Wednesday, April 27, 2016

The Promise of Poop

  Soon after Max Nieuwdorp started his residency at the internal medicine department of the Academic Medical Center (AMC) in Amsterdam on 2006, he was confronted with a sad case: an 81-year-old woman hospitalized for a complication after a urinary tract infection who seemed unlikely to survive. She had bed sores and high fevers and was unable to eat. After antibiotics had wiped out her colon's microbial population, an opportunistic bacterium called Clostridium difficile had taken over, causing terrible diarrhea and bowel inflammation.

C. difficile is a notorious pathogen that kills at least 14,000 patients a year in the United States alone.It is a major cause of antibiotic inducing diarrhea To treat it, the woman was given several courses of vancomycin, the standard antibiotic in such cases. But, as often happens, the bacteria had become resistant.
 "I want to try a fecal transplant” Nieuwdorp said.

The plan was simple: The duo would flush the contents from the woman's colon, including, hopefully, the C. difficilepopulation, and replace it with the healthy bacterial flora from a donor, in this case her son. To do so, they would mix the son's feces with saline in a blender and squirt it straight into the patient's duodenum, the upper part of her intestine, via a thin plastic tube inserted through her nose.
Three days after her treatment, the woman left the hospital—walking.

Many doctors now agree that intestinal C. difficile infections can be cured by transplanting stools from healthy people. Researchers also think that a wholesale replacement of the gut's microbial flora might help treat many other diseases, such as inflammatory bowel disease, diabetes, and the elusive chronic fatigue syndrome. 

Posted by: Mohammed Saleh


              http://www.nature.com/nature/journal/v517/n7533/full/nature13828.html

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