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Bacteriotherapy: what is this method and who is it suitable for

At first, the idea of fecal transplantation may seem like a joke below the belt, but for several years this method has been helping people fight an infectious disease in which antibiotics are powerless.
Fecal microbiota transplantation ( TFM), fecal transplantation, fecal therapy, fecal bacteriotherapy and, finally, fecal transplantation – all these are different names of one very strange, but very effective method of restoring the natural microflora of the human intestine, recognized by official medicine.

Fecal transplantation consists in using the natural capabilities of non-dangerous bacteria to displace pathogenic microorganisms by transferring the stool of a healthy donor to the recipient’s gastrointestinal tract.

Normal flora of the intestine
The gastrointestinal tract of a healthy person is home to hundreds of different types of bacteria that are in balance with each other. These bacteria, which make up the normal intestinal flora, are essential for effective digestion and play an active role in preventing allergic reactions and maintaining the body’s immune function.

All of them work to maintain balance and by self-regulation prevent the dominance of some bacteria over others. If this balance is disturbed, as is often the case after the use of antibiotics, the result can be disastrous for the gastrointestinal tract.

In most cases, the digestive system of a healthy body is able to restore the balance of intestinal flora on its own. However, for some people, the only possible way to improve intestinal health is fecal bacteriotherapy.

When antibiotics kill too many “good” bacteria in the gastrointestinal tract, fecal transplants can help replenish the bacterial balance.
Indications for fecal transplantation
The indication for bacteriotherapy is pseudomembranous colitis. This is a serious infectious disease caused by the antibiotic-resistant bacterium Clostridium difficile.

Despite the fact that Clostridium difficile can be found in the stool of healthy people, this bacterium is not capable of long-term existence in the normal intestinal microflora. Clostridium difficile triggers its pathogenic action when the balance of the normal microbiota is disturbed , which is usually caused by taking a number of antibiotics and leads to its excessive growth. Against the background of the death of normal intestinal microflora as a result of taking antibacterial drugs, the patient develops pseudomembranous colitis.

In 30 percent of patients, after undergoing a course of antibiotics, the infection returns within a few days or weeks. As a rule, for the treatment of relapse, a repeated course of antibiotic therapy is prescribed, which disrupts the balance of the microbiota and causes severe side effects such as chronic diarrhea, painful stomach spasms and in some cases fever – all of which, in turn, in addition to the delivered discomfort, can increase the risk of more severe infectious diseases. In this case, fecal bacteriotherapy can break the vicious circle and become a reliable alternative to antibiotics.

The results of the study, published in the New England journal of Medicine, showed that fecal transplantation is more effective in preventing relapses of pseudomembranous colitis than taking oral antibiotics. At the same time, the effectiveness of fecal bacteriotherapy reaches 91 %. It not only helps fight infection, but also restores the natural balance of microorganisms in the intestine.

Squeamishness is probably the main reason why people still continue to refuse this effective method of treatment. However, due to the severity of symptoms and often-recurring gastrointestinal diseases, the concept of donor fecal transplantation is becoming more acceptable for many patients.
Choosing a donor
Once you decide on a transplant, you will need to identify a potential fecal donor.

Generally, a healthy partner or relative is considered an ideal candidate for donation, but kinship is not a mandatory selection criterion. Anyone can voluntarily contribute to the good of your gut.

However, before collecting feces, the volunteer will have to undergo a medical examination, including a blood test for hepatitis A, B , C, as well as HIV and syphilis. In addition to the blood test, you will need to send feces for testing. It will be tested for worm eggs, parasites, Clostridium difficile, Giardia antigen, as well as seeding and sensitivity.

Also, candidates for donors will have to pass a special screening by answering “Yes” or” no ” to the following statements. A positive response to at least one statement will cause the potential donor to be disqualified.

Taking antibiotics in the last 6 months
Immune deficiency.
Tattoos or piercings made in the last 6 months
Taking drugs
Stay in places of deprivation of liberty
Recent trips to epidemiologically dangerous countries
Chronic infections of the gastrointestinal tract
The technique of transplantation
There are 3 ways to transplant faeces: colonoscopy, enema, and a feeding tube. However, the most common of them is a colonoscopy, which is usually preceded by a simple preparation.

All antibiotics should be stopped 2 days before the procedure. The day before the colonoscopy, you must adhere to a liquid diet. And in the evening, make an enema and take a laxative.

A fecal sample is obtained from a donor six hours before the transplant procedure. It is examined and checked for intestinal parasites and other infections that can disqualify the donor. If the sample is suitable, it is prepared for transplantation by mixing with sterile water and repeatedly filtering through a coffee filter.

Directly during the procedure, which takes place under intravenous sedation, a flexible endoscope is inserted into the rectum, which is then passed up the entire colon. The donor stool is delivered to the intestines as the endoscope is extracted.

Despite the effectiveness of the method, doctors warn: today, pseudomembranous colitis is the only indication for fecal transplantation. Bacteriotherapy performed for any other clinical indications should be considered experimental and should only be performed as part of a clinical trial. .

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