Fecal Transplants / "Poop Transplants"

ogopogo3

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#1
From news-miner.com:

After several straight months of persistent diarrhea, a New York woman was exhausted, uncomfortable, and frustrated. She also was out thousands of dollars that she’d spent on drugs and hospital bills. The problem had begun while she was being treated with intravenous antibiotics for an infection that caused inflammation in her colon. In healthy people, pathogens like the Clostridium difficile bacteria responsible for the woman’s diarrhea are held in check by harmless intestinal microorganisms, poetically referred to as flora. By killing off these benign bugs, antibiotics often upset the balance of the gut ecosystem and leave it open to novel invaders or nasty, normally latent microbes.

Dorothy Ogden (not her real name) learned the hard way that antibiotic-associated diarrhea can persist in some people long after they’ve beaten their original infection and stopped taking antibiotics. No treatment for the diarrhea gave Ogden more than temporary respite, she says, until she agreed to undergo an unorthodox procedure at Montefiore Medical Center in New York.

Lawrence J. Brandt, a gastroenterologist at Montefiore, reseeded Ogden’s colon with some of her husband’s fecal matter—replete with a normal array of thriving microorganisms. By replacing the flora that Ogden had lost to antibiotics, Brandt revived the natural microbial competition.

Using good bacteria to obstruct bad ones—a strategy known as bacterial interference—is one application of so-called probiotics, a field with growing medical promise. The name suggests a twist on antibiotics, which kill disease-causing microbes. Some probiotic bacteria do their work by competing for resources and space with pathogens inside the body and, in effect, elbowing the bad bugs out of the way.

Others secrete byproducts that are toxic to a disease-causing microbe but harmless to people, trigger the host’s immune system to gird itself for battle against hostile bacteria, promote other responses in the host that stymie pathogens, or use several mechanisms at once, says Gregor Reid, a microbiologist at the University of Western Ontario in London, Ontario.

Many folks, however, find the idea of receiving bacterial transfusions to prevent or treat illness rather hard to take, especially when it requires a distasteful treatment. “A lot of people don’t like this procedure and won’t do it,” Ogden, now 72, recalls Brandt telling her before he described the fecal colonoscopy that he was recommending. Brandt mixed samples of the husband’s stool in saline solution and deposited globules of it every 10 centimeters along her colon. The application extended from Ogden’s anus to her cecum, about 150 centimeters away, which is as far into the intestinal tract as a colonoscope can reach.

The infusion seemed to restore the proper bacterial balance, and Ogden’s symptoms disappeared immediately, Brandt reported in November 2000. It was the first time that Brandt—or anyone, as far as he knows—had attempted the procedure, although simpler fecal enemas had worked in several dozen earlier cases.
 
A

Anonymous

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#2
i just bought some Actimel... claimed to restore intestinal flora.... im woundering just what the hell im drinking now!!!!!!!!!!!
 

intaglio

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#3
Why didn't they just use Actimel and live yoghurt? Thats a well known treatment. NB if you are taking antibiotics and develop mouth ulcers it might be because the drug is killing off your intestinal flora - try yoghurt.
 

Cult_of_Mana

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#5
Actimel, Yakult, certain live yoghurts etc probably all contain bacterial cultures derived from human gut flora. According to New Scientist magazine, vol 167 issue 2246, 08/07/00, page 17, the fruit drink ProViva contains the bacterium Lactobacillus plantarum 299v which was originally isolated from the stools of Swedes (humans not vegetables!).
Lactobacillus is one of the commensal organisms living in the human gut and is normally ignored and/or suppressed by microbiologists looking for pathogens.
Now you know why they all taste like s**t (not that I've ever tried any of these drinks and I've always hated yoghurt).
 
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#6
Medicine

From hand to mouth
May 25th 2006 | ATLANTA, GEORGIA
From The Economist print edition

A new superbug is stalking the world

Alamy
IF YOU are unfortunate enough to catch it, you will suffer from intractable diarrhoea with gut-searing pain and fever. If you are frail, you may die. Should you survive, you may be stricken by repeated bouts of sickness. The disease is so debilitating that some turn to a treatment that is stomach-churning in its own right: enemas containing the faeces of a healthy donor, often a spouse. Although methicillin-resistant Staphylococcus aureus (MRSA) is more famous, Clostridium difficile is a superbug to be reckoned with. Like many other infections caught in hospital, it is increasingly becoming resistant to treatment with antibiotics.

