think? ‘Gross’ ‘Grotesque’ ‘Disgusting’ ‘Yuck’ ‘Appalling’ ‘Impossible’ ?

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