# Faecal transplants used to cure Clostridium difficile



## Mr 100 (Aug 1, 2011)

[I have paraphrased part of the report, click on the link for the original.]Some doctors are using the procedure to repopulate the gut with healthy bacteria, which can become unbalanced in some diseases. Dr Alisdair MacConnachie, who thinks he is the only UK doctor to carry out the procedure for Clostridium difficle infection, describes it as a proven treatment...================================================================...As well as patients, he says there are more doctors expressing an interest in the US."Within the next six months or year, this will be the most exciting thing that's happened to gastroenterology. It will change the way that certainly C. difficile is treated and many other diseases too."Irritable bowel syndrome, diarrhoea and constipation are also on his list of possible applications. "It looks like a terrific approach to a wide variety of diseases," he says.Proof? The practice has been reported only as a series of small case by case studies for recurrent C. difficile infection. There has been an average success rate about 90%. However, this is not enough for the technique to be widely adopted.The gold standard for determining if a treatment works is a randomised clinical trial - taking a large group of patients and giving one set the therapy and another a placebo or pretend therapy. The two groups are compared to see if the treatment really makes a difference.Until such a trial takes place, widespread acceptance will be difficult achieve.http://www.bbc.co.uk/news/health-15113440


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## Mr 100 (Aug 1, 2011)

...there is a radio program on the bbc i-player from march 2011, Dr Mark Porter discusses FT and gut bacteria.http://www.bbc.co.uk/iplayer/episode/b00z6dvv/Case_Notes_Gut_Bacteria/The program transcipt is here,downloads.bbc.co.uk/radio4/transcripts/20110308_cn_gutbacteria.rtf


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## Mr 100 (Aug 1, 2011)

