Fecal Transplantation Paper Example

Introduction

Fecal transplantation, also known scientifically as fecal bacteriotherapy or Fecal microbiota transplant (FMT) is the transfer of stool from a healthy individual (donor) to a client (recipient) with an altered colonic microbiome. The donor is mostly a family member (Floch 529). Fecal bacteriotherapy is used in the treatment of Clostridium difficile infection (CDI). The CDI forms spores, which can live in the gut of a human being and on other common surfaces such as toilet seats and bed rails. The most common treatment technique applied in this case includes the application of broad-spectrum antibiotic agents, such as clindamycin (Sobol et al. 878). The use of such antibiotics is effective especially in killing normal fecal flora, which allows the overgrowth of CDI in the gut. The spores then outgrow normal flora, causing toxins, which lead to inflammation and mucosal damage (Sobol et al. 878).

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CDI has complications ranging from simple to acute consequences to extents of mortality. Therefore, an overlook to the condition could lead to chronic challenges that could cause damage to the patient. Therefore, FMT applies in resolving the consequences of the proliferation of CDI through the restoration of bacterial homeostasis in the gastrointestinal system ("Fecal Microbiota Transplantation" 58). The method has been effective as there has been a decrease in antibiotics, which also disrupt the normal gut flora. Additionally, FMT is the most effective method of changing and sustaining the gut microbial composition. Besides, FMT can be used to treat ulcerative colitis, non-communicable diseases, and may as well be used for the replacement of antibiotics (Koleilat 2: Borody et al. 42).

When It Is Done?

As soon as a client shows cases of poor adaptive measures to infection, they are subject to the treatment of the condition. Other patients subject to the treatment of the condition include ones with a decreased diversity in colonic microflora. The bacterium is important in the limitation of C. difficile as the causal factor for CDAD. The curative approach to the people exhibiting the condition includes the reestablishment of the normal condition of intestinal flora (Haller 25). Most of the treatments done by new medics include antibiotics. The human gastrointestinal tract is complex in its composition hence; the best approach in curing is when the microbiome is present in the client's body (Khoruts et al. 354). A persistent pathogen is thought to be the cause of the complexity in intestinal flora (Borody et al. 42). The gut microbiota tends to prevent diseases through a competition between nutrients and binding in the colon's lining and an affected colon; fewer bacteria are present to prevent further diseases (Avery & Muhammad119). "In the human gut, there are 300-500 species of microorganisms (intestinal microbiota), with roughly ten bacterial cells per gram of stool" (Gough et al. 994). Their importance in the gastrointestinal system is to assist in various activities including digestion of carbohydrates, storage of energy, immune functions, as well as preventing invasion by pathogens. Any alteration to these normal functions of the body would lead to the condition. As soon as the bacteria are established, the gastrointestinal microbiota in the feces of the donor is transferred to the host's body. The process of transfer, rectal or nasogastric infusion is done at any time as soon as a case is presented to the medic. The disease affects approximately anyone with the risk factors for attaining the condition.

Fecal transplantation is done to patients who develop the C. difficile colitis, who also show an alteration in the microbial composition. Fecal transplantation is done after an administration of single fecal anema (Borody et al. 42). Additionally, fecal transplantation can be practiced in cases where antibiotics have failed (Borody et al. 42). Its research can lead to a future acceptance of the therapy as a form of treatment for other diseases (Floch 529).

Why It Is Done?

Fecal bacteriotherapy is performed to assist patients with the recurrent or refractory disease (Avery & Muhammad 124). There has been an increase in public health problem as a result of antibiotic-induced diarrhea and Colitis. The emergence of more persistent strains has led to the prevalence of the diseases as well as an increasing rate of fatality. Bacteriotherapy is used in the treatment of Clostridium difficile-associated disease (CDAD), which is a major disease that causes the two diseases. CDAD results from the disruption of commensal gut microbiota. Therefore, recurrent CDAD is treated through bacteriotherapy, which as well as normalizes colonic microflora. As a result of antibiotic exposure, age, and hospitalization, CDAD can be more prevalent. Additionally, fecal transplantation can also be the used in the treatment of inflammatory bowel disease and pharmacologic gastric acid blockade, which are the risk factors for CDAD (Koleilat 2: Borody et al. 42).

Fecal transplantation is done with the aim of altering microbial composition in the human colon. This is commonly done by practitioners through the introduction of exogenous colonic bacteria. When done, the composition of the microbiota in the colon becomes stable and resilient to the environment (Khoruts et al. 355). This creates an internal environment that is balanced to the external stimuli. The advantage of carrying out the transplantation is to reduce the health consequences resulting from the condition.

