What is the C Diff fecal transplant therapy?

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This c diff fecal transplant therapy is sometimes known as Fecal Microbiota Transplant (FMT). Because some people suffer chronic c difficile doctors are using a new therapy to dislodge the disruptive c diff from their intestine. Fecal matter from a family member is often sought so that the material entering their system is reflective of local stomach flora. This is then turned into a liquid slurry and inserted into the body to colonise the intestine.

How does it work?
For most people this introduces a new balance in the intestine and restores the bacteria depleted by antibiotic treatment. This bacteria would in normal circumstances combat the c diff anyway. It is by no means clear as yet exactly how the cure takes place in specific biological terms – but the general theory that recolonizing the colon with healthy bacteria will reverse the c difficile seems to be true. Some research indicates that the reintroduction of Bacteroidetes and Firmicutes elements are part of the cure.

What is the actual procedure?
The fecal matter is inserted into the intestine in one of 3 ways. Via a duodenal tube, a rectal tube or colonoscopy. The colonoscopy is favoured as the whole of the colon can be recolonized and the extent of the infection can be clarified during the process. The cure may happen within hours or a few days.

Has the procedure been validated by the medical authorities?

This is a not a new therapy, but it has been a rare one until the recent mushrooming of c difficile infections. It has been tested via clinical trials  and we link to information about those below. One of the major trials was extended to include those not receiving the therapy as it was felt to be unethical not to help them recover.

The FDA in the USA did seek to regulate the process and surround every procedure with extensive paperwork. They stepped back from this amidst a hail of protest from front-line doctors who were seeing sick people get well within days.

Does it work
Success rates of 97% have been noted and those for whom it does not work are often those with severe colitis. Overall a cure rate of 89% in 275 cases from a round the world has been noted. Initial research also suggest that a small minority who have further c diff infections have been reinfected from another source.

Who qualifies for this treatment?
This process is usually a last resort treatment. It will not be the first thing offered with your first c difficile infection. You will also need to find a facility willing to do it. Use a search engine to look for ‘fecal microbiota transplant xxxxxxxx. (Insert name of your state or city instead of xxxxxx.)

You will need to find a suitable donor, with family members preferred. You should note that their fecal matter will need to be tested and that much of the cost of the process – usually between $1500-2000 – relates to that testing. This is to ensure that they do not pass you another unhelpful infection. You should also note that heavily medicated people or recent users of antibiotics will not be suitable donors. A ‘fecal donor bank’ is also creating a resource for hospitals so that can can obtain pre-screened fecal matter for use in the procedure.

Is this therapy still developing?
Work is under way to discover the essential elements of the fecal donation that heal the c diff infection. This would then be used to create pills that could bypass the need for the intrusive procedure. It is also believed that this type of therapy could help several other conditions and research on those continues.

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Article written by Dave Roberts.
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{ 67 comments… read them below or add one }

RJ October 15, 2014 at 11:26 pm

Attn: Lisa Hurka Covington and everyone else..

I NEED help.. I have C-Diff and do NOT have a family member donor that will work. My husband is on too many medications.
I’m in the near Nashville, TN area.. I’m mid 50’s, female and am so sad I don’t have a donor. I know I would help anyone I could if the situation were reversed. I’ve been fighting this for over a year after I picked it up in a hospital stay and PLEASE I need a donor that lives near me. Vanderbilt hospital is where they will do it. They said I must find my own donor that lives near me.
PLEASE email me if you have any ideas of someone who can help or just to talk to me about this. I’m scared.

Thanks SO much. RJ

Reply

Lisa Hurka Covington October 17, 2014 at 3:11 am

Dear RJ,
I am so sorry you are going through all you are with c diff, you will get stronger and better. I will keep you in prayers, they are powerful.

I am enclosing information for you to go to for help with your transplant. Go to http://www.cdifffoundation.org and then go in the search box and you can type in stool bank OR on the right side of the page in category Fecal transplants FMT scroll through the information about the stool back on MASS.

If you need me for anything further, I am always here for you.

With warm wishes,
Lisa

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