I read through the transcription whilst re-listening to the broadcast and can't see any reason not to reprint it here,BRITISH BROADCASTING CORPORATIONRADIO SCIENCE UNITCASE NOTES Programme no. 9 - Gut BacteriaRADIO 4TX DATE: TUESDAY 8TH MARCH 2011 2100-2130 PRESENTER: MARK PORTERCONTRIBUTORS: GLEN GIBSON CHRISTINE EDWARDS THOMAS BORODY ALISDAIR MACCONNACHIE MARK PIMENTEL IAN ROWLANDPRODUCER: ANDREW LUCK-BAKERNOT CHECKED AS BROADCAST PorterHello. This week's programme is all about the bacteria that live inside us or gut flora as microbiologists prefer to call them. Most are friendly and help protect against problems like allergies, food poisoning and cancer of the colon. But some are not so friendly, with new research suggesting they are behind conditions like irritable bowel syndrome and obesity. Could probiotics, prebiotics or even antibiotics help? Or, how about a more extreme option - transplanting friendly bacteria from one person to another using some of their faeces? MacConnachieThe donor comes in briefly the morning of the transplant and provides a fresh sample of faeces. We administer about 30 mils of the faecal transplant down the tube into the stomach and then remove the tube.Porter More from the fascinating field of faecal transplants later on, but first some background on the bacteria that feast on our intestinal leftovers.Glen Gibson is professor of microbiology at the University of Reading.GibsonThe large intestine is phenomenally well colonised, there are a lot - 10 the power 12 in every gram, so that's 10 with 11 noughts after it in every one gram of contents. So actually altogether that's trillions and trillions and trillions of microbial cells, which is phenomenal, it's most of the cells in our body, I think the estimate is something like 90-95% of all the cells in the human body are bacteria inside the large intestine. So to take that literally - we're all 20 times more microbe than we are human.PorterPresumably there's a vast array of different species all doing different things?GibsonThere are, it's phenomenally diverse. There are several thousand different types of bugs in any one person's large intestine, some of these are positive for health and some are negative for health. The ones which I think we've all heard of are the bad bugs - E. coli, campylobacter, salmonella - these are the ones we keep hearing about because they cause problems. But it is the case that most bacteria actually are harmless and some can actually be good for health. And what they are doing there is helping us to digest the food we eat each day, they're helping to stoke up our immune response, some of them can produce vitamins - many of the B group - some of the bacteria are very effective at resisting infections and killing off the microbes which cause difficulties inside the gut, as well as systemically.PorterSo it's some sort of - it's a symbiotic relationship - we depend upon them, to some extent, and they depend upon us?GibsonAbsolutely. We feed them, as we feed ourselves but in return they offer us a lot of health bonuses. I think it would be fair to say that our lives would be extremely uncomfortable, if not impossible without them.PorterYou say we feed them, they're presumably eating the same stuff that we are, what is it in our diet that they particularly like?GibsonMany carbohydrates. Now the human body will absorb some of the constituents of our diet, say in the stomach and small intestine that happens fairly well, and the residues which are left and then enter the large intestine can then be broken down by the bacteria. There are certain ingredients within our foodstuffs which the body can't digest but the bacteria can.Newborn baby cryingPorterThe development of a healthy gut starts as soon as we're born. A newborn baby's bowel contains no bacteria - it is sterile - and the very first gift you receive from your mother is a starter culture of her flora. Christine Edwards is Professor of Nutritional Medicine at the University of Glasgow.EdwardsThe baby is born with no bacteria at all but of course very quickly, during the birth process, is exposed to the mother's bacteria in the birth canal and also to some of her faecal bacteria too - very close to the end of the digestive tract when you're born, so you're picking up those sorts of bacteria from your mother as well.PorterSo the baby is inoculated, if you like, at this stage and then those bacteria, once they gain a foothold, they breed and multiply.EdwardsThat's absolutely right. The bacteria are restricted mostly to types of bacteria that we call lactic acid bacteria and they're very similar to the sorts of bacteria that we think about as being friendly bacteria, which are present in probiotic products, so these are called lactobacilli and bifida bacteria mainly. More diverse flora that you see in an adult actually takes about two years before it is developed.PorterAnd what are they actually doing for the child at this stage?EdwardsWell it's a very important stage in development because not only is the baby born with a sterile gut but it's also born with an immature gut, which doesn't digest food as well as an adult does and also a very immature immune system. So the bacteria are important for fermenting some of the carbohydrate in milk that is not digested, allowing the infant to get energy from this unabsorbed material. But at the same time the bacteria are also educating the immune system, so that the immune system knows how to behave towards infectious bacteria but also towards all of the proteins in food which we normally eat and we should be able to react to perfectly healthily but if you don't educate the immune system properly things start to go wrong.PorterWhat happens to babies that are born by caesarean section because presumably they miss out on that initial inoculation?EdwardsYeah that's absolutely right and often there's a lot