Did you know that your gut contains both good and bad bacteria? As long as these two are in balance, our health is fine. But sometimes, especially when you take harsh antibiotics, all these good bacteria get wiped out and bad bacteria start to take over. That's when you start to have serious problems like stomach upset and diarrhea that lasts for days. So, today we're going to talk about a somewhat strange but very effective treatment that can be given at times like these.
What is a fecal transplant?
The name may sound a bit strange, but it's a very simple, scientific procedure. Simply put, this treatment involves inserting a small sample of stool from a healthy person into the colon of a sick person .
Think of a garden that has been overrun with weeds. To make that garden flourish again, we need to add good soil, good seeds, and new plants. That's how it is with this. A stool sample from a healthy person is a "good soil and seeds" that contains thousands of beneficial microorganisms (microbiota) that have been lost in the gut of a sick person. When these good microorganisms are introduced into the diseased gut, they fight off the harmful germs there and restore the balance of the gut microbiome.
How does this treatment work?
Our gut is a tiny world inhabited by trillions of microbes. It's a delicate ecosystem. Most of these microbes are helpful to us, essential to our health. They are the ones who control harmful germs and protect us from disease.
However, some medications (especially antibiotics), diseases, and other factors can destroy these good friends in our intestines. This allows bad microbes to thrive, and the balance in the gut is disrupted. A fecal transplant is designed to restore this lost diversity. Thousands of good microbes from a healthy stool sample repopulate the diseased intestine, restoring its health.
What diseases can be cured by fecal transplants?
Currently, this treatment is most effective and recommended for one specific bacterial infection. That is, recurrent Clostridium difficile (CDI) infection . This C. diff is a stubborn bacteria that sometimes cannot be controlled by antibiotics, causing severe diarrhea. When antibiotics fail to cure the infection, fecal transplant treatment is very effective.
Importantly, this treatment has only been proven for C. diff infection, but research is ongoing.
Doctors are researching whether this treatment method could be useful for many other diseases, because the health of our gut directly affects our digestive system, metabolism, and immune system.
| Diseases that may be useful in the future (research stage) | |
|---|---|
| Digestive system diseases | Inflammatory Bowel Disease (IBD), Irritable Bowel Syndrome (IBS) |
| Metabolic diseases | Obesity, Diabetes |
| Other situations | Food allergies, Autism Spectrum Disorder (ASD), Depression, Multiple Sclerosis (MS) |
How is this treatment done?
There are several ways to introduce these microorganisms into a patient's body. Your doctor will determine the method that is best for you.
- Through a colonoscopy: This is the most commonly used method. A thin tube with a camera attached is inserted through the anus and passed along the large intestine. The prepared stool solution is then passed directly into the colon through the tube.
- Through endoscopy: In this, a tube is inserted through the mouth or nose and a liquid is injected into the stomach or small intestine. However, this method is less successful because the microorganisms have to travel a long distance to reach the large intestine.
- Enema: Liquid is introduced through a tube inserted into the rectum. This is more effective because the microorganisms go directly into the large intestine.
- Oral Capsule: This is like swallowing a pill. There are capsules that contain dried, prepared microorganisms. These capsules are designed to go straight to the large intestine, rather than dissolving in the stomach.
How to prepare for treatment in capsule form
Usually, your doctor will tell you to start taking these capsules two or three days after you finish taking the antibiotics for your C. diff infection. This is a three-day treatment. You will need to swallow four capsules a day. The day before you start this, you will need to take a laxative to cleanse your bowels. Then, you should not eat or drink anything for about 8 hours before taking the first set of capsules. This should all be done exactly as your doctor has instructed .
Where do you get the feces needed for this? Who is a donor?
For this purpose, stool is donated by completely healthy volunteers . This donor is selected after a very strict screening process.
Don't just think that this is something you can do at home. Every step, from the donor to the patient, needs to be done under medical supervision and in a sterile environment.
Before becoming a donor, the person undergoes blood tests, stool tests, and many other tests. This is to make sure that there are no diseases that can be transmitted through stool. Anyone with the following conditions will not be selected as a donor.
- Other severe bacterial infections (e.g. E. coli)
- Viral infections (e.g. hepatitis, HIV, COVID-19)
- Parasites in the intestine
- If you have recently used antibiotics
- Drug use
- Diseases such as Inflammatory Bowel Disease (IBD)
- Autoimmune diseases
- Having a family history of cancer
The stool sample, which is carefully examined in this way, is mixed with saline in a lab using a special method, filtered, and prepared into a clean liquid. Or it is dried and made into capsules.
What are the benefits and risks of this treatment?
The main benefit for someone suffering from C. diff infection is the high cure rate . This treatment is 80% - 95% effective in preventing re-infection after antibiotics. This is truly a major breakthrough.
Side Effects:
Minor side effects may occur for a day or two after treatment. These are normal and nothing to worry about.
- Bloating and gas
- Nausea and vomiting
- A little stomach discomfort
- Some people have fever and chills.
Serious Risks:
There is a very rare, but serious risk. That is, the possibility that some germs that were controlled in the donor's body may become active when they enter the body of a patient with a weakened immune system. But to minimize this risk, donors are very carefully screened and approved products are used. Therefore, it is very important to follow only an approved method recommended by your doctor .
It may seem strange to us that feces could be used as medicine, but for someone who has been suffering for months with a serious infection like C. diff, this new concept is a great hope.
Take-Home Message
- Fecal transplant is a highly effective and safe treatment for recurrent C. difficile (CDI) infection.
- This involves introducing healthy microorganisms into a diseased intestine and restoring its natural balance.
- For this purpose, donors who collect feces undergo a very strict medical examination. Therefore, the risk of contracting infectious diseases is very low.
- This is definitely not something that can be done at home or on your own. It must be done in a hospital or clinic under medical supervision.
- If you or someone you know has this condition, talk to your doctor about this treatment method to learn more.
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