Fecal Transplants
It's icky, it's disgusting. But you know, this is just an editorial comment by me. People got to get over this ick business. I mean, surgery is icky - Steve Mirsky
image by: The Peggy Lillis Foundation
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Fecal Transplants: The Straight Poop
So fecal transplants—what are they?
Fecal transplants are based on the understanding that all of us carry around in our gut, in our intestines, a complex community of bacteria that are actually larger in aggregate than the rest of us. There are actually more bacterial cells in our intestines than there are cells that belong to us in the rest of our bodies. And most of the time that incredibly complex community works in a really interesting harmony to do all sorts of things for us: to extract nutrients from our food, to tune up our immune systems, to keep our reactions to things in our environment, from revving out of control the way that allergies do, for instance.
But…
Resources
New evidence suggests there’s a much easier way to get a fecal transplant
Fecal transplants are an increasingly useful treatment for a range of ailments—but getting one is not a pleasant process. Now new research into the treatment of Clostridium difficile suggests there may be a much easier way to replenish the beneficial bacteria of the gut that’s just as effective: fecal pills, which are simply swallowed.
The Enema of Your Enemy is Your Friend
Evidence has been accumulating for years that gut infections can be treated by introducing beneficial bacteria. A reliable source of healthy bacteria may be healthy people’s feces.
The Excrement Experiment
FMT, the chief medical application of microbiome research to date, is also at a rudimentary stage. The procedure has been proven to work only in the case of a single disease: a bacterial infection known as Clostridium difficile.
When Feces Is the Best Medicine
Fecal transplants have been proven to successfully treat certain types of infection, but proponents of the treatment are still fighting what they say are unnecessarily strict regulations.
Fecal Transplant Is Linked to a Patient’s Death, the F.D.A. Warns
The agency said two patients received donated stool that had not been screened for drug-resistant germs, leading it to halt clinical trials until researchers prove proper testing procedures are in place.
Stool transplants are now standard of care for recurrent C. difficile infections
The main risk factor for CDI is taking antibiotics, which is why doctors discourage unnecessary antibiotic use. Ironically, first-line treatment for CDI is also antibiotics. About 20% of people treated with antibiotics will develop recurrent infections, and the best way of clearing recurrent CDI is with FMT. This is supported by several guidelines. The reason why FMT works so well is largely unknown, but generally speaking it restores important helpful bacteria that help protect against CDI. But while supported by guidelines, FMT is still considered investigational and is not currently FDA-approved.
The Latest Poop On Fecal Transplants Vs. Antibiotics For C. Difficile Diarrhea
How can more poop actually help with severe diarrhea? Isn't that like asking for buckets of water during a flood? Well, when the diarrhea is caused by the antibiotic-resistant bacteria Clostridium difficile, a poop (scientifically called fecal) transplant may help get to the bottom of the problem, according to a research letter published in the New England Journal of Medicine.
Updated Guidelines on Management of Clostridioides difficile Infection in Adults
Are there any changes regarding the use of fecal microbiota transplantation? Essentially, no. However, it should be noted that since the 2017, three separate safety alerts have been published by the U.S. Food and Drug Administration. Two alerts pertain to Escherichia coli transmission from donor to transplant recipients, and the other documents concern for SARS-CoV-2.
When Poop Becomes Medicine
But poop is no panacea either. Scientists have treating all kinds of disorders with fecal transplants with mixed results, while a burgeoning community of DIY enthusiasts have tried the treatment without due awareness of its many risks.
Fecal Transplants: The Straight Poop
Journalist and author Maryn McKenna talks about fecal transplants, which have proved to be exceptionally effective at restoring a healthy intestinal microbiome and curing C. diff infections, yet remain in regulatory limbo.
Vowst
The first and only FDA-approved microbiota-based therapeutic in oral capsules to prevent C. diff recurrence following antibacterial treatment. A clinical study showed that 2 months after taking VOWST, most people were recurrence free and continued to be even 6 months later.
Rebyota
REBYOTA (fecal microbiota, live – jslm) is indicated for the prevention of recurrence of Clostridioides difficile (C. diff) infection in individuals 18 years of age and older, following antibiotic treatment for recurrent C. diff infection. REBYOTA is delivered rectally to your gut microbiome, where it’s needed.
OpenBiome
We are a nonprofit stool bank, expanding safe access to fecal transplants and catalyzing research on the human microbiome.
The Fecal Transplant Foundation
Awareness and support for Fecal Microbiota transplant.
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