June 7, 2023
Fecal Microbiota Transplants are an incredibly effective treatment for Clostridium Difficile infections. With success rates of 90% reported, it is now advocated for by many as a potential first-line treatment for the deadly infection. If you are interested in learning more about FMT for the treatment of C Diff infections, we cover the following below:
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Bacteria Lactobacillus, gram-positive rod-shaped lactic acid bacteria which are part of normal flora of human intestine are used as probiotics and in yoghurt production, 3D illustration[/caption]
Clostridium difficile, also known as “C Diff” and “C. difficile” is an infectious bacteria, which can cause a deadly bacterial infection known as C Diff Colitis. C Diff Colitis is mainly characterized by inflammation of the colon, leading to extreme and persistent gastrointestinal symptoms.
C Diff Colitis is an infection caused by the Clostridium Difficile bacteria and often develops after use of antibiotics. It is most commonly transmitted through surfaces contaminated with Clostridium Difficile spores. It is most often passed on from surface to hand, hand to mouth contact.
It is also possible to pass the infection from person-to-person. In general, the infection is contracted in hospital environments, while a patient's immune system is compromised (usually from antibiotic use). The infection has become increasingly common in recent years - last year, in the United States, almost half of a million C-Diff infections were reported.
The Clostridium Difficile bacteria can be carried without the carrier showing symptoms. Symptoms usually appear as a result of a compromised microbiome system, typically after the use of antibiotics. The symptoms are:
If you have recently taken antibiotics and are experiencing watery diarrhea or any of the symptoms listed above lasting more than 2 days, you should consult with your doctor, as it may be due to a Clostridium Difficile infection.
Some people are at a higher risk for C Diff infections than others. Things that can increase your risk are as follows:
Treatment options for C Diff depend on the regulations of your country of residence. Both antibiotics and FMT are the two main treatment methods for the infection. First-line treatment is usually antibiotics, and FMT is often used after the failure of antibiotic therapies. In the United States, FDA regulations specify that FMT can only be used after two or more failed attempts at antibiotic therapy.
The microbiome is the sum of all the bacteria, fungi, protozoa and viruses that exist in our bodies. There are different microbial communities in our bodies; they live on our skin, in our mouths, in our noses, and in our guts. They play a large part in the day-to-day functions of the body, including the regulation of the immune system and digestive system. The microbial community in the gut, or the gut flora, needs healthy bacteria in order to fight off infection when C Diff is present in the gut.
Clostridium Difficile Colitis is caused by a bacterial infection of the gut. It occurs when a compromised gut microbiome is exposed to the C Diff bacteria. If the gut microbiome doesn’t have the healthy bacteria necessary to stave off the C Diff bacteria, it can overtake, causing an infection.
FMT is an incredibly effective therapy for the treatment of Clostridium Difficile Colitis. Up to 90% of cases treated with FMT are cured, which is a far more effective rate than more common therapies like antibiotics. FMTs place healthy bacteria in the guts of those infected, displacing bad bacteria.
When FMT is performed on an individual suffering from a C Diff infection, good bacteria from a donor is transplanted into the upper part of the colon of the patient. The C Diff poop transplant bacteria are able to overtake the bad C Diff bacteria, and repopulate the gut flora with healthy bacteria. The exact bacteria responsible to fighting off C Diff is unknown, but the treatment continues to prove incredibly effective, despite the mystery of its methods.
Done in the proper clinical setting, with the right donor, a Clostridium Difficile fecal transplant is incredibly safe and effective, and yields a success rate of up to 90% - with no recurrence of infection. No other treatment demonstrates a success rate as high as FMT in treating the infection.
Despite this, it continues to be used as a last resort treatment, due in large part to its lack of consistency
(each donation would include an entirely different bacterial content), and the difficulty in classifying and regulating it. It is not yet fully approved in many places, like in the United States for example, where FMT is not actually approved, but there are no repercussions for using a stool transplant for C Diff as a primary treatment.
There is still lack of approval or lack of proper guidelines for FMT despite the fact that there have been two major reviews of collected data on patients treated with FMT for C Diff that demonstrate both its safety and effectiveness.
The first review, completed in November 2011, examined the data of published literature on FMT and found it to be 92% effective in 317 cases of C Diff. The second review, completed in April 2013, which looked at online medical databases for reports of FMT effectiveness in C Diff infections in 273 patients, reported success rates up to 95%.
There are few risks associated with FMT, but they are rare, and mostly mild. They include bloating, diarrhea, constipation, and gut lining perforation (extremely rare). There are reports of anecdotal side effects, but none that are considered general risks of FMT, as they are often singular cases.
If there are any long-term side effects of FMT, they are currently unknown at this time due to lack of data (or the fact that they may not be present).
Though FMT is proven to be highly safe and effective for the treatment of Clostridium Difficile Colitis, it is not widely practiced. Instead, most doctors prescribe antibiotics as a first-line treatment. A main reason this is the case is due to bureaucracy - and the fact that in places like the United States, the pharmaceutical industry is highly influential.
FMT as a means to treat C Diff is also a relatively new clinical practice, and the testing and approval process of new treatments can be long and arduous. Not to mention, trying to convince regulatory powers to classify poop as popular medicine has its challenges.
Access to fecal transplants for the treatment of a C Diff infection is dependant on where you live. If you live in Australia or England, access to the treatment is more readily available, but if you live in the United States, access is only permissible by the FDA after two or more failed rounds of antibiotics.
If you have a C Diff infection and have been prescribed antibiotics, but would prefer to try FMT, you should bring it up with your physician to see what can be done to accommodate your preference. FMT should always be performed by a skilled practitioner, who has the means to ensure a safe procedure, and you should never attempt to perform FMT on yourself.
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May 18, 2023
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