What is FMT and How Does it Work?

29 May

Fecal microbial transplantation (FMT) is the latest treatment for infections of the lower part of the gastrointestinal tract, primarily Clostridium difficile (C. diff) infections.  C. diff is one of the “hospital superbugs”, and is resistant to treatment with the majority of antibiotics.  Until now, it has been treated with specific antibiotics such as vancomycin and metronidazole.  However with time, it is becoming more common for the illness to recur once the course of antibiotics has been finished.


What is Fecal Microbial Transplantation?

Fecal microbial transplantation is a method of treating C. diff infections that does not involve the use of antibiotics or any other medication.  It has a much higher cure rate than antibiotics; investigations have shown it able to eliminate the infection in 92 percent of patients, and that figure rises to 98 percent of patients after a second treatment has been carried out.


FMT involves taking a stool sample from a person who is healthy and has no gastrointestinal infections.  This stool sample is then mixed with a saline solution and implanted into the bowel of the patient.


Once inserted into the bowel, the transplant material will help to restore the correct levels of the naturally present bacteria.  This means that the C. diff bacteria are less able to compete for energy sources and will be eliminated as a result.


Fecal microbial transplantation is not a new treatment.  It originally was used in veterinary medicine, and has been around in this form since at least the 17th century.  The first known use of FMT in humans was in 1958, but it has since fallen out of favor, as antibiotic use has become more widespread.


How is FMT Performed, and What Are the Risks?

Fecal microbial transplantation is performed using a standard colonoscopy procedure to transplant the fecal material into the colon of the patient.  A channel in the colonoscope (the narrow tube that is inserted through the anus) is used to deliver the transplant material.  Colonoscopy is generally performed using sedation, rather than anesthetic.  Sedation is used because it eliminates the additional risks that are associated with the use of anesthetic, while still making it more comfortable for the patient.


The risks of colonoscopy are very low, but you should always be aware of them before you agree to undergo any form of medical procedure.  It is possible that there may be damage to the bowel during the procedure, which should be repaired immediately, as it can be dangerous.  However, perforations of the colon are extremely rare, and this risk is minimal with an experienced surgeon.


You will be required to take laxatives for several days prior to the procedure, which will ensure that the bowel is empty of stool.  For FMT, this will also help to flush out some of the bacteria that are present in the gastrointestinal tract, making it easier for those in the transplant sample to colonize the digestive tract and return the natural flora to normal levels.


What are the Benefits of Using FMT?

FMT is a treatment that has been demonstrated in a number of studies to be highly effective at eliminating C. diff infections.  It restores the correct levels of the natural flora of the gastrointestinal tract, which prevents the pathogenic (disease-causing) bacteria from multiplying.


The use of FMT eliminates the need for powerful antibiotics, which can lead to severe side effects, and which must be taken for several days in order to be effective.  FMT is effective for over 90 percent of patients after just one treatment.  In fact, a study carried out in January 2013, comparing FMT to the standard treatment of vancomycin, had to be stopped early, because it was considered unethical not to offer the FMT treatment to all patients.  In this particular study, FMT had a cure rate of 94 percent, while the rate for vancomycin was 31 percent.  Recurrence of C. diff infection is also much less likely when FMT is used as the treatment.


Seeking Advice and Treatment

If you are experiencing any of the symptoms of C. diff, then you should book an appointment with your local colorectal surgeon, who will be able to advise whether you require treatment, and what the best approach for your particular case would be.


What Are The Symptoms of C. diff and How Can It Be Treated?

26 May

C. diff is short for Clostridium difficile, which is one of the newly termed “superbugs” causing concern in places such as hospitals and nursing homes, and it is highly unlikely to infect any person who is otherwise healthy.  There are certain groups of people who are much more susceptible to developing an infection than others, and these will include:

  • People who have been in hospital or a nursing home environment for a considerable length of time.  They will have been exposed to the C. diff bacteria and therefore it is more likely to be present within the colon.

  • People who have been taking broad spectrum antibiotics, which will disrupt the amount of bacteria found naturally in the gastrointestinal tract.  This allows C. diff to flourish instead, allowing the toxins to be produced, leading to the onset of the symptoms.

  • People who have had surgery on the gastrointestinal tract, or other procedures, including regular enemas.

  • Age is a factor, with those over 65 years of age at a higher risk of developing the infection.  However, this could also be due to the fact that this age group is more likely to need hospital treatment, and therefore more likely to be exposed to the pathogen.

  • The use of medications such as chemotherapy, or the presence of conditions such as diabetes can lead to the weakening of the immune system and increase the risk of the infection taking hold.

How Can a C. diff Infection be Recognized?

The most obvious symptom of a C. diff infection is the onset of diarrhea.  This will be watery, foul-smelling and can occur up to five times a day in a mild case of the disease.  In a severe case, however, the diarrhea may occur up to fifteen times in a day.  It may also contain traces of blood, and will often be associated with painful abdominal cramps.

