There is a fungus among us, or within us, to be specific; fungi, plus yeasts, viruses, and bacteria. These bugs and bacteria all form what is known as the human microbiome. The microbiome is a kinetic system that evolves over time as we pick up bacteria and viruses from foods, animals, others, and the environment. How we respond to this outside material depends on the balance of microbes and bacteria within our microbiome at any given time.
The increased use of antibacterials and antivirals has been a mixed blessing for the microbiome. Although both have helped prevent and defeat harmful bacteria and viruses, long-term use and reliance have depleted the body’s natural ability to stave off infection. Similarly, antiviral use kills off not just the ‘bad’ bacteria, but also the ‘good.’ The movement now is to boost the ‘good’ bacteria in the microbiome through pre- and probiotics. But when faced with a severe infection or gastrointestinal distress, it remains unclear whether probiotic rich foods like yogurt and sauerkraut are enough to rebalance the system.
What Is A Fecal Transplant?
Fecal microbiota transplantation (FMT) is a method of transferring the stool of one person into the intestinal system of another. The idea is that introducing the healthy microbia from one into the system of another will promote new, positive bacterial growth to help combat the source of the recipient’s distress. FMT is an old technique used historically to treat gastrointestinal complications that has come back into view for its effectiveness in treating Clostridium difficile (C. difficile), a severe infection causing diarrhea and colitis.
Most FMT is conducted by a provider in a clinical setting. The common method is transplantation using a colonoscope under general anesthesia. It is typically a one-day, one-time procedure, with immediate results; however, some patients have required repeat visits.
Who Can Benefit From A Fecal Transplant?
To date, FMT is most effective – over 90% – for patients suffering from C. difficile. Patients who contract C. difficile often have unstable microbiomes, either from repeat antibiotic use or advanced age. The dilemma is that the traditional treatment for the infection is a rigorous course of antibiotics to rid the body of the virus. While this works in most cases, many suffer repeat attacks or chronic reinfection. Relatedly, continued antiviral use to combat the infection ends up further depleting the microbiome, and thus the body’s ability to stave off relapse.
FMT has gone from a rare, last ditch effort to a first line treatment for doctors treating patients with C. difficile. The high rates of immediate and sustained long-term success have propelled patients to move past the ‘ick factor,’ and the procedure is gaining traction. From New York to California, physicians across the US are increasingly presenting FMT as a new treatment option to reverse the harmful effects of C. difficile.
FMT is also being tested for Crohns disease and ulcerative colitis, though the results remain inconclusive. Anecdotal evidence suggests that FMT may one day be used for allergies, obesity, and constipation. As the research continues, physicians seeking to reduce gastrointestinal disease look optimistically to the microbiome as a new frontier to relieve patient distress and improve health and wellness.
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