Faeces transplant may help relieve severe diarrhea: study

It may sound like the most unappealing treatment available, but a European study has concluded that inserting fecal material from a healthy person into the gut of somebody with severe diarrhea may cure their problem better than antibiotics.

The study, which appeared in the New England Journal of Medicine, involved patients who had repeated bouts of diarrhea caused by a bacterium known as Clostridium difficile, which can take over the intestines after antibiotic treatment has killed off the beneficial bacteria found in the gut.

About 3 million people in the United States are infected annually with the bacterium, known as C. diff, which spreads mainly through hospitals, nursing homes and doctors' offices.

When it controls the gut, it can be hard to eradicate. Antibiotics typically only work in 15 to 26 percent of patients with C. Diff, and after repeated rounds of treatment, the drugs become less effective.

"The efficacy of antibiotic therapy decreases with subsequent recurrences, and it seems reasonable to initiate treatment with donor-feces infusion after the second or third relapse," wrote researchers led by Josbert Keller of the University of Amsterdam.

Keller and his colleagues compared three treatments in a small trial.

Thirteen volunteers with C. Diff received a standard antibiotic four times a day for 14 days. After 10 weeks, four were free of bacteria-related diarrhea.

Another 13 patients had the same drug therapy after drinking a solution to clean out the bowel, known as bowel lavage. That worked in three cases.

The remaining 16 volunteers, had a brief treatment with the antibiotic, combined with bowel lavage, followed by the infusion of 500 milliliters of diluted donor feces through a tube that went into the nose, down the throat and into the small intestine.

In the three cases where the treatment failed, the doctors re-treated patients with fecal material from a different donor. That worked in all but one case.

... contd.

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