In severe cases of C. diff, the condition known as colitis may develop.  This is the inflammation of the colon, and will lead to the onset of additional symptoms.  These will include dehydration, as the colon is unable to absorb sufficient water when the swelling is present.  There can also be nausea and vomiting, which can lead to weight loss, and it is possible that a fever may also develop.  The abdominal pain is also likely to be more severe.


How Can a C. diff Infection be Treated?

The most effective method of treating a C. diff infection is to use fecal microbial transplantation, or FMT.  This is a relatively new method of treating bacterial infections, but it has been known about for many years – the first recorded use in humans was in 1958, and it has been available in veterinary medicine for over three hundred years.

Fecal microbial transplantation involves taking a stool sample from a healthy person, combining it with saline solution and then transferring it to the colon of the infected patient.  This restores the natural levels of the bacteria in the colon, which prevents the growth of the pathogenic bacteria.  This method has been shown repeatedly in studies to have a cure rate of over 90 percent, and there is a very low chance of recurrence.


The most commonly used method, however, is treatment using antibiotics such as vancomycin.  This is intended to kill the C. diff bacteria, but it also causes considerable disruption to the natural flora that live in the digestive tract.  These are known as the “good bacteria”, and they help to prevent infections when they are present in the right numbers.  However, as antibiotics will also destroy some of these, there is a much greater chance of the C. diff infection recurring.  The cure rate for vancomycin, in a recent study, was lower than 40 percent.


When Should I See a Doctor?

If you are experiencing any of the symptoms of a C. diff infection, then you should seek advice from your local colorectal surgeon.  If it is a mild case of infection, then your body may be able to deal with it without any need for treatment.  However, if your symptoms are severe, then you will need to undergo some form of treatment, and your specialist doctor will be able to advise you of the most appropriate course of action.

How Does FMT Compare to Other Treatments For C. diff?

19 May

FMT is fecal microbial transplantation, and it can be used to treat infections of the lower part of the gastrointestinal tract, such as C. diff, which affects the colon.  The colon is the region that is also known as the large intestine.  C. diff, or Clostridium difficile, is one of the latest generation of hospital superbugs, and these are becoming increasingly difficult to treat.


FMT is not a new method of treating disease.  In fact, its use has been widely acknowledged in veterinary medicine for over three hundred years, and its first recorded use in humans was in 1958.  Since then, the technique has fallen out of favor due to the increasing number of antibiotics and other medications developed in the years after this.  However, due to the progression of antibiotic resistance being faster than drug development, there are very few ways in which we can now treat some infections.  C. diff infections, for example, only respond to treatment with vancomycin and metronidazole, and this is not in all cases.  Therefore, this has led to doctors searching for alternative methods of eliminating these infections.


Fecal microbial transplantation is one of these alternative methods.  C. diff does not generally cause infection in a person (adult or child) who is healthy and has not been taking antibiotics recently.  This is because the gastrointestinal tract normally contains a variety of bacteria that normally colonize this part of the body – they are called the natural flora.  These bacteria mean that pathogens (disease-causing organisms) such as C. diff are unable to find the space and the nutrients that they require in order to survive, so the infection is unable to develop.  In a person who has been taking antibiotics, the natural flora will also have been affected and their numbers considerably reduced.  If the pathogen enters the body during this time, then it will be able to colonize and grow much more easily.  Once the numbers of the pathogenic bacteria have increased, they will begin to release toxins, which will cause the distinctive symptoms of the disease.


FMT is designed to restore the levels of the good bacteria back to what they should be.  This helps to remove the pathogens and prevent the disease from recurring.  However, the treatment is something that many people might not want to undergo, as it does not exactly sound pleasant.  A stool sample is taken from a healthy donor who has not been taking any medications recently.  It is then turned into a liquid suspension by mixing it with saline solution, and then transferred to the colon of the infected patient.  This transfer is carried out using a standard colonoscopy procedure, where a narrow, flexible tube is passed into the colon through the anus.  A channel on the side of this tube can be used to transfer the solution.


How Effective is FMT, and How Does it Compare to Other Methods?

Many studies have been carried out recently into the effectiveness of FMT.  It has consistently been shown to cure over 90 percent of C. diff cases with just a single treatment.  If a second treatment is carried out, then the cure rate increases to approximately 98 percent.  In a recent trial, carried out in January 2013, the research had to be stopped prematurely because it was considered unethical not to offer the more effective FMT treatment to every patient.  This particular trial was comparing FMT and the standard treatment of the antibiotic vancomycin.  FMT demonstrated a cure rate of 94 percent, while vancomycin was 31 percent.