of hygienic procedures that go along with caesarean section which prevent the baby picking up bacteria directly from its mother. When babies are born by caesarean they get a different bacterial flora and it seems that caesarean section is a risk factor for increased levels of allergy.PorterWhat about the effects of formula milk - bottle fed babies versus breastfed babies - is there any significant difference there?EdwardsThis is a major, major factor. In the mother's milk there are a lot of factors which really encourage the growth of this lactic acid style bacterial flora, there's particular carbohydrates called oligosaccharides in human milk, which the bacteria can ferment and particularly helps these friendly bacteria, we then have lots of antibacterial agents in milk - human milk - which helps to protect the infant against a lot of the pathogens that make you ill, so by having these in breast milk it really does swing the pattern of the bacteria over to a more healthy style of flora. And breastfed babies are much less likely to get diarrhoea than formula fed babies.PorterAnd presumably that's a direct implication of the fact that their bowel is full of healthy bacteria, there's no room for a pathogen to get a foothold or less room?EdwardsThat's right. The environment becomes difficult for the pathogen to grow in.PorterWhich brings us back to faecal transplants - using samples of faeces from one person to recolonise the bowel of someone else. The ultimate probiotic.It's a technique used to rebalance the bowels of people who have picked up nasty infections. The subsequent diarrhoea washes out all the friendly bugs leaving the nasty one with more room to establish itself - a vicious cycle that is likely to keep on repeating unless enough healthy bacteria are introduced to allow them to gain a foothold and compete. And that's the principle behind faecal transplants.Gastroenterologist Thomas Borody helped establish the technique at the Centre for Digestive Diseases in Sydney, Australia BorodyTwenty four years ago a young lady came along, Jackie, and she was so - at her wit's end, you know she went to Fiji for a holiday and she came back with this chronic unrelenting diarrhoea. And I think I was the eighth gastroenterologist to see her and she had seen countless general practitioners and everybody had colonoscoped her, and we did too, there were some patches of inflammation and I didn't know what to do either. But somehow, I don't know how, I came across a journal article from 1958 by Eiseman which showed that if you do introduce new faecal flora it can actually reverse severe diarrhoea. So we gave her an implant of homogenised liquefied donor healthy stool from her brother, Tony, on the Saturday and a second enema on the Sunday and then I had to fly out to the US for a conference. And two or three days into my being in New Orleans I called from the hotel and I asked how are you Jackie and she said I'm cured, it's all gone away and I couldn't believe it. So I called a few days later, it was still gone and had she not been fixed I would probably never have done anymore.Porter Thomas Borody has gone on to do hundreds of faecal transplants since, but it's still a very unusual technique that most doctors have never even heard of. Alisdair MacConnachie is a specialist in Infectious Diseases at the Gartnavel General Hospital in Glasgow, and probably the only doctor in the UK doing faecal transplants - which he uses to treat resistant cases of the superbug C. difficile that have not responded to conventional therapy.MacConnachieThe patient is pre-treated with antibiotics to lower the burden of C. difficile in their gut. We admit them the night before we're going to do it, we admit them to hospital, and we stop those antibiotics the night before. They're given medication the night before and in the morning to lower their gut acidity because we don't want the gut acidity to kill off the bacteria that we're going to give. The donor comes in briefly the morning of the transplant and provides a fresh sample of faeces. We then take a portion of that, we liquidise it and we filter it, to produce a watery solution which will contain many of the normal bowel organisms that exist in the healthy donor's gut. We then pass a small feeding tube, called the nasogastric tube, up the nose of the person who's receiving the faecal transplant, it goes up the nose over the back of their throat and down into their stomach. And we administer about 30 mils of the faecal transplant down the tube into the stomach and then remove the tube. That is essentially the procedure.PorterAnd if it works how quickly does it take for those bugs, the friendly bugs in the faecal sample, to establish themselves?MacConnachieUsually people are diarrhoea free from then on.PorterYou say often, what sort of success rate - how many of these have you done and what sort of success rate have you had?MacConnachieI've treated 21 people with this and it's worked in all but one individual.PorterHow did the patients react when you - when you mention this as a possibility?MacConnachieThe patients whom I've treated have often had multiple courses of antibiotics, often other treatments as well, to try and treat their C. difficile and they have failed. I've yet to have someone say no when it's suggested and the last six patients I've treated have actually done their own research and have requested that the doctors looking after them refer them to me for a faecal transplant, so many of the patients that I've treated have actually requested the treatment themselves.PorterWho are the donors?MacConnachieThe donors are often a relative. The original reason for that was that it was felt that a household - someone who lives in the same household is likely to have a similar bowel flora to the individual and that's probably correct. But I think probably aesthetically it is