For recurrent cases of C. difficile, a doctor may recommend bacteriotherapy, or a fecal transplant. Fecal microbiota transplantation (FMT) involves transferring of healthy bacteria from a donor’s stool to a patient’s intestine to restore the proper balance of bacteria in the intestine so the immune system can be restored. Fecal transplant is quickly becoming accepted as a safe and effective treatment of C. difficile infection of the colon.
A person’s digestion depends on a delicate balance of healthy bacteria in your intestines. Sometimes, the good bacteria in one’s body can be disrupted by sickness or medication, and one may develop an infection caused by bacteria called Clostridium difficile or C. difficile, for short.
Symptoms of C. difficile are:
Although C. difficile is rare, it can develop after taking antibiotics because of an illness. Antibiotics are very helpful in eliminating bacteria-related illness, but they are so powerful that they can eliminate the healthy bacteria in one’s digestive system as well. When the healthy bacteria are gone, people are more susceptible to developing a C. difficile bacterial infection. It is also possible to develop C. difficile if someone has been hospitalized and you are exposed to C. difficile spores. C.difficile can be very difficult to eliminate. If someone is diagnosed, the doctor will treat the infection with an antibiotic such as metronidazole, vancomycin or fidaxomycin that specifically targets the C. difficile organism. This treatment is effective for about 70 percent of patients. For the remaining 30 percent, the C. difficile infection returns within days or weeks after finishing the antibiotic. The doctor may suggest a second round of antibiotics, but sometimes the infection returns again. Should the infection return again or does not respond to antibiotics, then the doctor often recommends fecal transplant. FMT can cure C.difficle infection in over 90% cases.
FMT is performed similar to a standard colonoscopy. During the procedure a solution of donor stool and saline is introduced into the colon through a channel in the colonoscope to eliminate the C. diff infection.
Imodium is taken either immediately before or immediately after fecal transplant and patient resumes normal diet and activity. No driving for 24 hours after procedure due to anesthesia received.
While the true long terms risks of fecal transplant are not well known as it is a fairly new treatment, there have been few side effects. Some patients can exhibit diarrhea, constipation, abdominal pain or increased flatulence. Researchers are conducting long-term studies of fecal transplant to identify if they are any other side effects.
As for colonoscopy, the risks associated with it are better known and low. Bleeding can occur from a biopsy or removal of a polyp or growth from the colonoscopy, but such bleeding often stops on its own or can be controlled through the colonoscopy. Perforation (a hole or a deep tear in the lining of the colon or rectum) may require surgery, but this is an uncommon complication. Injury to other organs such as the spleen can occur, but is very rare. Other risks involve complications related to the anesthetics and sedatives (breathing difficulties, aspiration) or complications related to heart and lung disease.