Vancomycin is still the standard treatment for gastrointestinal infections, but FMT is increasing in popularity due to the repeated studies demonstrating its effectiveness.  Many patients who have previously been treated with antibiotics are now requesting FMT, because it is much more effective and also greatly reduces the risk of recurrence.


Seeking Further Advice

If you have been experiencing symptoms of infection, then you should book an appointment with a local colorectal surgeon.  They will be able to advise you on whether you require treatment, and can also discuss the different methods available to you.  It is important to find out both the benefits and the risks before you make a decision about further treatment.

Diagnosis and Treatment of C. diff

12 May

Clostridium difficile, more commonly known as C. diff, is a species of bacteria that can cause the symptoms of severe diarrhea, fever and abdominal cramps.  It is considered to be one of the “superbugs” that will be found most commonly in hospitals; few people outside hospital will contract a C. diff infection.  In some cases, these bacteria can lead to serious complications that may even be fatal.  These complications will usually begin with gas building up in the bowel, leading to swelling.  This is known as the “toxic megacolon”.

How Can a C. diff Infection Develop?

A C. diff infection will usually develop in the colon, because there is very little oxygen present, and these bacteria do not require oxygen in order to survive – they are anaerobic.  Healthy children and adults will not normally develop a C. diff infection, because the natural flora of the gastrointestinal tract (which is sometimes referred to as the good bacteria) prevent it from growing.  However, if you have recently been ill and have needed to take antibiotics, then this will have had an impact on these healthy bacteria, reducing the numbers that are present.  This can lead to a surge in the number of C. diff bacteria, which will multiply rapidly and begin to produce toxins.  These are poisons that lead to the symptoms of the illness.


The majority of C. diff infections occur in hospitals and associated places, such as nursing homes.  This is because people are in close proximity to one another, and many will be taking medications, including antibiotics.  People who are most at risk of a C. diff infection include:

  • Those who have recently been taking antibiotics, particularly broad spectrum antibiotics that will also affect the natural flora of the body.
  • People who have been staying in a care home or hospital for a long period of time.
  • Have a weakened immune system, which may result from a number of serious, underlying conditions, such as diabetes, or from taking medications such as chemotherapy.
  • Have had a large number of enemas, which involve the insertion of fluid into the rectum, or surgery on the gastrointestinal tract.

How is Clostridium Difficile Infection Diagnosed?

The most obvious symptom of the infection is diarrhea, which can occur up to five times a day.  However, as diarrhea can result from many different conditions and infections, the only reliable way to check whether C. diff is responsible is to perform tests on a stool sample.  This will involve examining a sample of the stool to check for the presence of the C. diff bacteria.


A blood test may also be carried out.  This will not show which species of bacteria is responsible for the infection, but a high level of white blood cells confirms the presence of a severe infection and can help to determine the most appropriate form of treatment.  A blood test will also indicate whether there are any imbalances in the mineral ions found in your blood.  Correcting these may also form part of your treatment.


How Can a C. diff Infection be Treated?

The treatment for a C. diff infection will depend on the severity of the symptoms.  For a mild form of the condition, it will most likely have been caused by taking antibiotics that have upset the levels of the natural bacteria found in your gastrointestinal tract.  After you have finished your course of antibiotics, you will generally find that the levels of bacteria return to normal and your symptoms will soon disappear.


If you have a more severe infection, that includes swelling of the bowel as one of the symptoms, then you will need some form of treatment.  This will usually involve the use of antibiotics to kill the C. diff bacteria, and there are very few antibiotics that are able to do this.  Metronidazole and vancomycin are the two treatments that are most commonly used.  It can take up to ten days of using these for the treatments to subside.


A newer treatment that has been developed for C. diff infection is fecal microbial transplantation, or FMT.  This has been shown in studies to be more effective than antibiotics for treating the infection, though it is not yet used widely.  FMT involves taking a stool sample from a healthy person, mixing it with saline solution, and then transplanting it into the gastrointestinal tract of a patient.  This restores the normal levels of the natural flora, which helps to eliminate the infection.  The cure rate for FMT is 92 percent after one treatment, rising to 98 percent after a second transplantation.


When to See a Doctor?

If you have experienced any of the symptoms of a C. diff infection, you should seek advice from a colorectal specialist.  They will be able to test for signs of the bacteria, and provide a suitable treatment if it is found that you do have the infection.

What is C. diff and FMT?

4 May

C. diff is known in full as Clostridium difficile, and this is one of the “hospital superbugs” that has been making headlines in recent years.  It tends to infect patients who have been taking broad spectrum antibiotics, particularly on a long term basis.  This is because antibiotics affect the natural flora of the body in addition to the pathogenic (disease-causing) bacteria that are present, such as C. diff.  Once the natural flora of the body have been reduced in number, it means that there is more space and more nutrients available for use by the pathogenic species, which will flourish.  Once the C. diff bacteria have increased considerably in number, the toxins they produce will begin to cause the recognizable symptoms of the condition.


