Tuesday, April 9, 2013

Fecal Transplantation for Ulcerative Colitis in Children = 67% Clinical Response

Recently in a study it was learned that a fecal transplant (also known as fecal microbial transplantation (FMT) helped pediatric patients who suffered from ulcerative colitis. Dr. Thomas Borody in Austrialia in 2003 published this paper showing that six patients who received a fecal transplant went into remission for 13 years (which to me is pretty close to a cure). As many of you now I am interested in fecal transplants and did an exhaustive study of them in this post. There were only 10 patients in the study (ages ranged from 7-20) who had mild to moderate ulcerative colitis. The patients took an enema daily for 5 days.
The good news is that 67% of patients maintained a clinical response while 78% of patients achieved a clinical response within one week. There is no question that fecal transplants may become another therapy for ulcerative colitis and possibly Crohn’s (the FDA is still trying to figure out how to regulate it). Right now the thinking is that fecal transplants would help ulcerative colitis patients more since mainly the colon and rectum are involved.  Although, I don’t suffer from ulcerative colitis I welcome anything that helps people with inflammatory bowel disease.
If patients can get over the yuck/gross/etc factor (which I think will happen once people see how effective it is for c difficile and ulcerative colitis) then doctors can start doing more of these procedures which will only get safer and more effective as time passes. Some questions still remain. What is the best way of performing the fecal transplant (colonscope, nasogastric tube, other). Also more work could be done on the fecal donor. One idea might be to do genome work on the fecal matter and then one on the individual and see which type of fecal matter would lead to the best result. Also most of these studies just look at doing fecal transplants (via enema) for a few days. Would it make sense to have it has a constant routine to see if it yields better results? As more of these studies are done these questions along with others will get answered.

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