“Fecal Cocktail” for Colon Infections Due to Clostridium Difficile
February 3, 2013 by Robert Wascher
Filed under A Cancer Prevention Guide for the Human Race, Antibiotic-Associated Diarrhea, Antibiotics, Clostridium Difficile, Colitis, Fecal Cocktail, Fecal Transplant, Feces, Infection, Pseudomembranous Colitis, Stool, health
A new study finds that a “feces cocktail” may be a lifesaver for patients with
severe colon infection from the Clostridium difficile bacterium.
“FECAL COCKTAIL” FOR COLON INFECTIONS DUE TO CLOSTRIDIUM DIFFICILE
Warning: You may not wish to read the following article if you are currently eating….
Many of us have a bacterium known as Clostridium difficile living in our colon. As long as we remain in good health, the other bacteria that also live in our colon prevent overgrowth of Clostridium difficile. However, when the “healthy” bacteria in our colon are killed off, Clostridium difficile can begin to grow, and may result in a potentially life-threatening infection, pseudomembranous colitis. The most common cause of Clostridium difficile overgrowth is the use of antibiotics to treat other sites of infection in the body. Following decades of excessive and inappropriate use of antibiotics, there has recently been an explosion in the number of cases of colitis caused by Clostridium difficile. Moreover, as with many other “super bugs,” Clostridium difficile is becoming increasingly resistant to the antibiotics traditionally used to treat this bacterium.
Previously, there have been anecdotal reports of the use of suspensions of feces from “donors” to reestablish the normal, healthy bacteria in the colons of patients with colitis caused by Clostridium difficile. However, this practice has not been formally studied. Now, a newly published clinical study in the New England Journal of Medicine strongly suggests that patients with recurrent Clostridium difficile colitis may, indeed, benefit from a “feces cocktail” from healthy donors.
In this study, 42 patients with recurrent pseudomembranous colitis were randomized to three treatment groups. The first group received the antibiotic vancomycin, followed by irrigation of their colon and the placement of “donor feces” into their small intestine through a tube passed through their nose. The second group received vancomycin, alone. The third group received vancomycin and colonic irrigation (but no “donor feces”).
Because of the marked superiority of the “fecal cocktail” as a treatment for recurrent Clostridium difficile colitis, this study was actually terminated prematurely. Following a single duodenal infusion of “donor feces,” 81 percent of patients experienced resolution of their pseudomembranous colitis. Of the remaining three patients with continuing diarrhea, a second infusion of “donor feces” resulted in the cure of two patients’ colitis, for a total cure rate of 94 percent associated with the administration of a “fecal cocktail.” By comparison, only 31 percent of patients receiving vancomycin alone experienced resolution of their colitis, and only 23 percent of the patients who received vancomycin and bowel irrigation experienced a cure of their colitis.
The findings of this small pilot study could eventually lead to a rather dramatic change in the management of severe and recurrent colon infections associated with Clostridium difficile. However, before we begin to routinely administer “fecal cocktails” to patients, larger clinical studies should be performed, and longer term follow-up should be performed, particularly to assess for the risk of infections with other types of bacteria and viruses known to be transmitted by the “fecal-oral” route. While it may not be very appealing to consider, “fecal cocktails” may offer critically ill patients with life-threatening Clostridium difficile infections a chance for cure when antibiotics fail.
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Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author
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