What Are The Symptoms of C. diff Infection?

Clostridium difficile infection may result in a variety of symptoms, and these may not occur immediately after taking antibiotics; in some cases, there has been a delay of up to ten weeks before recognizable signs begin to show.  The most obvious symptom is diarrhea, which will usually occur between three and five times a day.  It will be watery and foul-smelling, and may also contain blood.  This will generally be associated with pain and abdominal cramps.  These symptoms will occur in cases of C. diff, regardless of the severity – even mild cases will result in diarrhea several times a day.


However, more severe cases of infection will lead to additional symptoms, some of which may be extremely dangerous if left untreated.  In severe cases of C. diff, the large intestine (also known as the colon) can swell and become inflamed, leading to a condition known as colitis.  There will, as a result of the inflammation, be dehydration (also caused by diarrhea – the water cannot be absorbed into the body), weight loss, loss of appetite and more severe abdominal cramps.  A fever will also develop as the body’s immune system tries to fight against the infection.  Diarrhea bouts may also occur more frequently.


What is Fecal Microbial Transplantation (FMT)?

FMT stands for fecal microbial transplantation, and it is the latest method being used to C. diff infection.  It is, however, not a new idea, having first been used to treat humans in 1958, and its use in veterinary medicine dates back to at least the 17th century.  A stool sample from a healthy person who has no gastrointestinal infections and has not been taking antibiotics recently is taken, and saline solution is used to create a suspension.  This mixture is then placed into the bowel of the C. diff patient, using a colonoscopy procedure.


A colonoscopy is when a narrow, flexible tube is passed into the colon through the anus, usually to screen the lining for any abnormalities.  However, when used in the FMT treatment, the solution will be passed down a tube and flow into the colon.

The FMT procedure is intended to restore the natural levels of the bacteria that should be present in the gut.  The presence of the natural bacteria in their correct amounts will mean that it is more difficult for the C. diff bacteria to compete for the nutrients that they require.  This eliminates the infection and stops the symptoms from showing.

FMT is currently the most effective treatment available for C. diff infections.  In recent studies, it has consistently been found to be over 90 percent effective after a single treatment.  After two treatments, the cure rate is 98 percent.  The standard treatment, of the broad spectrum antibiotic vancomycin, has a cure rate of only 31 percent.  The use of antibiotics, though it may be effective in some cases, can disrupt the natural flora and this will allow the infection to recur.  Recurrence is unlikely with FMT, as these natural bacteria are still present.  However, fecal microbial transplantation is not yet accepted as the standard treatment for the condition, though it is becoming more widely available as studies consistently show that it is effective.

When Do I Need to See a Doctor?

If you have experienced any of the symptoms of C. diff, then you should contact your local colorectal surgeon for more advice, and to find out whether treatment is required.  Mild cases will often resolve without the need for treatment, but for more severe symptoms, this is not the case.

A General View of Beverly Hills Colonoscopy

8 Apr

Beverly Hills colonoscopy is performed to remove sample cells from the colon for biopsy, or simply to examine the colon. A patient who complains of gastrointestinal problems will often be advised to undergo a colonoscopy. Generally, people over 50 years old are advised to undergo colonoscopy once a year for prevention of colon diseases.

The procedure will only require a patient to spend a few minutes in the doctor’s clinic, and will not require hospital confinement. However, one has to prepare for the procedure as instructed by his doctor. This is for the purpose of ridding the intestines of anything that might stop the doctor from making a clear assessment of the colon’s condition. 24 hours prior to the procedure, the patient will no longer be allowed to take in anything, whether solid or liquid, except laxatives that will promote bowel emptying.

A patient should always follow doctor’s instructions before undergoing a colonoscopy, to ensure that the most accurate examination results are made possible.

Essential Tips to Help You Prepare for Your Colonoscopy

1 Apr

If you are scheduled for your first colonoscopy you may feel a bit apprehensive, and understandably so. The most important thing you can do to prepare for the procedure is to follow the directions and guidelines that your proctologist has given you.

It is essential that you follow the directions exactly as stated so your procedure can be performed properly. You also don’t want to put yourself at risk of painful cramps that can occur from not following the guidelines correctly. Here are just a few important tips to help you prepare for your colonoscopy:

  • Mix your laxative completely.
  • Drink plenty of clear liquid the day before.
  • Avoid red food coloring.
  • It is okay to drink the laxative at a cool temperature but not cold.
  • Drink each glass quickly.
  • Wear loose and comfortable clothing and pants that are easily removed.
  • Keep a supply of flushable wipes readily available.

These tips are basic tips for a colonoscopy procedure. The guidelines that were given to you by your proctologist will be more in depth.