Ordinarily, the human colon harbours very few of the rod-shaped bacteria that cause Clostridium difficile associated disease or CDAD. But the guts of those people who are given antibiotics to prevent or treat infection during a stay in hospital are different. Antibiotics may rid the colon not only of harmful bacteria, but also of the beneficial ones that normally live there. This, in turn, can give C. difficile the chance to take hold.


Rates of the disease among patients in, or recently discharged from, American short-stay hospitals seem to have doubled between 2000 and 2003 and risen another 25% in 2004, the most recent year for which estimates are available. That translates into at least 225,000 new cases a year, according to the Centres for Disease Control, a government agency based in Atlanta, Georgia. As this number does not capture all of America's hospitals and ignores its nursing homes, the real figure is probably at least 500,000 cases a year.

What lies beneath
The full extent of the illness is unclear because American hospitals are not required to report it. Even when someone with the disease dies, his death certificate may not say he had it. Whatever the true numbers, about 20% of people infected have repeated bouts of the illness and some 1-2% of the stricken die; chiefly, but not exclusively, the victims are elderly people who are already in frail health.

Worryingly, the disorder is now being found in people who have not stayed in hospital. This new sort of case includes 48 pregnant women, one of whom died along with her fetus; others miscarried. Some of the people who seem to have caught the disease outside hospital had recently been on antibiotics; early studies suggest that others may have picked up the disease from eating infected animals or by taking medicines to combat heartburn and indigestion.

Australia, Belgium, Britain, Canada and Japan have been grappling with the problem, too. In Britain since January 2004, all health-care facilities in National Health Service trusts—not just hospitals—have to report every case in a person aged 65 and older. Acute-care hospitals in Quebec, in Canada, must report every case that strikes within a month of a patient's being discharged, regardless of his age.

Three American federal agencies—the National Institutes of Health, the Food and Drug Administration and the Centres for Disease Control—are so alarmed that they recently convened a workshop in Atlanta to determine what research is needed to tackle the disease.

Unlike many bacteria, C. difficile makes poison-forming spores. These spores are, in effect, reservoirs for infection. Only when they hatch in the intestines do they produce their toxins. About half the hospital patients infected after taking antibiotics have no symptoms of CDAD. But they still shed spores and so are carriers.

The spores can survive for months on virtually everything they touch: toilets, bedpans, bathroom floors, sheets, bed rails, call buttons, telephones and door-knobs. The spores cling to the hands of hospital staff, lurking under fingernails and rings. A good defence is for doctors and nurses to wash their hands meticulously with soap and water between seeing each patient, but that is not easy to enforce. Alcohol-gel hand-cleaners are more convenient than hand-washing, but are less effective. Household bleach is the most efficient killer of C. difficile spores, but most hospitals do not routinely apply it to every patient's room, let alone to communal areas.

What else can be done to combat C. difficile? Dale Gerding of the Loyola Stritch Medical School in Maywood, Illinois, wants a sensitive, rapid and affordable test for the diagnosis of CDAD and the prompt identification of carriers. Such a test could rely on a technique known as “polymerase chain reaction” to magnify a small sample to the point where testing becomes relatively easy. Several companies are developing such tests but none is ready for widespread use.

Moreover, there is a problem: C. difficile grows poorly in the laboratory—which is why it was named “difficile” when it was discovered in the 1930s. The name is still well deserved. Molecular biologists are still struggling to pin down the bacteria's genes and their behaviour—in order, among other things, to verify the apparent emergence of more virulent strains of the bacterium. Fortunately, there are other kinds of bacteria that form spores in much the same way as C. difficile does. These are being used to understand exactly how the genes responsible for making spores work, which in turn may make it possible to switch them off.

Can you get better?
Patients also need treatments to cure sudden, severe cases of the disease. Two drugs, metronidazole and vancomycin, are commonly prescribed for C. difficile, but both are antibiotics that can themselves predispose patients to relapses. Ciaran Kelly, a Harvard Medical School researcher, says that broad-spectrum antibiotics—used to treat many different kinds of bacteria—tend to make many species of bacteria resistant to them, and limit the treatments available for CDAD. Antibiotics designed especially to act against C. difficile would be far less likely to affect other bacteria: some in late-stage clinical trials give cause for hope.