easier for the patient if they know where the faeces have come from.PorterThey're more - they're happier to take it from a relative than a stranger.MacConnachieIndeed.PorterWhat about screening the donor - is there any possibility of transmitting any nasty diseases?MacConnachieYeah, that is obviously a concern. We do attempt to reduce that significantly, so the donor - they have three stool samples examined for bacteria that cause gut infections and also for parasites that cause gut infections and they have blood checked looking for the hepatitis viruses, for HIV and for syphilis infection and that's kind of similar to the screening that you would receive were you to be a blood donor for example. But the individuals that I'm treating have often come to the end of other treatments and their C. difficile infection poses the greatest risk to them at that time.PorterAnd if you find the idea of getting your intestinal flora from someone else's stool somewhat off putting, where do you think the friendly bacteria in most probiotic products originate from? Glenn Gibson at the University of Reading. GibsonThe bacteria which are used as probiotics are actually isolated from the gut normally, so the gut flora of people or animals. There's one famous strain which is called the Nissle strain, which is actually isolated from the flora of a German Second World War soldier who had resistance to food poisoning in the barracks and the scientists began to look at his gut flora and found these very hardy probiotics in there and that's actually used in the product now today.PorterSo it's the relations of his original bacteria?GibsonIt is yes and probiotics are meant to exert their effects in the gut, so it makes sense that that's really where they arise from.PorterSo, probiotics are cultured concentrations of friendly bacteria - usually of the lactobacilli and bifidobacter varieties - the types that we get from our mothers when we're born. The idea being that supplementing your diet with them will boost their numbers in your bowel and benefit your health - but in what way? That's a question Glen Gibson and his team at Reading are currently trying to answer and they have made some interesting discoveries. But their work isn't just limited to probiotics - they are also investigating prebiotics - dietary nutrients, typically carbohydrates with strange names that preferentially boost friendly bacteria. Glen Gibson:GibsonGood prebiotics are things called FOS - F O S - or inulin not to be confused with insulin or GOS - G O S. FOS and inulin are present in foods naturally, like bananas, garlic, leeks, asparagus, artichoke. GOS is synthesised from lactose as a starting material and after a very short feeding period these boost levels of friendly bacteria in the gut to very high levels indeed.PorterGlen, looking at the research that's going on into the role of prebiotics and probiotics at the moment what particularly excites you?GibsonSome of the areas of interest for me are quite generic really, they take the view that many of the gastrointestinal tract difficulties are caused by types of bacteria and what one is trying to do with a probiotic is to keep these problematic bugs at bay, so it's germ warfare if you like in its simplest sense. So that's the generic concept. So the understanding then arises from beginning to unravel which bacteria cause which problems. So the ideas that we have are driven towards acute gastroenteritis, for instance, we work with some of the Commonwealth Games teams, for instance, in the Games in Delhi last October to try and reduce their risk because if you're a high class sportsperson and you get a tummy upset you're not going to do well when you need to perform. So there are at risk populations, like sports people, like the military, people in hospitals where infections are quite rife. So anybody I think who's interested in trying to reduce their risk of this acute problem with food poisoning pro and prebiotics are probably for them. On a more chronic basis there's very good research in irritable bowel syndrome, ulcerative colitis, which is an inflammatory bowel disorder and some incredibly exciting new research into metabolic syndrome and obesity, even obesity is being looked at in regards to gut bacteriology.PorterWe'll return to the link between gut bacteria and obesity later on, but first could the germ warfare Glenn Gibson mentioned really help people with the most common chronic bowel complaint of all - irritable bowel syndrome or IBS? Mark Pimentel, a gastroenterologist at the Cedars-Sinai Medical Centre in Los Angeles, is convinced that bacteria are at least partly to blame.PimentelTradition has it that irritable bowel syndrome is caused by stress or psychological problems but now because of the unanimous symptom of bloating across most IBS groups, whether they be diarrhoea, mixed or constipation groups, there's been a desire to understand if this is due to fermentation in the gut and whether bacteria are playing a role in some of the symptoms of irritable bowel syndrome - over this last decade we've come a long way in understanding that gut microbes are playing a significant role here.PorterEarlier this year Mark Pimentel and his team published a landmark study in the New England Journal of Medicine suggesting that antibiotics can relieve the symptoms of IBS. The drug they used was rifamaxin - a type of antibiotic that is not absorbed into the body, and which only wipes out bacteria in the small bowel, upstream from the large bowel, or colon, where most friendly bacteria live. Half the 1200 volunteers in the study were given a course of rifamaxin, and half were given a dummy version or placebo. Treatment only lasted for two weeks but…PimentelThe benefit lasted for a duration of three months, so unlike other therapies for irritable bowel syndrome were you're required to take it continuously