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Stool Transplant Effective For Treating Intestinal Disorders, Claims Study

A recent study conducted by researchers at the University of Adelaide suggests an effective treatment for ulcerative colitis, a type of inflammatory bowel disease (IBD). The study asserted that faecal microbiota transplantation (FMT), commonly termed as 'poop transplant' can be effective in the treatment of intestinal disorders, especially ulcerative colitis.

What Is Poop Transplant?

Although the term may sound silly, it is the commonly used term for faecal microbiota transplant (FMT) which also goes by the name stool transplant. FMT is the process of transplantation of faecal bacteria from a healthy individual into a recipient, by restoring the colonic microflora by introducing healthy bacterial flora through the infusion of stool.

The process is done through colonoscopy, enema, orogastric tube, or by mouth in the form of a capsule containing freeze-dried material, obtained from a healthy donor. FMT has been widely used for the treatment of Clostridioides difficile infection (CDI), which can cause diarrhoea to pseudomembranous colitis [1] [2] .

FMT has been used experimentally to treat other gastrointestinal diseases, including colitis, constipation, irritable bowel syndrome, and neurological conditions such as multiple sclerosis and Parkinson's [3] .

And the recent study by the group of researchers asserted that the treatment method has aided in improving the condition of people affected by intestinal disorders. Let's take a detailed look at the study.

FMT Can Improve The Symptoms And Reduce The Severity & Pain

Upon carrying out the study, the researchers found out that FMT can help in improving the symptoms, as well as, reducing the severity of intestinal disorders. It was ascertained that the treatment is increasingly beneficial for ulcerative colitis, a type of inflammatory bowel disease (IBD) that leads to inflammation of the large intestine and the rectum [4] .

The treatment was effective in individuals who had mild to moderate ulcerative colitis. Ulcerative colitis is one of the diseases that fall under the broad umbrella of Inflammatory bowel disease IBD [5] . Ulcerative colitis can range in severity. Symptoms can include bloody diarrhoea, abdominal pain and cramps, rectal pain or bleeding, weight loss, fatigue, and fever.

FMT involves the transfer of helpful gut bacteria from the healthy donor so the person with IBD, with the hope of regaining the balance to their gut microbiome. The study made use of 73 adults who had mild to moderately active ulcerative colitis. The respondents were divided into two different groups, where one was given FMT that was prepared in an oxygen-free environment and the others were given their own stool through a colonoscopy, followed by two enemas over the course of seven days.

Consequently, the results suggested that preparing the FMT in an oxygen-free zone led to a 32 per cent remission rate for the disease; whereas only 9 per cent was reported in individuals who were given the placebo.

Anaerobic Preparation Played A Major Role In Treatment Effectiveness

The researchers were able to assimilate that preparing the samples without oxygen seemed to be key for this treatment [6] . The lead author of the study said, "many gut bacteria die with exposure to oxygen and we know that with anaerobic stool processing, a large number of donor bacteria survive so that they can be administered to the patient."

They assumed the aforementioned to be the reason that the treatment helped in providing a therapeutic effect in the respondents with ulcerative colitis. Unlike the traditional treatment methods that aim at the person's immune system to reduce inflammation, FMT centralises on the person's gut microbiome, which regulates a person's gastrointestinal tract [7] .

FMT Helped Restore The Microbial Balance

The treatment method was effective in managing the symptoms and easing the pain and severity because the treatment helped in restoring the normal microbial balance and thereby promoting the reduction of inflammation caused by ulcerative colitis [3]. Although it is understood that the treatment has a positive impact on individuals with intestinal disorders, there is ambiguity in the exact reason how.

The study has gained prominence due to its differential approach adopted, which focused on the preparation style of the FMT, which was supported by the head researcher who went on to state that, "many bacteria living in the gastrointestinal tract thrive in an oxygen-free (anaerobic) environment and struggle to survive when exposed to an oxygen-containing (aerobic) situation. Previous FMT studies exposed the stool to oxygen during processing, potentially killing many of the anaerobic bacterial species." [8] [9] .

On A Final Note...

The researchers are currently in the process of studying the means to develop rationally designed microbial therapies that can replace FMT, which will have the healthy gut bacteria in a pill; thereby avoiding the need to take whole faeces. In addition to that, the researchers are also looking at ways to ascertain whether FMT can maintain remission in ulcerative colitis [10] .

View Article References
  1. [1] Ekekezie, C., Simmons, S., Perler, B., Burhke, T., Duff, C., Hott, B., ... & Kelly, C. R. (2018). Understanding the Scope of Do-It-Yourself (DIY) Fecal Microbiota Transplant (FMT): 180. American Journal of Gastroenterology, 113, S102.
  2. [2] Edmond, M. B. (2016). The power of poop: Fecal microbiota transplantation for Clostridium Difficile infection. Transactions of the American Clinical and Climatological Association, 127, 71.
  3. [3] Lopez, J., & Grinspan, A. (2016). Fecal microbiota transplantation for inflammatory bowel disease. Gastroenterology & hepatology, 12(6), 374.
  4. [4] Paramsothy, S., Paramsothy, R., Rubin, D. T., Kamm, M. A., Kaakoush, N. O., Mitchell, H. M., & Castaño-Rodríguez, N. (2017). Faecal microbiota transplantation for inflammatory bowel disease: a systematic review and meta-analysis. Journal of Crohn's and Colitis, 11(10), 1180-1199.
  5. [5] Anderson, J. L., Edney, R. J., & Whelan, K. (2012). Systematic review: faecal microbiota transplantation in the management of inflammatory bowel disease. Alimentary pharmacology & therapeutics, 36(6), 503-516.
  6. [6] Colman, R. J., & Rubin, D. T. (2014). Fecal microbiota transplantation as therapy for inflammatory bowel disease: a systematic review and meta-analysis. Journal of Crohn's and Colitis, 8(12), 1569-1581.
  7. [7] Smits, L. P., Bouter, K. E., de Vos, W. M., Borody, T. J., & Nieuwdorp, M. (2013). Therapeutic potential of fecal microbiota transplantation. Gastroenterology, 145(5), 946-953.
  8. [8] Bakken, J. S., Borody, T., Brandt, L. J., Brill, J. V., Demarco, D. C., Franzos, M. A., ... & Moore, T. A. (2011). Treating Clostridium difficile infection with fecal microbiota transplantation. Clinical Gastroenterology and Hepatology, 9(12), 1044-1049.
  9. [9] Damman, C. J., Miller, S. I., Surawicz, C. M., & Zisman, T. L. (2012). The microbiome and inflammatory bowel disease: is there a therapeutic role for fecal microbiota transplantation?. The American journal of gastroenterology, 107(10), 1452.
  10. [10] Aroniadis, O. C., & Brandt, L. J. (2013). Fecal microbiota transplantation: past, present and future. Current opinion in gastroenterology, 29(1), 79-84.
Read more about: intestinal disorder ulcer
Story first published: Thursday, December 5, 2019, 15:30 [IST]
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