Another advance could come from inactivating the spores. Two drugs that could have been useful—cholestyramine and colestipol—are already on the market. Unfortunately, their effects have, to date, been modest. Neither was developed for C. difficile, and they do not bind well to its spores. At least one newer candidate—tolevamer—could, in principle, do a better job by binding not to the spores but to the toxins they produce. It, too, is in late-stage clinical trials. Because it is a synthetic polymer, not an antibiotic, it should not destroy the good, protective bacteria along with the bad ones in the gut. At the very least it would be more pleasant than some of the treatments patients turn to today.


http://www.economist.com/science/displa ... id=6971098
 

OneWingedBird

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#7
The application extended from Ogden’s anus to her cecum, about 150 centimeters away, which is as far into the intestinal tract as a colonoscope can reach.
150cm of tube up your ...! OMG :shock:
 
A

Anonymous

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#8
Apparently baby cockroaches eat their mothers faeces so that they have microbes in their stomachs to digest food with.

Apparently they cannot survive without these microbes in their stomachs.

:blah:
 
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#9
All that things like Actimel do is put back in the bacteria modern processing removes.

The efficacy of probiotics is little clearer. In the old days, beneficial gut flora could be boosted by the live cultures found in plain yoghurt. However, industrial processing of cheap yoghurt with its high-speed machinery pumps the culture along miles of pipes and kills the live micro-organisms.

Today's probiotic foods claim to act by restoring the balance of microflora in the digestive tract. Many of the dairy-based functional foods contain lactobacillus and bifidobacterium bacteria, which are already naturally present in the gut and aid digestion. The theory is that eating extra good bacteria top them up and keep bad bacteria at bay. But does it work?

A report for the Food Standards Agency on probiotic products found that some of the added bacteria did not actually survive in the digestive system to reach the parts they were supposed to help. The strain used in Yakult was one of those that survived in some tests but not in others. The Japanese company says, however, that it has its own independent research to support its claims.

Danone, too, points to extensive research on the value of its probiotics and says various studies are underway to show that its added bacteria survive. It concedes however that "results reported by individual Actimel users can be as individual as their gut flora profile and overall diet and other lifestyle factors."

The independent Drugs and Therapeutics Bulletin says that the evidence as to whether probiotics work is patchy in relation to the gut and non-existent in terms of improving general wellbeing. The evidence for probiotic effect was strongest for helping with diarrhoea caused by antibiotics and infections or with flare-ups of inflammatory bowel disease. "There are a lot of, how shall we put it, interesting claims out there. We don't know whether they are true or not," says Michelle Smythe, of the Which? food campaign team. Which? wants products properly evaluated by regulators before they are sold.

One of Smythe's concerns is that probiotic foods claiming to be good for you are often high in other unhealthy ingredients. Two thirds of the probiotics Which? looked at were high in sugar, for instance Actimel has 14% added sugar, while Yakult has 18%. But without sweetening, these probiotics full of very sour bacteria would be simply "unpalatable", as Yakult puts it.
www.guardian.co.uk/food/Story/0,,1704888,00.html

Sounds like you'd be better off eating organic yoghurt - or not worrying about it ;)
 

EnolaGaia

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#11
Fecal transplants do entail risks. This news item describes the first documented case of a patient dying as a direct result of the procedure (or, more accurately, the material transplanted).
How a Man's Fecal Transplant Turned Fatal

A 73-year-old man is the first person known to die as a result of the procedure. ...

The first person known to die as a result of a fecal transplant is a 73-year-old man who developed a fatal infection with antibiotic-resistant bacteria that were in the donor's stool sample.

News of the man's death surfaced in June; he was one of two patients in separate clinical trials who became ill after receiving fecal transplants from the same donor, Live Science previously reported.

Both patients developed infections with a strain of Escherichia coli, or E. coli, that demonstrated resistance to different types of antibiotics. Details of the man's death were described in a new study published online yesterday (Oct. 30) in The New England Journal of Medicine. ...
FULL STORY: https://www.livescience.com/fecal-transplant-death.html
 
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