this was a two week course that resulted in a substantial improvement that had a durable effect. PorterWhen you say a substantial improvement, what sort of proportion of the people in the trial got better?PimentelThe measure we used was declared adequate relief. This is patients telling us - do they feel better. The rifamaxin group had approximately 41% of patients declared that they had adequate relief of their IBS symptoms and 31% in the placebo group, and this was statistically significant.PorterAnd would the idea be to use it as a one off treatment or is this something that's likely to have to be repeated every few months?PimentelWell what we understand is that a certain proportion of patients who do get a response to rifamaxin at some point in the future they might have a relapse. Studies from Europe have suggested that the number of patients relapsing could be 50% of them by six to nine months. So there is a possibility that patients might need retreatment.PorterAnd what do you think the antibiotics are doing - presumably they're wiping out a large proportion of the bacteria that live in the gut?PimentelWell you see this is where we have tried to be careful. Earlier in this previous decade we were looking at a number of antibiotics and we were struggling because of resistance to the antibiotics, so the IBS patient might have a good response the first time but we soon learned that 75% of patients wouldn't have a good response the second time because of resistance in most of the conventional absorbed antibiotics. The refamaxin, we learned, was quite special - it doesn't get absorbed and because it's not soluble in water, the reason it doesn't get absorbed, it actually primarily causes its effect in the small bowel. So it doesn't affect the colon bacteria. So for those who think that you need to take a probiotic after or it's going to cause damage or harm to the normal bacteria of the colon, in fact studies have shown that refamaxin doesn't change the colon bacteria.PorterWhich is interesting because when most people think of bacteria that live in the bowel they think about the colon because that's where most of them are thought to live.PimentelThat's correct.PorterSo do we think that irritable bowel syndrome's being caused by bad bacteria or normal bacteria in the wrong place?PimentelWell the leading theory on this is that it's actually an excessive proliferation of the normal bacteria of the colon into the small intestine where they don't belong. Humans generally don't have much bacteria in the small intestine, so if you have all these extra bacteria in the small intestine every time you eat you get bloated, they change the dynamics of your bowel function as well as causing cramping and pain in part due to the bloating and gas.PorterAnd this gas is coming from the bacteria breaking down the food - fermenting it - and producing gas as a by-product?PimentelRight, I guess the way we think of it is that when you have too much bacteria in the small intestine this is the area of the bowel or the digestive system where food is assimilated and absorbed by you. And so when you have all these bacteria there they're actually very happy because they're not getting the leftovers in the colon, they're getting the good fresh stuff which allows them to ferment at a much more rapid rate. And so the symptoms become more significantly provoked by that.PorterMark Pimentel talking to me from Los Angeles.Meanwhile back in the UK there's growing evidence that gut flora may also play an important role in cancer of the colon. Ian Rowland is Professor of Human Nutrition at the University of Reading.RowlandWe know from some of our studies that the bacteria in the bowel - if you look at them as a whole you just look at the metabolic activity of that mass of bacteria, then there are some reactions which can generate carcinogens, which cause cancer, there are some reactions which can generate DNA damaging agents and we know DNA damage is very important in cancer. But they also produce things which might protect against cancer and I think it's probably the balance of the organisms that are there - and we all have very different organisms and different organisms have different activities. So I think it's very much about the balance of organisms that are there and of course that's the possibility that we can alter that balance in a beneficial way to actually reduce cancer risk.PorterHow does your understanding now of what the bacteria are actually doing in the colon fit in with our accepted sort of risk factors for bowel cancer, can they be explained by acting through this bacterial pathway?RowlandYes some of them can. They include things like high fat diets are associated with increased risk, increased meat intake, processed meat intake is associated with increased risk of colo-rectal cancer and high fibre diets are associated with lower risk. And to a certain extent that fits in quite nicely with some of the effects on the metabolism of those bacteria. For example, people on very high fat diets produce more bile acids and bile acids are produced by the liver to help in the digestion of fats that we consume. Some of the bacteria in the gut are very good at converting those bowel acids into derivatives which are much more toxic and we've shown that they are potentially tumour promoters - that is they assist the development of cancer. We know that meat can increase the levels of compounds called nitroso compounds in the large bowel and again we've shown that it's bacteria that can convert those precursors in the meat to nitroso compounds.PorterHave we taken this on to the next stage in looking at ways of altering the population of the bowel has some impact on the incidence of bowel cancer?RowlandYes, we've done a lot of studies here in terms of potential of probiotics and prebiotics to actually reduce cancer risk. Now the