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.