Fecal transfusion therapy

Stool transfer: a new technology that may save patients' lives

Stool transfer: What you need to know about stool biopsy transplant in Turkey to treat intractable digestive problems

It may seem overwhelming and strange at first sight, but fecal culture is one of the latest and most effective methods of treating serious digestive diseases and may save a human life.

Fecal culture is the placement of the stool of a healthy person into the colon of another sick person. This new technology is now being applied in Turkey to treat gastrointestinal diseases.

Your doctor may call this a treatment with beneficial bacteria or microbes.

Who needs a stool transfusion?

A stool culture is used to treat an acute bacterial infection called C. difficile, whose toxins cause irritation and irritation of the intestinal wall.

Like most infections, C. difficile is usually treated with antibiotics. But in some people, the inflammation can return again and again and may not respond to anti-inflammatories.

Stool transfer is a more successful treatment than antibiotics and medications. It often eliminates inflammation quickly, and its effectiveness is significant and noticeable.

What is the concept of “fecal transfer”?

The idea of the stool transfusion process is to transfer beneficial bacteria to the colon of a sick person

Under this procedure, stool filled with beneficial bacteria is placed in the colon of the sick person. When you have enough good germs in your gut, they can pick up, restrict and eliminate any harmful bacteria.

Anti-inflammatories are not specialized to fight a specific type of pathogen. It can kill the bacteria that make you sick but also kill the good germs that aid in digestion and keep you healthy as well. In the absence of a balance between good and bad bacteria, harmful bacteria can take over and produce toxins that make you suffer from diarrhea and intestinal infections.

A stool transfusion can restore a proper bacterial balance to the health of your gut. This will help you fight infections and make you feel better quickly. It can also help your body fight C. difficile infection in the future.

Can fecal transplant treat other diseases?

Loss of balance in gut bacteria may play a role in other health problems, too. Doctors have begun testing stool cultures on people who have one of these diseases:

  • Ulcerative colitis.
  • Crohn's disease.
  • cirrhosis.
  • Multiple Sclerosis.
  • Depression.
  • obesity.
  • Food allergy.
  • Diabetes mellitus and diabetic neuropathy.

Stool transfer and treatment of chronic bowel ulcers

Stool culture appears very promising in the treatment of ulcerative colitis. One reason may be that people with this disease often have an unhealthy mix of microorganisms inside their intestines. This makes it difficult for their bodies to resist stomach infections.

A new study revealed that patients with ulcerative inflammation received a mixture of stool from two donors. Some showed improvement in symptoms and a decrease in inflammation after just one month, while in 15% subjects, symptoms disappeared completely. Researchers have found evidence that a suitable donor can improve the chances of success for people with this disease.

The presence of a donor in good health is important and it may help even more to be close to the age of the recipient. In addition, it is preferable that the donor of faeces is a member of the recipient's family and is free from the same disease or other diseases. Also, transferring between brothers and sisters gives better results than if it was between parents and their children. Perhaps it is because the brothers are more close in age.

More study and research is needed to find out why stool transfusion gives better results for some people with ulcerative infections than others.

Anatomical section of the colon and its divisions
Anatomical section of the colon and its divisions

 

Persons who are not candidates for fecal transfusion

Stool transfer can be risky for some individuals and a doctor may advise against transplantation when one of the following conditions exists:

  1. If the person has had a bone marrow transplant recently.
  2. If the patient is taking immunosuppressive drugs.
  3. If the person has cirrhosis of the liver.
  4. If the patient suffers from acquired immunodeficiency - AIDS.
  5. If the person is receiving treatment against cancer.

Who can be a stool donor?

Most stool donors are a family member or friend of the patient, but they do not have to be. The patient may also receive frozen stool from the waste bank.

In a bank, the stool is analyzed and the donors and their stools are sorted. Where the donor conducts a blood and stool test in order to check for the presence of infections or any drugs that can be transmitted through the stool to the recipient's body. The donor must not have taken any antibiotics for at least a month before the transplant date.

To be eligible to donate feces, a person must:

  • He does not have a weak immune system.
  • He should not have any intestinal infections.
  • Not have a history of drug abuse.
  • He never went to prison.
  • He should not have had his body tattooed or pierced 6 months prior to the donation process.
  • He must not have traveled to areas where he may have been exposed to certain types of infections or infected with certain bacteria.

