Faeces transplant may help relieve severe diarrhoea

It may sound like the most unappealing treatment available, but a small new study has concluded that inserting faecal material from a healthy person into the gut of someone with severe diarrhoea may cure their problem more effectively than antibiotics.

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

One transplant of faecal material from a volunteer — with its mix of healthy bacteria — resolved severe diarrhoea in 13 out of 16 volunteers. Standard treatment with an antibiotic, in comparison, worked in four of 13 patients.

"This is the first hard evidence that has been provided for the treatment," senior author Dr. Josbert Keller of the University of Amsterdam told Reuters Health.

"Those of us who do it know how effective it is," said Dr. Colleen Kelly of Brown University's Alpert Medical School in Providence, Rhode Island, who was not connected with the study but uses faecal transplant in her practice.

About 3 million people in the U.S. are infected annually with C. diff, which spreads mainly through hospitals, nursing homes and doctors' offices.

The bacterium underlying the problem is called "difficile" for a reason. When it controls the gut, it can be difficult to eradicate. Antibiotics typically only work in 15 to 26 per cent of patients with C. diff. - and after repeated rounds of treatment, the drugs become less effective.

"I've done 90 of these now in the last four and a half years. In patient after patient who has failed multiple courses of antibiotic, if you give them a dose of stool, they get better," she told Reuters Health.

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