Fecal Microbiota Transplantation: Gross Yet Effective

The new big thing in medicine is fecal microbiota transplantation. While the very name of it sounds like most patients would like to opt out if offered, this approach has recently proved to be effective in treatment of various gastrointestinal problems, including C. dif. colitis.

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The beasts within

Inside your colon, there is a world of diverse bacteria inhabiting it, cooperating and fighting for their place in the sun (well, or whatever is valued in the colon environment). Some of the microorganisms dwelling in it are beneficial – they help digest food, produce important chemicals, and fight off pathogens. Others are hostile and would like to edge out their beneficial counterparts: if they do not manage to do it, the body is healthy; if they succeed, it marks the onset of a disease. There are also bacteria staying on the sidelines, sitting on the fence and blissfully watching someone else’s fight as they nibble at what you have recently eaten.

Over the years, the research into the issue of the impact microbiota has on the body has evolved. Today, many health problems are linked to a lack of balance between different bacteria varieties. When a person is born, he or she inherits their microbiome from their mother, but then other factors come into play: what we eat, what we do, where we live, etc. That is why every microbiome is unique. When this balance is disrupted, problems ensue.

When one variety prevails, either due to antibiotic use or some other reasons, a disease is likely to strike. For instance, Clostridium difficile can bring on C. dif. colitis, and the diarrhea it causes may range from mild to life-threatening. It is often treated with antibiotics, but a new approach which is now gaining ground is fecal microbiota transplantation, or, as it is commonly abbreviated, FMT.

How it works

Here is what the method implies. A healthy donor, who must meet rigorous criteria, donates his or her stool. It is then screened for pathogens, parasites and other things that should not be shared with the recipient. Commonly used tests include the same set that is used for screening blood samples, such as hepatitis of various kinds, HIV, etc. Then this stool is diluted using a saline solution. Here is what it looks like.

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Then the strained solution with donor microbiota is implanted in the patient’s colon. It can be done by means of endoscopy (it is rarely used), an enema (also not the preferable option), or a colonoscopy (the most popular way of reintroducing healthy bacteria).

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After the balance in the colon is restored, pathogens that tried to conquer the body are eliminated, and the symptoms vanish. It is not only C. dif. colitis that can be treated this way: research is underway to find out if it can help manage Crohn’s disease, irritable bowel syndrome, obesity, and even ulcerative colitis.

Say no to DIY FMT!

While the approach may appear to be gross, it turns out to be an effective way of tackling some gastrointestinal problems. However, there is an important thing that must be understood: do not try this at home. This therapy is still being researched, and even if you manage to reintroduce the donor microbiota, it may lead to adverse effects. You cannot be sure the donor who provided you with their stool is healthy. Scientists pick donors meticulously, performing a wide range of tests, and very few people qualify (in the OpenBiome project, only 40 volunteers out of the first 1,000 applicants qualified!). If you introduce unhealthy microbiota, it can exacerbate your symptoms and cause new health problems (for instance, receiving a sample from an obese donor can result in your gaining weight fast).

In the video below, Mayo Clinic experts explain what FMT is and how it works.

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