evidence is pretty strong if you look at animal studies and in vitro studies for the preventive effects of probiotics and prebiotics. When you come on to looking at trying to get evidence from humans it becomes a lot more difficult. We've conducted one very large European study where we fed people a mixture of two different probiotics and a prebiotic and had a control group that weren't given the pro and prebiotics and we looked at various bio-markers of susceptibility to cancer and we found changes, for example, in DNA damage and we know that DNA damage to genetic material is very important in the initiation and progression of colon cancer. So we found that by giving pro and prebiotics it was possible to reduce the level of DNA damage in tissue samples taken from the colon of these people. We also found that in the subjects given the pro and prebiotics they had a lower rate of cell proliferation - cell multiplication - in the colon and high levels of cell proliferation in the colon are associated with increased cancer risk. I mean it's not cancer as an end point but it would indicate that pro and prebiotics are doing something that might be helpful in preventing cancer.PorterAnother exciting area of on-going research is the recent discovery that obese people often have different types of bacteria in their bowel. Could gut flora influence your odds of being overweight? Mark Pimentel in Los Angeles has been looking at species of bacteria that produce the gas methane.PimentelThere began to be some literature in animal studies suggesting that methane types of bacteria in the intestine could be a predisposing factor to obesity. Methane producing bacteria, when they're present, they metabolise food products differently and liberate more calories - at least that's the theory. But actually what we found is that methane gas that's produced by these bacteria actually slow the gut down by 60-70% and by slowing the gut down we found it was associated with significant constipation and we have a number of studies on this. So the extension of that slowing of the gut is you have more slowing, therefore you have more time to absorb food. And so my hypothesis is that the more time to absorb food means for every meal you get slightly more calories as a result. So these are the things that we're working on now and we have a number of studies that are demonstrating this association between these methane bacteria and a greater body mass.PorterAnd how can you identify whether someone contains more than their fair share of these methane producing bugs?PimentelWell we do a breath test and breath test is very reliable for methane and the patients are either positive or they're not positive. And we can tell on the breath by analysing the gas from their breath because methane is not produced by humans, it's only produced by bacteria and principally in the gut.PorterSo this methane is produced in the gut, absorbed into the blood and then blown off via the lungs - that's how you're picking it up?PimentelThat's how we're picking it up, exactly.PorterAnd you found a correlation between the people who are excreting methane and they tend to be more obese than people who don't?PimentelRight, in a study we took patients whose body mass index was greater than 30 and that is generally believed to be the cut off point for patients who are of excess body fat. And among that group, when we actually measured their breath samples, we found that patients who had methane on their breath had 40 pounds greater body fat and weight as compared to those who did not have methane on their breath.PorterDo we know why these patients have this particular type of bacteria living in their bowel - could it be that they're obese and the link is the other way round?PimentelWell you know what we're looking at is whether diet influences these bacteria and therefore it's a consequence of diet rather than a primary cause or whether it's a consequence of the gas in them and the methane bacteria themselves. And we're demonstrating some interesting results which unfortunately I can't discuss yet because they haven't been made public at the research fora yesterday but I think we'll have answers on that within the next year.PorterBack at Reading University, Glenn Gibson's team is testing whether they can influence weight gain by altering gut flora. GibsonWe're doing a trial right now with a prebiotic but the trial is going to have to last a long time, it's a yearlong trial, because if you're looking at something like weight management you need to do it for a long time. So unfortunately the results are a long way off but given our results in the laboratory we're fairly confident of some success.PorterOne of the problems that I see, as somebody with a sort of foot in both camps really, is on the one hand we have the public and this concept of probiotics - they're good for your general health - and yet I see researchers, like yourself, working on very specific conditions, with very specific bacteria, are you worried about this sort of generalisation that's going on in the public mind that probiotics can do everything for everybody because that's obviously not the case?GibsonVery much so. I'm also very worried about how the products are advertised, you know you switch on the TV and you see things about wellbeing and bloating and I feel better and you think well this is actually a little bit nebulous, this is not really telling us what pro and prebiotics can do. But the science tells us they can do a lot and I think something needs to come together there, such that if the research hangs together and adds up the claims should be made such that people understand exactly what they are getting with these products, rather than something a little bit wishy washy.PorterProfessor Glen Gibson reminding us that, exciting though probiotics may be, they are certainly no panacea.