Before performing a stool transfusion

The night before the stool transfusion, the donor must take a laxative, and the next morning he must collect his stool in a container called a “hat” (previously obtained from the pharmacy) and deliver it to the outpatient clinic where the transfusion will take place. Sample preparation for cultivation is by mixing it with sterile water and repeatedly filtering it to remove solids. Once ready, it must be transplanted into the future intestine within 6 hours.

For the recipient, he should not have taken an anti-inflammatory in the two weeks prior to the operation. He has to take a laxative (or enema) the night before implantation in order to have an empty bowel when the stool sample is received. On the day the fecal transplant is performed, the patient should be given a proton pump inhibitor (PPI) to prevent the killing of the beneficial bacteria with stomach acids. In addition to giving him an anti-diarrheal medicine to preserve the sample transferred in his intestines.

Be sure to have someone accompany the person home after the fecal culture work is completed.

Fecal transfer in Turkey

The transplant is usually done on an outpatient basis. It can be done in several ways to choose from after taking into account the diseases of the digestive system that the recipient may have, its severity, general health, as well as personal preferences.

by enema

When choosing this method, the stool sample is placed in an injection device bag or bottle and then injected into the rectum where it must be kept there for as long as possible. This technique may need to be repeated for several days in order to adequately restore normalcy to the intestinal tract.

by colonoscopy

The enema can only reach the colon, so another method can be resorted to, which is a fecal transplant through endoscopy of the lower gastrointestinal tract. In this case, the sample is placed in the endoscopy device, where it is inserted into the anus and slowly pushed into the colon to release the sample into it. This type of medical intervention takes about 30 minutes and the person must be given a sedative.

through upper endoscopy

When there are contraindications to a colonoscopy, the transplant can be performed via an upper endoscopy. The recipient is given a sedative and then your doctor inserts the endoscope from the mouth. Air is used to open the entire esophagus, stomach, and intestine, and the sample is then placed in the small intestine. This process takes about 15 to 20 minutes.

via capsule

Here the stool should be enclosed in capsules within three layers of gelatin, each the size of a large vitamin capsule. The patient should take approximately 40 capsules over the course of one or several days, under the supervision of the responsible surgeon, in search of any side effects. One study found that this method is as effective as a colonoscopy.

Via feeding tube

There is a method that uses a feeding tube to pump a stool sample directly into the intestine. This method is usually used for patients who cannot tolerate other methods. The sample is injected through a nasal tube and placed directly into the intestine.

After the stool transfusion using any of the mentioned methods, the recipient is asked not to empty his bowels for at least two hours. So that the new bacteria are not lost, which are beneficial bacteria.

Complications

After a fecal transplant, the recipient may experience some side effects, including:

  • Abdominal discomfort or cramps.
  • holding.
  • Diarrhea.
  • Belching or flatulence.
  • Reaction to sedatives.
  • There can be a serious risk of bleeding or perforation of the intestinal wall when using colonoscopy or endoscopy from above.

Stool transfers are not without serious risks. In April 2020, the US Food and Drug Administration issued a statement saying that six patients who received stool from a specific stool bank developed serious infections and two more patients died.

After fecal transplant

Stool transfusions are done on an outpatient basis and the recipient goes home the same day. If the patient has received a sedative, he will be monitored until the effects wear off before he can leave the clinic. Diarrhea may be present for several days, but most patients experience a reduction in the severity of gastrointestinal symptoms within 48 hours. It may take up to three months for the recipient's gut bacteria to become similar to that of the donor.

If symptoms recur within four weeks, the operation is believed to have failed.

In some cases, a person may need to repeat the transplantation of microbes in the future, although there are currently no specific guidelines for the optimal timing of the procedure for a second time.

Evaluation of stool transfusion in Turkey

According to a review 2019 results Researchers found that faecal bacterial therapy had a cure rate ranging from 70% to 93% in people who had recurrent C. difficile overgrowth and associated symptoms. The success rate is generally low when using the capsule method, while it is high when using the enteroscopy method. Some may find this method disgusting and not accept the use of someone else's stool. But it is an effective way to treat intractable cases.

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