Fecal Microbiota Transplant (FMT)

fecalAbout twenty years ago, I was asked to speak at a fibromyalgia-fatigue conference in Michigan. The speaker before me presented his idea of fecal implants to “cure” fibromyalgia and chronic fatigue syndrome. His plan was to radiate the patient’s bowel to eradicate the bowel flora and, as he put it, “re-populate the bowel with fecal implant.”

I was horrified. When I reached the podium after him, I heard myself ask “Couldn’t we think of putting the patient out of misery by some other, faster, more humane way?” I heard the audience chuckle and immediately recognized my indiscretion. I have often thought and regretted my words. But the words which once leave one’s lips never return.

The notion of treating a disease by inserting one person’s poop into another would be amusing if it were not saddening. How can anyone be so profoundly ignorant about crucial ecologic concerns about the colon flora and how it coexists with the flora of the small intestine, stomach, and the oral cavity? I wondered then and I wonder when I continue to hear about fecal implants.

Here is information from The Fecal Transplant Foundation

Fecal Microbiota Transplant (FMT) is a procedure in which fecal matter, or stool, is collected from a tested donor, mixed with a saline or other solution, strained, and placed in a patient, by colonoscopy, endoscopy, sigmoidoscopy, or enema.

The purpose of fecal transplant is to replace good bacteria that has been killed or suppressed, usually by the use of antibiotics, causing bad bacteria, specifically Clostridium difficile, or C. diff., to over-populate the colon. This infection causes a condition called C. diff. colitis, resulting in often debilitating, sometimes fatal diarrhea

C. diff. is a very serious infection, and the incidence is on the rise throughout the world. The CDC reports that approximately 347,000 people in the U.S. alone were diagnosed with this infection in 2012. Of those, at least 14,000 died. Some estimates place that number in the 30,000 to 50,000 range, if the U.S. used the same cause of death reporting methods as most of the rest of the world.

Fecal transplant has also had promising results with many other digestive or auto-immune diseases, including Irritable Bowel Syndrome, Crohn’s Disease, and Ulcerative Colitis. It has also been used around the world to treat other conditions, although more research in other areas is needed.

A Woman Became Obese After a Poop Transplant

This is the title of a case report. The report concerns a woman who gained 36 pounds and became obese in the 16 months after a fecal transplant. Here is an excerpt from that report: “The 32-year-old woman had maintained an average weight her entire life, according to a case report in Open Forum Infection Disease. Then she fell sick with Clostridium difficile, a gut infection that is difficult to cure with antibiotics but very easy to treat with a fecal transplant, which replaces the entire gut microbiota with one from someone healthy. The woman’s donor was her 16-year-old daughter, who weighed 140 pounds at the time but later went up to 170 pounds.” …”After her fecal transplant, the woman started packing on pounds and couldn’t lose it, despite “medically supervised liquid protein diet and exercise program.” She ended up at 177 pounds and suffered from constipation and bad digestion.”

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