Called a fecal transplant, the stool of a healthy patient is directly transplanted into the colon of a C. diff patient to replenish the normal bacteria in the colon. C. diff infections typically happen following repeated doses of antibiotics, causing the healthy bacteria in the colon to be killed off. That is when infection can occur, and patients often experience severe bouts of diarrhea that over time can be life-threatening. C. diff is one of the most common hospital-acquired infections.
As reported in the August 2013 edition of Mayo Clinic Proceedings, in a two-year study between January 2011 and January 2013, 31 patients with two or more episodes of recurring C. diff were treated with a fecal transplant at Mayo Clinic.
Eighty-seven percent of those patients experienced relief within one week. No serious adverse events directly related to the fecal transplant were reported. Improvement or resolution of their diarrhea occurred in 97 percent of the patients.
A fecal transplant works like this: Once the stool sample is collected from a healthy donor – often a family member or friend – the material is mixed with saline and filtered before being readied for transplant. Donors are screened to assess their general health and eligibility and are excluded if they have gastrointestinal or other disorders of the bowel, or if they have used antibiotics within three months preceding the study.
Participants in the study were administered the liquefied stool via colonoscopy so that the healthy bacteria solution could be delivered throughout the colon– the site of most C. diff infections.
The study was led by Neal Patel, M.D., Gastroenterology; John DiBaise, M.D., Gastroenterology; Robert Orenstein, DO, Infectious Diseases and Cheryl Griesbach, R.N., Gastroenterology, all from Mayo Clinic in Arizona.
“The incidence of C. diff has risen sharply over the past two decades,” says Dr. Orenstein. “Although half of all C. diff cases occur in people under age 65, it is a huge problem for the elderly. They have few conventional treatment options. However, one therapy – fecal transplantation – has proved to be highly effective in eradicating C. diff and restoring healthy bacteria in the gut.”
Dr. Orenstein adds that on the basis of published data, fecal transplantation is the most effective therapy for repeated bouts of C. diff, although it remains an investigational treatment.
“Social stigma and the ‘ick’ factor have often been cited as reasons to avoid fecal transplantation,” he says. “But none of the patients we treated, who were miserable because of their health issues related to C. diff, felt that way.”
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