Fecal transplantation is done to normalize the microbiome as distorted by antibiotics, inflations, diet, and other causes (Haller 24). A recurrent C. difficile infection leads to CDAD, a risk factor for the condition. This can result from decreased activity of microbiota in the gut and the community resilience. The imbalanced nature of the host's body is, therefore normalized through fecal transplantation. Besides normalization, the treatment technique can also be used to restore a protective intestinal flora before the germination of C. difficile spores to vegetative forms. Additionally, fecal transplantation is important in the treatment of UC. The form of therapy is important since there is a prolonged remission of UC as a result of decreased C. difficile.

How does it work and how it was discovered?

The idea of fecal disease treatment by use of fecal matter started millennia ago in China. The Chinese medical literature back in the 4th century suggests that it applied fecal matters in the treatment of food poisoning and its diarrhea implications by a Chinese researcher known as Ge Hong (Avery & Muhammad 119). A century later, it is believed that Li Shizhen applied "yellow soup" in the treatment. The soup was comprised of dry, fermented or fresh stool in the treatment to give a remedy in the abdominal complications. The major soup ingredient was the fecal matter and water mixture, whereby the concoction would be drunk by the person suffering from any stomach complication. The use of fresh and warm camel feces has been recommended as a solution for bacterial dysentery by Bedouins. Its efficiency is probably as a result of it is an association with the antimicrobial subtilisin that is manufactured by the Bacillus Subtilis. This was confirmed anecdotally by Afrika Korps German soldiers during the Second World War.

Fecal microbial transplant first use in western medicine was published by a group of Colorado surgeons in 1958 (Avery & Muhammad 119). Ben Eiseman and his colleagues treated four people who were critically sick with fulminant pseudomembranous colitis before the discovered C. difficile by use fecal anemias which was caused rapid health recovery. Throughout 20 years, FMT has been considered as a treatment option by professor Thomas Borody the current FMT proponent in Five Dock at the Center for Digestive Diseases (Avery & Muhammad 119). In 1988, the group of physicians was successful in the treatment of the first ulcerative colitis patients by application of FMT, which in turn proved to be a resolution of all the long-term signs and symptoms. By 1989, through the use of FMT, they had treated more than 50 patients suffering from diarrhea, constipation, Crohn's disease, abdominal pain and ulcerative colitis (Avery & Muhammad 119). With the use of FMT, 20 patients were discovered completely cured whereas other nine patients had reduced the signs and symptoms. Since then, stool transplants have been considered 90% effective especially for those with advanced cases of Clostridium difficile colonization, in cases where antibiotics have not been effective (Avery & Muhammad 119). However, in January 2013, the first randomized clostridium difficile infection controlled trial was published. Nonetheless, the research came to a halt as a result of the FMT effectiveness with more than 80% of the patients experiencing a successful cure after one attempt and more than 93% after the second infusion (Avery & Muhammad 119). The institutions have recommended the FMT as the therapeutic options for most of the abdominal complications by most of the institutions.

The patients who are likely to be receiving this kind of treatment are the ones who have had more than three occurrences of C. difficile infection and have not yet received any other assistance from the conventional therapies comprising of pulsed and tapered vancomycin regimen (Caglar 132). The first step in case a fecal transplant is recommended is to find a stool donor. The donor is supposed to be someone who is in the same household (Caglar 133). The advantage of being donated by a person in the same household is that the potential pathogens are already present in both the donor and the recipient; there are reduced risks of contracting infections in the transplant.

Some methods are carrying out the stool transplant. This includes the use of capsules, feeding tube or anema. However, the use of colonoscopy on patients is the most common. In this case, the healthcare inserts little amount of filtered and liquefied stool into the colon of the patient (Woodworth et al. 227). The fecal matters can be obtained from a volunteer, family members, and friends who must be healthy and living a stable lifestyle. The donors should not be suffering from any ailments and have to go through thorough medical research to ensure that their health is up to the required status. Extensively, the stool donors would have to undergo some blood screens to check some infections HIV/AIDS, hepatitis A,B, and C as well some stool tests for the viral, bacterial and parasitic bacterial infections (Avery & Muhammad 119). Once the donor has been screened, the specimen is collected. The preparation of the stool for delivery is normally done is a suite that is endoscopic by the healthcare providers (Woodworth et al. 227). Since in most cases, the procedure is performed at the hospital or a clinical setting, the donors are advised to deliver the stool in the hospital in an airtight container within the six hours of the procedure of the transplant. The previous night before the transplant, the donors are advised to take magnesia milk to ensure that they have a consistent soft tool to facilitate an easy process of carrying out the transplant. However, safety concerns are held paramount as the specimen is a level 2 biohazard material therefore high and healthy precautions undertaken. The stool volume and diluent amount are different depending on the mode of stool administration on the patient. The specimen is mixed with either sterile water or non-bacteriostatic normal saline and well blended by use of a disposable handheld shaker. The consistency of the stool should be watery enough to permit its delivery through the biopsy colonoscope or nasogastric tube channel (Avery & Muhammad 119). The consistency is m...