Poop Scoop: FMT Transplants Disgust and Delight Medical Researchers

Fecal microbiota transplantation, aka FMT, is the process of transplanting the feces of a healthy person into the gut of a patient with chronic intestinal problems. Despite all the advances in technology and modern medicine, doctors are relying more and more on this  smelly, crude and ancient technique to treat chronic intestinal problems such as severe diarrhea  and irritable bowel syndrome. Increasing the yuck factor by more than one notch is the process itself, which occurs either via a tube or a capsule put down one's throat or up one's bottom. It is believed that at least 10 teaspoons of transplanted healthy stool will introduce a strain of powerful healthy bacteria that can annihilate the bad bacteria causing infection and disease.

What is C.diff bacteria?

The enemy is the  recurring, virulent bacteria, Clostridium difficile, aka C.diff. Its home is the human gut where it releases toxins that attack the intestinal lining and cause inflammation of the colon, resulting in diarrhea so severe that it can be and often is fatal. According to a recent study published in the New England Journal of Medicine, this bacterium causes 500,000 infections and more than 29,000 deaths every year in the United States. Illness often occurs in hospitals where antibiotics are administered for some other sickness. These antibiotics eliminate the good bacteria in the gut, allowing C.diff to frolic and play.

 

Fecal Microbiota TransplantologyFecal Microbiota Transplantology
Gastro NYC


Where do the fecal transplant come from?

Fecal transplants are an ancient remedy whose first documented use dates back to 4th century China where it was used to treat food poisoning and severe diarrhea and was known as "yellow soup." Fecal transplants have been used for at least a century in the field of veterinary medicine and many poorer countries have been using it as a first line of defense against the C.diff bacteria.

 

Fecal Transplant, circa 1900Fecal Transplant, circa 1900
CDLFFoundation

 In the United States,  FMTs have  been performed sporadically since the 1950s without much regulation but doctors have always considered it to be a "last resort therapy" because of its invasive nature, potential risk of infection, lack of Medicare coverage for donor stools and medical opinions about infectious diseases. But all that has changed.

A new procedure and new hope for fecal transplantation

More than 4,000 gut specialists gathered at the 80th annual meeting of the American College of Gastroenterology held recently in Honolulu, Hawaii, where a lengthy discussion on the merits of FMT took place.  Dr. Sahil Khanna of the Mayo Clinic in Rochester, Minnesota, was a guest speaker and he and a few of his colleagues discussed the new technique they collectively developed to accurately predict,for the first time, which patients are unlikely to benefit from antibiotic treatment, based on the number of diverse bacterial species in the  patient's stool.

In Khanna's own words: :This new prediction technique could help tailor more appropriate treatments for patients. It can be crucial in saving lives, given that recurrent C.diff infections are even more difficult to treat than the initial infection."

 

Fecal Transplant  IllustrationFecal Transplant Illustration
TerryMDavis

 

Is there a future for fecal transplants?

Many medical experts believe that fecal microbiota transplants is more effective and less expensive than antibiotics in treating recurrent C.diff bacteria. Using a "stool bank" instead of the standard treatment could save the nation more than $121 million yearly and has a success rate estimated to be well over 90%. Still, the FDA is hesitant about issuing regulation procedures, seemingly pooh-poohing its success as a powerful treatment for intestinal infection and disease.

 

Stool SampleStool Sample
PowerofPoop

Do you think  that further use of fecal transplants could lead to ways to treat other diseases as well? If so, please explain.

Closing thoughts on bacteria:

What's great about bacteria is that you have a surprise every day waiting for you because they're so fast, they grow overnight.~ Bonnie Bassler