Poop Transplant!!!!! By Dr Ritu Walia
DO YOU MIND IF I KEEP YOUR POOP
Stool transplanted from a healthy person (donor) to a sick patient is being widely performed across North America by gastroenterologists. This transfer of stool is done as to cure patients with chronic infections due to bugs such as Clostridium difficile and now more recently for inflammatory bowel disease. C. difficile infection diarrhea and affects about 3 million people per year. The rate of hospitalizations due to this infection amongst children in the United States has also increased tremendously. Typically, these infections are treated with antibiotics such as metronidazole and vancomycin. These antibiotics can also make the infection worse by killing off beneficial bacteria and allowing the C diff. to survive. These recurrent infections can be very severe in children and the elderly.
The art of stool transfer
The mere thought of the transfer of the good bacteria from the colon of one person into the colon of another — is just plain disgusting. But works according to Dr Rahil Khan, infectious disease specialist at the University of West Virginia. No matter how yucky it sounds-it works. It decreases the deaths and sickness due to bugs such as Clostridium diffcile infections. This infection is increasing and poses a huge burden on patients and hospitals for infection control.
Though there are many physicians who perform this procedure in adults, only a handful of physicians have been successful in performing this procedure in children. Dr. Sudhir Dutta and his team of physicians including Dr. Ritu Walia, Mohit Girhotra and Shashank Garg are one of the few physicians who have had success with therapeutically transplanting stool in children from a healthy person also called the donor.
This concept is not new but was used in china in the fourth century to cure patients with food poisoning or
severe diarrhea. The patient was made to drink the stool. It may sound evil but it cured the patient.
A two year old male patient was referred from Johns Hopkins to Dr Dutta and walia. He had many episodes of diarrhea due to Clostridium difficile. Antibiotics were given many a times but the child continued to have symptoms of diarrhea and blood in the stool. His weight and length started dropping. Dr Dutta and his team then decided to perform the stool transplant also known as fecal microbiota transplant. The morning before the procedure, stool was collected from the mother who was tested for many stool and blood infections. This stool was then made into a solution by the microbiology department. The patient received the mothers stool specimen into his intestine though a colonoscopy n.wikipedia.org/wiki/Colonoscopy done under general anesthesia. The patient's symptoms improved after 48 hours and now one year after the transplant he has gained weight and is thriving. He has not had any more symptoms of blood in his stool; stomach cramping that is commonly seen in patients with these bugs. www.today.com/.../fecal-transplant-mom-cures-ailing-t...
Dr. Dutta and his team of doctors Walia, Girhotra and Garg have since then performed this procedure in many other children. Dr. Dutta has also a vast experience of performing this procedure in the older population.
Dr. Sachin Kunde has used this technique in children with inflammatory bowel disease especially ulcerative colitis. Ulcerative colitis is an inflammation of the colon where the person’s immunity turns against them. These patients require steroids and other medications that suppress their immunity. Often these patients don't respond to any medication and often require surgical removal of the colon. According to Dr Kunde if conventional treatment fails then this technique of fecal transplant should be performed before sending a patient to surgery.
Fecal transplants — can be done by transplanting fecal material through an
enema, colonoscopy or nasal tube. There was a study presented last year where adult patients were given this stool in a capsule form.www.medpagetoday.com/MeetingCoverage/.../
Like every procedure there are some risks. It is important to rule out infections of the blood and stool from the donor before the stool sample is collected and used. Some other diseases also need to be eliminated before the donor sample is taken. Side effects of the procedure in children still need to be studied. If used in North America for indications other than C.difficile permission from the Food and Drug Administration is needed.www.fda.gov
Dr. Ritu Walia
West Virginia Univeristy, Charleston