Tuesday, August 21, 2012

Fecal Microbiota Transplant - From Trash To Treasure!

In order to understand why a person would have a Fecal Microbiota Transplant, we first need to understand the incredible history of Fecal Microbiota Transplants.

In 1958, Chief of Surgery at Denver General Hospital, Dr Ben Eiseman, reported in the Journal of Clinical Gastroenterology of four patients who were cured of pseudomembraneous colitis.  Enemas containing feces from healthy colons successfully replenished good digestive bacteria.  Pseudomenbranous is a painful, extremely debilitating and potentially fatal inflammation of the colon associated with a bacterium called Clostridium difficile. 

In the mid 1980s, Australian gastroenterologist, Professor Thomas Borody, who invented the triple antibiotic therapy for helicobacter pylori bacterium (the cause of stomach ulcers), was faced with one of the most difficult cases he had seen at that time.  His patient was a woman who had developed an incurable colitis through an unidentifiable pathogen after holidaying in Fiji.

He searched medical literature for alternative treatments and came across the paper which was published in 1958 by Dr Eiseman.  "So I looked at the method and I kind of made up the rest of it," Borody said.

The woman's brother donated stool which was screened for known pathogens.  Using a blender, and mixed with some brine (nowdays he uses normal saline) Professor Borody made a slush which he filtered to remove any solids.

He administered it to his patient by enema on two consecutive days.  The results were incredible and her colitis was gone within days! It never returned!

This was the beginning of an amazing medical story - one that is still evolving - one that has helped countless people regain normal lives after the ravages of clostridium difficile.  Both Dr Ben Eiseman and Professor Thomas Borody have something special as doctors.  The ability to "think outside the box".  Fortunately others have followed these pioneers into the new fronteer.

Fecal Microbiota Transplants are now being used across the USA with increasing frequency.  The cure rate for clostridium difficile has been quoted at between 90 and 95% success rate.  But it doesn't stop there - there are reports of reversal of symptoms and disease of ulcerative colitis, crohn's disease, parkinson's disease, multiple sclerosis, acne, autism and even obesity!  How could FMT possibly help with these diverse diseases and disorders?  Look for my next post and find out. :-)

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