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Stool transplant could provide cure for bacterial infection

Sunday, June 23, 2013 8:14 PM
Last updated Monday, June 24, 2013 2:00 AM
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Patients with chronic problems caused by life-threatening diarrhea from an overgrowth of a nasty bacteria could be facing an unsavory solution: ingesting someone else’s feces. 

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Dr. Satish S. C. Rao, the chief of Gastroenterology/Hepatology and director of Digestive Health Center, talks about the use of fecal transplant to restore a healthy balance of bacteria.  JON-MICHAEL SULLIVAN/STAFF
JON-MICHAEL SULLIVAN/STAFF
Dr. Satish S. C. Rao, the chief of Gastroenterology/Hepatology and director of Digestive Health Center, talks about the use of fecal transplant to restore a healthy balance of bacteria.

As bad as it sounds, researchers at the University of Alabama at Birmingham say fecal transplant, which is administered through a tube or a colonoscopy, can help restore the healthy balance of bacteria needed to overcome problems posed by clostridium difficile infections, which are linked to diarrhea that kills 14,000 people a year.

The problem stems from the widespread use of antibiotics to control bacteria and treat disease, which has led to overuse.

“Patients were trained that if you go to your doctor with something and you don’t leave with a prescription, then you’re not being fully treated,” said Dr. Craig Smith, the medical director for infectious diseases at University Hospital and chairman of the Georgia Healthcare-Associated Infec­tion Advisory Committee.

It’s not just the prescription antibiotics the patients are taking, he said.

“You also have to consider the literally tons of antibiotics used in agriculture, to have healthy meat, to have healthy milk, to have high-production farms,” Smith said.

That can have a big impact on the up to 100 trillion bacteria inside the colon, said Dr. Casey Morrow, a professor at the UAB School of Medicine.

“We’re inhabited by a huge number of microbes that we carry around with us,” he recently told a gathering of the Association of Health Care Journalists. “These are actually interacting with us” in functions such as digestion and absorption of nutrients. A healthy population would have a wide variety of bacteria, but antibiotics can wipe out many of the species, allowing resistant and virulent strains, such as clostridium difficile, to run wild.

Treatment with other antibiotics can often bring that infection under control, but in about 30 percent to 40 percent of cases the bacteria have become resistant and diarrhea and other problems persist, said Dr. Sa­tish S.C. Rao, the chief of gastro­enterology/hepatology at Geor­gia Regents Univer­sity.

The simplest solution would be to bring back the previous balance, Morrow said. A fecal transplant, rich in bacteria, seemed to be the solution.

A couple of landmark studies seemed to show that grinding up the stool of a donor – preferably someone close to the patient – mixing it into a solution and applying it through a colonoscopy appeared to work in stubborn bacterial infections, Rao said.

“They showed some dramatic improvement,” he said.

A New England Journal of Medicine review of 500 patients showed a cure rate of 80 percent to 90 percent, said Dr. Martin Rodriguez, an associate professor in the Division of Infectious Di­seases at the UAB School of Medicine. His institution has done eight such treatments, and for many a response is seen within hours or a day or two.

UAB has been administering a “microbiome transplant” through a feeding tube, and Rodriguez said some people just can’t deal with that.

“Some patients are like, ‘I’ll continue to have diarrhea and see how it goes,’ ” he said.

Georgia Regents Medical Center found the treatment helped one patient who had been hospitalized there three times and at every other hospital in Augusta, Rao said. The institution has created protocols by screening potential patients and donors and now, with less rigorous requirements from the FDA, stands ready to do more, Rao said.

The FDA told the Ameri­can Gastro­entero­lo­gical Asso­cia­tion last week that the treatment could be given with just informed consent from the patient. Previously, it said the treatment should be treated like a clinical investigation.

Smith said others have talked to him about doing the procedure at University Hos­pi­tal, but he said he has not had a patient who couldn’t be helped with antibiotics, and he would like to see more thorough research.

“I think that scientifically it makes sense,” Smith said. “But I think it is still a new therapy that is in evolution.”

Comments (13) Add comment
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soapy_725
44111
Points
soapy_725 06/24/13 - 04:56 am
2
0
This is just soooo ripe for comments........
Unpublished

we will all go back to the stone age.

soapy_725
44111
Points
soapy_725 06/24/13 - 04:58 am
2
0
How about the tons of preservatives American consume...
Unpublished

it s a wonder anything is processed in our bodies. And you want to do a comparative study of American Health vs. Europe or Asia. Its not what we eat, its how much preservative we consume.

palmetto1008
9782
Points
palmetto1008 06/24/13 - 05:37 am
6
2
Holy cow pie. Don't try this
Unpublished

Holy cow pie. Don't try this at home.

KSL
143745
Points
KSL 06/24/13 - 11:15 am
4
1
Not a new idea

Read a book in the 70's, written by a doctor who experienced success via a very unconventional manner.

nocnoc
49130
Points
nocnoc 06/24/13 - 06:17 am
5
1
All these years of being told

not to come in contact with fecal matter, because it is infectious and now the medical establishment wants to put someone else's into a person where the sun doesn't shine.

But (pun intended) IF it works and saves a life who am I to say, if a person is full of someone else's (fecal) and not his own?☺

Hopefully If it happens to me, I don't get a "Liberal's" donation

bdouglas
5777
Points
bdouglas 06/24/13 - 07:25 am
4
0
I've been accused of being

I've been accused of being full of you know what before, but never of someone else's you know what...

jrsc429
408
Points
jrsc429 06/24/13 - 08:04 am
3
0
what a crappy idea!

what a crappy idea!

allhans
24885
Points
allhans 06/24/13 - 08:28 am
3
0
I think I will by-pass this

I think I will by-pass this treatment.

itsanotherday1
48305
Points
itsanotherday1 06/24/13 - 09:06 am
3
0
I could handle it via

I could handle it via colonoscopy, but I would be like the patients who refused it via feeding tube. "I'll just live with my problem".

Young Fred
21006
Points
Young Fred 06/24/13 - 11:58 am
5
0
Overuse of antibiotics is a

Overuse of antibiotics is a decades old problem. Nice to see it get a little press. I wish the medical community nationwide would make a commitment to tackle this problem. I just fear it will never happen because of big pharma’s relationship with the med community.

BamaMan
2687
Points
BamaMan 06/24/13 - 12:30 pm
3
0
Whaat???

I thought I misread the article heading. Not!

kmb413
533
Points
kmb413 06/24/13 - 12:46 pm
4
0
This gives new meaning to

eat poop! (couldn't put the other word)

belle
311
Points
belle 06/24/13 - 01:04 pm
0
0
kmb413 you're right!
Unpublished

Only it will change the meaning because the full phrase was "eat (poop) and die!" now it will be "live". May even become a future term of endearment.

Jake
34052
Points
Jake 06/24/13 - 01:18 pm
5
0
Chinese Food

This treatment brings new meaning to the pu-pu platter.

Darby
29248
Points
Darby 06/24/13 - 03:03 pm
3
0
In the immortal words of Scarlett O'Hara,

"Oh, I can't think about this now! I'll go crazy if I do! I'll think about it tomorrow. "

Red Headed Step Child
4490
Points
Red Headed Step Child 06/24/13 - 03:36 pm
2
1
Oh no!! I just had a visual

Oh no!! I just had a visual of Scarlett O'Hara gnawing on a turd during that epic hunger scene...make it go away!!!

urright
465
Points
urright 06/25/13 - 07:28 am
1
0
Donor sites?

I can see it now--Democrat Community Poo Center. I wonder if you'll get a pin for donating a gallon!

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