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Fecal Transplant May Treat Stubborn C. diff

Study Shows Procedure Can End Symptoms of Diarrhea

Tracking Results of FMT continued...

Many reported severe fatigue, 20-pound weight loss, and more than six bouts of diarrhea a day.

The FMT was done by colonoscopy (insertion of a lighted flexible tube into the colon), a common method, Brandt says.

After the fecal transplant procedure, patients answered a detailed questionnaire. The results:

  • At the three-month mark, 70 of 77 patients (91%) reported no diarrhea, considered a treatment success.
  • Another four recovered after an additional course of antibiotics.
  • Another two recovered after receiving both more antibiotics and another fecal transplant. That brought the total success rate to 76 of 77. The other patient, in hospice care, died.
  • Diarrhea resolved on average in six days, sometimes as quickly as in three. Fatigue went away in about a month.

No complications or side effects were reported. The cost of the procedure, which is currently done by a limited number of doctors, is often less than what several rounds of expensive antibiotics could cost, Brandt tells WebMD.

For the FMT, the main charge is the cost of the colonoscopy, which is often covered or partially covered by insurance. Colonoscopy can cost several hundred dollars or more. Among possible complications are tearing of the colon.

Brandt reports serving as a consultant for Optimer Pharmaceuticals, which makes fidaxomicin (Dificid), a C. diff treatment.

FMT Basics

FMT is not new. The first successful use was reported in 1958, with a transplant done by enema. In the U.S., the first case of FMT done by colonoscopy was reported in 2000.

Researchers try to get a stool sample from someone close to the patient, such as a spouse. They believe the healthy person will have exposure to some of the same bacteria, living in the same environment, so their stool will be a good match.

Before transplant, the donor's sample is screened for hepatitis, HIV, and syphilis, Brandt says.

Second Opinion

Martin H. Floch, MD, MS, clinical professor of medicine at Yale University, says that the process is simple. He reviewed the study findings for WebMD.

Although the new study reported no complications, Floch says it is possible some could develop later.

He cautions that the donor stool must be thoroughly screened to avoid disease transmission.

Overall, however, he considers the results good news. The 91% success rate, he says, is ''terrific. Nine out of 10 people doing this succeed, and remember these are resistant cases."

Although more study is needed, he says FMT should be viewed as a successful therapy for stubborn cases when medications don't work.

This study was presented at a medical conference. The findings should be considered preliminary as they have not yet undergone the "peer review" process, in which outside experts scrutinize the data prior to publication in a medical journal.

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