The Promise of Poop: Faecal transplants to treat C. difficile infection – An age old therapy moving into the light?

Clostridium difficile – a hospital superbug?

Clostridium difficile is a bacterium that is commonly found in the environment around us – in soil, air and water. C. difficile is also present in the gut of up to 3% of healthy adults and 66% of infants, but rarely causes any problems in healthy people. This is because it is usually kept in line by the normal bacterial population in the intestine. However, when people undergo antibiotic treatment, this can disrupt the balance of bacteria in the gut, allowing C. difficile to rapidly multiply and cause illness. C. difficile infection (CDI) can result in very mild diarrhoea, but can also result in some particularly nasty, life threatening symptoms, that in the extreme can lead to someone having their colon surgically removed.

Clostridium difficile
Clostridium difficile – a ubiquitous bacterium

CDI is the leading cause of infectious diarrhoea in healthcare institutions worldwide, and the problem doesn’t seem to be going away anytime soon. In fact, over the last decade CDI has become more frequent, more difficult to get rid of fully and more often actually causes death. This is thought to be due to the emergence of more aggressive C. difficile strains.

CDI is commonly treated with antibiotic therapy, but this is by no means the perfect treatment option as it is becoming increasingly associated with treatment failure and return of infection. In addition, CDI weighs a heavy financial burden on healthcare systems across the world, each case costing approximately £4000. This particular conundrum has led to a race in the development of alternative treatment therapies for the disease and has recently reignited the interest in an age old therapy: the faecal transplant.

What is a faecal transplant?

The faecal transplant has been knocking around for centuries, with its first use to treat diarrhoea being described all the way back in 4th century China. Possibly one of the reasons it hasn’t proved so popular is due to the fact that it sounds so disgusting. The faecal transplant involves the transfer of poop from a healthy individual to the gut of a patient to cure their disease. Obviously, there is only one of two routes to administer this lovely load; via a nose tube directly into the stomach (apparently rather unpleasant when the patient burps) or through colonoscopy. I think we can all agree that neither of these options seems at all appealing, but treating patients with CDI with faecal transplants does seem to work.

Indeed, clinical trials suggest that the faecal transplants are both well tolerated and very effective. In the most recent study carried out in the Netherlands, published in the New England Journal of Medicine earlier this year, it was found that that faecal transplants cured 15 out of 16 patients with recurring CDI – a 96% success rate compared to less than 30% for standard antibiotic therapy.

So, what is the science behind a faecal transplant and why does it work?

It is estimated that over 4000 bacterial species reside in the gastrointestinal tract, and amazingly, we are inherently outnumbered by the number of bacteria that live in our body. The human microbiota contains as many as 100 trillion bacteria, which is ten times greater than the number of human cells in our body. Not to worry though folks, these bacteria are friends, not foes.

In fact, it has become very apparent in recent years that friendly bacteria residing in the gut do their bit to keep us healthy. A number of diseases, including cancer, inflammatory bowel disease and arthritis, are linked with changes in the make-up of the types of gut bacteria. With respect to C. difficile infection, the disease most commonly arises in patients who have undergone antibiotic therapy, which results in the disruption of their normal intestinal microbiota. Antibiotics can wipe out the good bacteria in the gut that usually provide a protective defence against C. difficile, allowing it to flourish and cause infection.

With this in mind, a faecal transplant doesn’t seem so daft. Transferring poop from a healthy donor to the gut of a patient with CDI is thought to restore the good bacteria for them to help fight C. difficile, preventing any further disease.

Can we get past the yuck factor?

We know that the results from clinical trials suggest that the faecal transplant not only works, but is well tolerated: the two gold stars with respect to disease therapy. But the fact remains that the faecal transplant is also, quite frankly, gross. People often don’t like the thought of taking others seconds or leftovers – is this treatment taking it one step too far?

Testimonials from patients treated with the faecal transplant suggest quite the opposite; these patients have won their battle with CDI and changed their life thanks to the unusual therapy. They are all more than happy to recommend it to others.

Yes, we know that the faecal transplant is not pretty, but neither is the possibility of major surgery leaving us with a stoma bag because all other treatment has failed.

Which option would you choose?

SSAThis post, by author Hannah Simpson, was kindly donated by the Scouse Science Alliance and the original text can be found here.

3 thoughts on “The Promise of Poop: Faecal transplants to treat C. difficile infection – An age old therapy moving into the light?

  1. Wow! That was most certainly informative! I am disgusted, slightly confused and ever so impressed by this phenomenal cure to treat C. difficile infection. We all know that there are always far too many risks when undergoing surgery and will do anything to avoid it. Anything? Transferring faeces from one individual to another seems a bit daunting and ludicrous if i must say! But if it cures the infection why not? What i do want to know however, is if there is perhaps a possibility of transferring any potential diseases that may lie within faeces from the donor to the new patient? And how exactly is this particular procedure performed? I am intrigued by this article and definitely agree on going the natural way! I would do it. Every human being strives for a longer healthier life at whatever price it , evidently…

  2. This is rather interesting even though the concept is quite disgusting – but if it works why not? It would be remarkable is if people could find a successful way for harvesting the bacteria or even growing them and administering them in the form of medication. Whilst I do understand that trillions of bacteria are required, other scientific research (organs on a chip and a gut on a chip by Geraldine Hamilton) proves that almost anything can be done. If the all the science came together would this not be possible?
    Payal
    14103908

  3. Hi there!

    My name is Heather Von St. James and I’m reaching out to you today in hopes that you will help me with a cause that is very near and dear to my heart.
    Eight years ago, I was diagnosed with mesothelioma; a rare and deadly cancer caused only by exposure to asbestos. I had just given birth to our daughter Lily, and was only given 15 months to live. After a life saving surgery that included the removal of my left lung, I’ve made it my life’s mission to spread awareness about mesothelioma and the dangers of asbestos.
    My father had worked in construction and would come home with dust all over him. As a child I would wear his work coat, unknowingly exposing myself to the asbestos he worked with daily. Mesothelioma was once considered a ‘man’s disease’, but women have swiftly become the new patient profile due to second-hand exposure.
    In honor of National Women’s Health Week (May 11-17), I am reaching out to bloggers to ask for help in spreading the word about mesothelioma and it’s causes. During this week, individuals, families, and communities work to help women learn how to achieve longer, healthier, and safer lives! Although this week has passed, women’s health is an important issue and deserves to be shared.
    The site I blog for, the Mesothelioma Cancer Alliance, has a great deal of information on mesothelioma and asbestos exposure. It would mean the world to me if you could help me with my mission by spreading awareness on your blog to help educate and inform your readers about this preventable disease!
    Hope to hear from you soon!
    All my best,
    Heather
    http://www.mesothelioma.com/blog/authors/heather/

Leave a Comment

Share This