Fecal Microbiota Transplants

Primary Care Blog

Yes, you read it right.  I said "Fecal Transplants".  It may sound disgusting but there is increasing evidence that placing a healthy patient's feces inside the GI tract of a patient with Clostridium difficile gut infection may be the wave of the future.  And it shows just how important our normal gut microbe flora is for good health.  Here is how it works:

Our GI tracts are colonized by hundreds of microorganisms at birth as we pass through the mother's birth canal.  These bacteria live in  balanced homeostasis, helping digest food, helping absorb Vitamin K and Vitamin B complex and helping our immune response.  When this balance is upset with antibiotics, Clostridium difficile bacteria overgrowth can occur.  Clostridium difficle infection is serious and it is the most common cause of hospital acquired diarrhea and often leads to severe illness and death. As patients are treated with yet more antibiotics to eradicate the infection a month later recurrent C. diff  can commonly return.

Fecal microbiota transplantation involves taking stool from a healthy donor (a relative is best) and instilling that stool into the GI tract of the infected patient.   The donor is screened for HIV,  hepatitis, syphilis, parasites and C difficile.  The stool is made into a slurry with saline in a household blender and then instilled into the patient.  This can be done with a nasogastric tube directly into the stomach or placing it in the colon with a colonoscope or enema.

A recent multicenter long-term follow-up study showed that diarrhea resolved within 90 days after fecal transplantation in 91% of patients.  Some patients also reported to have improvement of preexisting allergies and peripheral neuropathy and other autoimmune diseases.   And a study published in the New England Journal of Medicine in January, 2013 showed infusion of donor feces was significantly more effective for the treatment of recurrent C difficile infection than the usual treatment with Vancomycin.

The Human Microbiome Project is focusing on understanding the role of human genetic and metabolic bacteria that may help other diseases such as inflammatory bowel disease, irritable bowel syndrome, multiple sclerosis, rheumatoid arthritis and sjogrens syndrome.  These early trials point to the benefits of millions of microbes in our bodies and one can't help but wonder about our factory farmed animal food supply that is so injected with antibiotics and how that may contribute to disease.

Fecal transplants make a lot of sense as we appreciate more and more how important it is to have healthy gut microbes.  To keep your gut healthy please:

1.    Avoid antibiotics unless necessary for a known serious bacterial infection

2.    Buy only organic, local farmed meat and poultry that has not been fattened with antibiotics

3.    Eat more fiber, fruits, vegetables and legumes

4.    Drink water between meals