The intriguing, yet somewhat malodorous, topic of poo transplants is in the news. A study published today found poo transplants are better at treating a particular type of diarrhoea than an antibiotic or placebo (a fake or dummy treatment).
The study collated and analysed the results from earlier studies in how effective poo transplants were in treating diarrhoea caused by the bacterium Clostridium difficile.
Researchers have been interested in alternative treatments for this condition due to the rise in resistance to standard treatments (including antibiotics). So this type of diarrhoea has quickly developed into a more life-threatening disease.
The study findings are in line with recent European advice strongly encouraging setting up centres specialising in poo transplants to treat C. difficile diarrhoea.
Despite the apparent success of poo transplants for this particular condition, there is still much we don’t know about this therapy. It’s important to figure out how long the effects last, and which bugs in the poo transplant help us cure disease and which don’t.
How do poo transplants work?
Poo transplants (or “faecal microbiota transplantation”) involve transferring poo from a healthy donor to a sick recipient. The collective community of bugs and compounds (the gut microbiota) in the donor’s poo is then believed to establish itself in the recipient’s gut.
The scientific consensus is poo transplants work if the recipient’s gut microbiota is “restored”. The most consistent measure of this has been an increase in the diversity of the community of organisms in the recipient’s gut. By encouraging a more diverse and beneficial community of organisms in the gut, the idea is that this allows the recipient to resist being overwhelmed by the “bad” bugs.
Before donating their poo, donors’ poo and their blood is screened for many infectious agents such as C. difficile, HIV and viral hepatitis (A, B and C). This is to make sure a donation doesn’t transfer pathogens (disease causing microorganisms) by accident.
The screened donor poo is then delivered to the recipient in a number of ways.
Delivery methods from above involve recipients swallowing a poo capsule (or “crapsule”) containing frozen poo. Alternatively, a diluted sample can be delivered through a plastic tube inserted into the nose down to the stomach or small bowel (nasogastric intubation).