An unconventional therapy that uses donated human stool to treat the highly contagious and potentially fatal C.diff is safe and beneficial, according to a new study being presented at the annual Infectious Disease Society of America Meeting in San Diego.
A team of investigators discovered that 43 out of 49 patients recovered quickly after treatment and had no negative side effects from C.diff three months after. Treatment was given through a nasogastric tube or colonoscopy, on an outpatient or inpatient basis.
Mayur Ramesh, M.D., a Henry Ford Infectious Diseases physician and senior author of the study, says the treatment, while unusual, has promising results:
“More than 90 percent of the patients in our study were cured of their C.diff infection. This treatment is a viable option for patients who are not responding to conventional treatment and who want to avoid surgery.”
During the study, researchers examined 49 patients who contracted Clostridium difficile, or C.diff, a bacterium that produces diarrhea and other severe intestinal problems, and also causes 14,000 deaths annually.
Symptoms of C.diff include water diarrhea, fever, loss of appetite, nausea, abdominal pain and tenderness. It is found in patients taking antibiotics, and easily passes from person-to-person or from contact with contaminated equipment and objects like door knobs.
People infected with C.diff infection are generally treated with the antibiotics metronidazole or vancomycin.
In some cases, surgery may be required to remove the infected part of the intestines. In this particular study, patients were treated between May 2010 and June 2012 with a therapy known as intestinal microbiota transplantation (IMT), which uses donated stool from a health family member.
They then mixed the healthy stool with warm tap water and used it to re-establish the regular intestinal flora into the patient’s gastrointestinal tract. Intestinal flora is healthy bacteria that trigger the immune system and help the digestion and absorption of food.
Dr. Ramesh says:
“Patients who receive treatment through a nasogastric tube don’t taste or smell the stool mixture as it’s administered. Patients often resume their diet within a couple hours and are feeling better within 24 hours.”
Forty-three patients fully recovered, four died of causes unassociated with C.diff, one had intestinal surgery, and one showed no improvement, out of the 49 patients in total.
In May 2011, doctors at Sinai Hospital performed fecal transplant procedures on two patients with severe C. diff colitis. Neither of them had responded to routine antibiotic or other treatments.
One patient, Elen Blackwell, had been struggling with C. diff for one year before undergoing the procedure. Blackwell said “My choices were to lose my colon, die or have a fecal transplant from a loving donor. I had no choice. This saved my life.” The donor was her daughter.
Written by Kelly Fitzgerald