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posted: 10/31/2011 6:00 AM

Fecal transplantation shows results against bacterial infection

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Although most of the time, we try to avoid contact with fecal matter, there may be one situation where it could save your life. Traditionally, feces are associated with disease and death. With the advent of plumbing, the rate of infections like cholera dropped quickly … and this was before the discovery of effective antibiotics. Plumbers have had a much greater impact on disease than physicians, medications and medical procedures combined. However, for one infection by the bacteria Clostridium difficile, using fecal matter may be the best choice.

Clostridium difficile is the bacteria that cause the most serious form of antibiotic-associated diarrhea and the life-threatening medical conditions, pseudomembranous colitis and toxic megacolon.

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Clostridium difficile infection is not uncommon in hospitals and nursing homes where antibiotics are commonly used. Clostridium difficile infection rises quickly with the length of a hospital stay. After four weeks in the hospital, the infection rate can be 50 percent or more. Among the elderly, mortality rates are as high as 30 percent and are steadily rising. One strain is now resistant to even the most powerful antibiotics. This is one really serious infection.

The most common cause of Clostridium difficile infection is antibiotic use. Although its growth is kept in check by the other bacteria in the bowel, Clostridium difficile can remain dormant in the bowels for years as a spore. However, when a person takes antibiotics and much of the normal bacteria are killed, the Clostridium difficile spores germinate and grow uncontrolled causing a serious infection.

The treatment for Clostridium difficile infection is stronger antibiotics to kill the Clostridium difficile, but these antibiotics also kill the good bacteria needed to limit Clostridium difficile growth. Antibiotic use also increases the risk of bacteria developing antibiotic resistance. In contrast, introducing good bacteria into the bowels (fecal transplant) has a cure rate of more than 90 percent, thus curing disease naturally.

Fecal transplant is based on the concept of using probiotics (good bacteria) to prevent or treat disease. In this case, the feces of a healthy donor are used to reseed the bowel with good bacteria to suppress the growth of Clostridium difficile.

The healthy donor is usually a close relative who has been tested for bacterial, viral and parasitic pathogens. The donor feces are diluted with salt water or milk and then administered either as an enema or via nasogastric tube directly into the intestines.

Fecal transplantation is not a new concept. Since 1958, there are more than 100 published medical reports and studies in the medical literature. It is more successful than antibiotics alone and does not contribute to bacteria developing antibiotic resistance. In all of the studies, fecal transplantation results in a complete cure in more than 90 percent of the cases.

The biggest problem is that the traditional medical community has been very slow to accept fecal transplantation. However, considering that the best traditional medical therapy may cause or exacerbate the very disease it treats and fecal transplantation is almost risk free and has a high cure rate, maybe fecal transplantation should be a first-line therapy instead of the "last resort."

• Patrick B. Massey, M.D., Ph.D is medical director for complementary and alternative medicine for the Alexian Brothers Hospital Network. His website is alt-med.org.

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