Could poop transplants cure painful inflammatory bowel disease?

It is currently used as a treatment for recurring clostridium difficile infection.

But, scientists have found fecal microbiota transplantation is an effective approach to helping individuals who suffer from ulcerative colitis.

The condition is an inflammatory bowel disease, which causes long-term inflammation and ulcers in the digestive tract.

It affects the innermost lining of the large intestine and rectum, which can lead to rectal bleeding, diarrhea and abdominal discomfort.

Fecal microbiota transplantation is an effective approach to helping individuals who suffer from ulcerative colitis, a new study has revealed

After carrying out the transplants on a group of patients, researchers at the University of New South Wales in Australia, found marked improvement in their symptoms. 

One in four patients who were resistant or intolerant to conventional treatment – steroid or anti-inflammatories – reported their symptoms had disappeared and showed signs that their digestive tracts improved. 

Furthermore, more than half of patients reported an improvement in their symptoms after undergoing fecal transplant.

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Dr Sudarshan Paramsothy, a gastroenterologist at the University of New South Wales, said: ‘In recent years, researchers have gained a better understanding of the gut microbiota, and the critical role it plays in health and disease, including conditions like ulcerative colitis.

‘By using fecal microbiota transplantation, we aim to treat the underlying cause of ulcerative colitis instead of just its symptoms, as opposed to the majority of therapies currently available.’

Dr Paramsothy and his team enrolled 81 patients across three Australian study sites.

Forty one received fecal transplant treatment, while the remaining 40 received a placebo, or non-active treatment.

Patients received the first transplant or placebo through a colonoscope.

Subsequently, patients were given enemas that were self-administered five days per week for the next eight weeks.

After that time, more than three times as many patients who underwent fecal transplants, responded to their treatment than the control group.

Specifically, 11 of the 41 fecal transplant patients (27 per cent) achieved the study’s primary goals – to report no symptoms and for doctor’s to see substantial improvement and healing in the digestive tract.

Only three of the 40 patients (eight per cent) in the control group reached this goal.

When researchers looked at just the number of patients reporting being symptom-free they found 44 per cent of fecal transplant patients reported improvement compared with 20 per cent in the control group.

Dr Paramsothy said: ‘Previous research in this area has been limited to small case series and two single center trials with conflicting outcomes.

The condition is an inflammatory bowel disease, which causes long-term inflammation and ulcers in the digestive tract. It affects the innermost lining of the large intestine and rectum, which can lead to rectal bleeding, diarrhea and abdominal discomfort

‘Our study is the first multi-centered trial that uses an intense therapy of fecal microbiota transplantation infusions, 40 over eight weeks, and has been able to show definitively that fecal microbiota transplantation is an effective treatment for ulcerative colitis.

‘This is important because there are millions of people worldwide seeking alternative treatments for their condition.

‘This population is accustomed to using enemas as part of previous treatment, so our approach would not be unusual to them.’

To perform a fecal transplant, clinicians collect fecal matter from healthy individuals who are screened to determine that the stool is safe for transplantation.

The stool is processed and prepared for use, then placed in patients by methods including colonoscopy, endoscopy or enema.

In this study, each enema consisted of a stool from at least three donors.

Dr Paramsothy and his team used this multi-donor method to ensure that study results were not influenced by a ‘donor effect’, where individual patient outcomes may be unduly influenced by the microbial characteristics of a single donor.

According to the Centers for Disease Control and Prevention, there are approximately 200 cases of UC for every 100,000 adults. 

UC is a chronic condition with no known cure. It causes inflammation and ulcers in the lining of the colon, 

Dr Paramsothy presented data from the study at Digestive Disease Week 2016, the largest international gathering of physicians, researchers and academics in the fields of gastroenterology, hepatology, endoscopy and gastrointestinal surgery.