Bacteriotherapy: what is this method and to whom it …

Health Tips

Fecal microbiota transplantation (FMT), fecal transplantation, fecal therapy, fecal bacteriotherapy and, finally, fecal transplantation – all these are different names for one very strange, but very effective method of restoring the natural microflora of the human intestine, recognized by official medicine.

Fecal transplantation consists in using the natural capabilities of bacteria that are harmless to humans to displace pathogenic microorganisms by transferring the stool of a healthy donor into the gastrointestinal tract of the recipient.

normal intestinal flora

In the gastrointestinal tract of a healthy person, there are hundreds of species of various bacteria that are in a state of equilibrium with each other. These bacteria, which make up the normal intestinal flora, are essential for efficient digestion and play an active role in preventing allergic reactions and maintaining the body’s immune function.

All of them work to maintain balance and, with the help of self-regulation, prevent the dominance of some bacteria over others. If this balance is disturbed, as, for example, often happens after the use of antibiotics, the result can be disastrous for the gastrointestinal tract.

In most cases, the digestive system of a healthy body is able to restore the balance of the intestinal flora on its own. However, for some people, the only possible way to improve intestinal health is fecal bacteriotherapy.

When antibiotics kill too many of the “good” bacteria in the gastrointestinal tract, fecal transplants can help replenish the bacterial balance.

Indications for fecal transplant

The indication for bacteriotherapy is pseudomembranous colitis. It is a serious infectious disease caused by the antibiotic-resistant bacterium Clostridium difficile.

Although Clostridium difficile can be found in the stool of healthy people, this bacterium is not capable of long-term existence in the normal intestinal microflora. Clostridium difficile starts its pathogenic action when the balance of the normal microbiota is disturbed, usually caused by taking a number of antibiotics and leading to its overgrowth. Against the background of the death of normal intestinal microflora as a result of taking antibacterial drugs, the patient develops pseudomembranous colitis.

In 30 percent of patients, after taking a course of antibiotics, the infection returns again within a few days or weeks. As a rule, a repeated course of antibiotic therapy is prescribed to treat a relapse, which disturbs the balance of the microbiota and causes such severe side effects as chronic diarrhea, painful stomach cramps and in some cases fever – all this, in turn, in addition to the discomfort delivered, can increase the risk of more severe infectious diseases. In this case, fecal bacteriotherapy can become a reliable alternative to antibiotics to break the vicious circle.

The results of a study published in the New England Journal of Medicine showed that fecal transplantation was more effective in preventing recurrence of pseudomembranous colitis than oral antibiotics. At the same time, the efficiency rate of fecal bacteriotherapy reaches 91%. It not only helps fight infection, but also restores the natural balance of microorganisms in the intestines.

Disgust is perhaps the main reason why people still continue to refuse this effective method of treatment. However, due to the severity of the symptoms and the often recurrent gastrointestinal disease, the concept of faecal donor transplantation is becoming more acceptable to many patients.

Choosing a donor

Once you decide to have a transplant, you will need to identify a potential fecal donor.

As a rule, a healthy partner or relative is considered an ideal candidate for donation, but relationship is not a mandatory selection criterion. Anyone can volunteer to contribute to the good of your gut.

However, before stool sampling, the volunteer will have to undergo a medical examination, including a blood test for hepatitis A, B, C, as well as HIV and syphilis. In addition to a blood test, feces will also need to be sent for research. It will be tested for worm eggs, parasites, Clostridium difficile, Giardia antigen, as well as culture and sensitivity.

Also, donor candidates will have to undergo a special screening by answering “yes” or “no” to the statements below. A positive answer to at least one statement will be a reason for disqualifying a potential donor.

  • Taking antibiotics in the last 6 months
  • immune deficiency.
  • Tattoos or piercings within the last 6 months
  • Taking drugs
  • Stay in places of detention
  • Recent trips to epidemiologically dangerous countries
  • Chronic infections of the gastrointestinal tract

Transplant technique

There are 3 ways to transplant feces: colonoscopy, enema, and feeding tube. However, the most common of these is a colonoscopy, which is usually preceded by a simple preparation.

All antibiotics should be stopped 2 days before the procedure. The day before the colonoscopy, a liquid diet should be followed. In the evening, do an enema and take a laxative.

A faecal sample is obtained from the donor six hours before the transplant procedure. It is examined and tested for intestinal parasites and other infections that may disqualify the donor. If the sample is suitable, it is prepared for transplantation by mixing with sterile water and repeatedly filtering through a coffee filter.

Directly during the procedure, which takes place under intravenous sedation, a flexible endoscope is inserted into the rectum, which is then passed up the entire colon. The donor stool is delivered to the intestine as the endoscope is withdrawn.

Despite the effectiveness of the method, doctors warn: today, pseudomembranous colitis is the only indication for fecal transplantation. Bacteriotherapy performed for any other clinical indication should be considered experimental and carried out only as part of a clinical trial. .

Text: Elizaveta Petrova

Photo: Vostock-photo

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