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## Bradw4040 (Feb 10, 2006)

WOW!!! Thanks for the post. Wish they would try it for IBS.


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## Mr 100 (Aug 1, 2011)

Hi Brad, part of the problem with FT is the lack of clinical evidence and practical experience to back up this kind of treatment. Once you think of how a trial should be designed and measured you start to realise why the medical community have avoided this for so long. Add in public perceptions, the "ugh" factor etc and it's easy to see why this has only been used in desperate situations, so far...Still, lots of good info in the program transcription.


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## Mr 100 (Aug 1, 2011)

Research news...http://www.queensu.ca/news/articles/synthetic-stool-prospective-treatment-c-difficileSynthetic stool a prospective treatment for C. difficile2012-04-30 A synthetic mixture of intestinal bacteria could one day replace stool transplants as a treatment for Clostridium difficile (C. difficile). C . difficile is a toxin-producing bacteria that can overpopulate the colon when antibiotics eradicate other, naturally protective bacteria living there. "A synthetic stool transplant has a lot of potential because we can control what goes in and we can alter, change, or modify it as necessary," says Elaine Petrof, an assistant professor in the Department of Medicine at Queen's University and in the Gastrointestinal Disease Research Unit (GIDRU) at Kingston General Hospital. Dr. Petrof and her collaborator at the University of Guelph, Emma Allen-Vercoe, believe that a stool compound made from synthetic or "purified" bacteria could significantly improve on regular stool transplants. It could eliminate the chance of transmitting an infectious disease through fecal bacteria; physicians could tailor the mixture so as to increase patient acceptance; it would be easily reproducible; and, it may appeal to both doctors and patients as a 'cleaner' therapy. Dr. Petrof and Dr. Allen Vercoe, an anaerobic microbiologist specializing in intestinal bacteria, are working closely to develop such a therapy. The goal behind their synthetic stool project is to offer a single-dose remedy, putting an end to revolving-door hospital visits for patients with recurring symptoms. Currently, they are continuing their research before using it as a new therapy. Dr. Petrof recently presented the project's preliminary findings at the Beneficial Microbes Conference in Noordwijkerhout, the Netherlands.


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## Mr 100 (Aug 1, 2011)

Last week, in the UK, Channel 4's 'Embarrassing Bodies - Live from the clinic' featured FT. There is a link below,A pioneering new treatment uses faecal - or poo - transplants, to tackle dangerous bacteria like C Difficilehttp://www.livefromtheclinic.channel4.com/case-videos/faecal-transplant


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