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Fecal bacteriotherapyFecal bacteriotherapy is a promising new treatment for patients suffering from pseudomembranous colitis, ulcerative colitisand Crohn's disease. It has been developed in recent years by dr. Thomas J. Borodyand his team in Sidney, Australia, primarily as an alternative to the often low succes rate treatments for pseudomembranous colitis. This debilitating disease is caused by C. difficileinfection, and is typicaly treated with antibiotics, but often requires prophylactic bowel removal due to complications caused by the chronic infection. The theory behind fecal bacteriotherapy suggests that the cause of inflammatory bowel diseasemay, like in the case of pseudomembranous colitis, be a previous infection by a still unknown pathogen (possibly Mycobacterium paratuberculosis), which resolves itself naturally but somehow damages the healthy bacterial flora of the colon, causing a bacterial imbalance, which then proceeds to reinfect and damage the colon in an endless cycle which can be broken by "recolonizing" the colon with bacteria from a healthy bowel. This may be considered an extension of the probiotic research that has been gaining momentum in the last decade. The procedure itself involves a 5 day treatment with fecal enemas, made of bacterial flora from feces of a healthy donor (who needs to be tested for a wide array of bacterial and parasitic agents). The enemas are prepared and administered in a hospital enviroment to ensure all necessary precautions. Regular checkups are required up to a year following the procedure. While it's effects on ulcerative colitis and Chron's disease have not yet been adequately researched (although anecdotal evidence suggests great results in treating this diseases), the procedure itself has been used to succesfully cure C. difficileinfections for a number of years, with a succes rate of nearly 97% according to some sources. A recent article by dr. Borody in which he details 6 cases of severe chronic ulcerative colitistreated using Fecal bacteriotherapy suggests that the procedure may be extremely succesful in these cases as well, as most patients remained in symptom free remision following the treatment, some even 13 years to date. Interestingly, in some cases, secondary complications seemingly unconnected with the bowel but characteristic for ulcerative colitishave been resolved as well, most significantly the case of a patient with a damaged liver (presumably caused by sclerosing cholangitis, a disease frequently associated with IBD), who recovered fully after the treatment and whose liver function subsequently normalized. Further research is needed, however, fecal bacteriotherapy may prove to be a step in the right direction in the understanding and treating chronic inflammatory bowel conditions. See also
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Categories: Gastroenterology
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