Camille Eyvazzadeh, MD
Berhanu Geme, MD
Called Fecal Microbiota Transplant (FMT), the relatively inexpensive procedure replaces killed or suppressed bacteria in the gut. During FMT, a patient suffering from CDI receives stool containing beneficial intestinal microbiota from a carefully screened, healthy donor.
Gastroenterologist Berhanu Geme, MD, explains that after the stool is placed in the patient’s gastrointestinal tract, the transplanted fecal matter delivers microbiota necessary for the gut to function properly.
“Clearly, the thought of this is distasteful,” says Dr. Geme of the procedure. “The people who consider this option are at the point that they would do almost anything to rid themselves of the devastating diarrhea that has adversely affected their lives.”
Colon and rectal surgeons also perform the procedure. At St. Luke’s,
Dr. Camille Eyvazzadeh has treated patients with FMT. In patients that do not respond to medical therapy and FMT, surgery will be needed to save lives.
“FMT is now easily available at St. Luke’s University Health Network and has more than a 90 percent cure rate,” Dr. Eyvazzadeh says. “The majority of patients get results in three to five days. Five to 10 percent feel better but don’t get complete relief the first time so the procedure may be repeated.”
The procedure offers hope to individuals who suffer with severe cases of CDI that cause recurrent and debilitating diarrhea. Weight loss resulting from the diarrhea can cause weakness and even death, in extreme cases. In fact, about 29,000 people in the United States die each year from CDI, according to the Centers for Disease Control. Those most at risk are the elderly who take antibiotics.
Several methods can be used to place the stool. Dr. Geme, and Dr. Eyvazzadeh, prefer colonoscopy to enema or nasogastric tube, because the new bacteria will bypass the gastric acid, it is more effective, and the camera used in colonoscopy enables to see within the colon for any potential lesion. Patients prepare for FMT as they would for any colonoscopy. Before the procedure they are sedated and bed rest is encouraged for the remainder of the day.
Although some patients use fecal matter donated from a family member, Dr. Geme, and Dr. Eyvazzadeh, prefer using standardized specimens from a stool bank because each donor has been carefully screened for infections and potential diseases. For a family member to be considered as a donor, he or she must undergo extensive and expensive tests that may not be covered by insurance.
Traditionally, physicians treat CDI with a course of antibiotics and probiotics. However, the effectiveness of this treatment varies. Recurrent CDI occurs in 15-30 percent of patients after the first round of treatment, and the percentage of recurrence rises with each episode. Up to 65 percent of patients who experience CDI will have subsequent recurrences after antibiotic therapy ends. CDI can become chronic and lead to repeated use of antibiotics, adverse drug events, antibiotic resistance and repeated hospitalizations.
Dr. Eyvazzadeh adds that determining how bacteria in the gut affect the body and brain is an emerging field of medical research and treatment. Researchers are studying what relationship the presence or absence of gut bacteria has on a variety of conditions from excess weight to mood disorders.
Denise E. Rader
Director, Network Media Relations
St. Luke's University Health Network
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