Poop transplant effective in C. difficile infection, not Crohn’s

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It was already known that fecal microbiota transplantation (FMT) is an effective treatment for recurrent Clostridium difficile infections. A new Cochrane Review published in the Cochrane Database of Systematic Reviews by Nathan Zev Minkoff et al. shows this point once again: in an eight-week period after such treatment, 77 percent did not get a re-infection, compared with 40 percent of those treated with antibiotics alone. were treated. Minkoff et al. analyzed the aggregated data from six trials (n=320) comparing FMT to standard vancomycin therapy.

Dysbiosis

There is some evidence that an unhealthy mix of gut bacteria (dysbiosis) can increase the risk of repeated or multiple C. difficile infections, which can lead to life-threatening diarrhea. Dysbiosis is often caused by the use of antibiotics. The standard treatment with antibiotics can therefore lead to a vicious circle of a short treatment effect followed by a recurrent infection. This happens in almost a third of the infected persons.

Transplanting healthy donor stool into a gut with dysbiosis is intended to rebalance the microbiome, significantly reducing the risk of C. difficle recurrence.

Ulcerative colitis

Dysbiosis is also believed to play a role in the pathogenesis of ulcerative colitis and Crohn’s disease. In a Cochrane Review, Aamer Imdad et al. investigated whether good results can also be achieved with FMT in these diseases. That turned out to be disappointing. They included 12 studies, with a total of 550 participants. The results were promising for ulcerative colitis, but firm conclusions cannot yet be drawn. The results for Crohn’s disease were inconclusive.

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