Probably any of us has heard about kidney or heart transplant. However, the term "stool transplant" is almost unknown to public. It may sound a little bit bizarre, but this procedure has proven to be effective in therapy of certain serious intestinal infections.
The principle is a theory that intestinal inflammations are associated with disruption of the natural balance of microorganisms in the intestines. Normally, the large intestine is inhabited by about 6 pounds of bacteria. Many of these bacteria are potentially harmful, but they are suppressed by other beneficial bacterial types.
An imbalance in this environment may mean decrease of numbers of beneficial bacteria. This is used by harmful bacteria that multiply and may cause serious intestinal infection. Patients with intestinal troubles may be served probiotics (cultures of beneficial microorganisms), but their effect may not be adequate. Therefore, the doctors have tried what happens, when the sick patient with an intestinal infection gets a stool sample of a healthy individual, which should be inhabited mainly by the beneficial intestinal microorganisms. The method has proven to be successful and the stool transplant has been invented.
The main targets are infections caused by the bacterium known as clostridium difficile. This bacterium causes a variety of infectious inflammations of the intestines, the most serious is known as the pseudomembranous colitis. The disease occurs most frequently in weakened individuals, whose intestinal microorganisms have been eradicated as a side-effect of antibiotic therapy. The therapy usually includes special antibiotics targeting the clostridium, but many patients do not respond well to the treatment and the condition may easily deteriorate into toxic megacolon, peritonitis, sepsis and death. Other possible indications for stool transplant are certain forms of inflammatory bowel diseases, especially the ulcerative colitis.
The stool intended for the transplant comes from a donor that should be a person close to the patient, ideally living in the same household. From the microbiological point of view, it can be assumed that the digestive tract of such donor is inhabited by similar spectrum of beneficial intestinal microorganisms as in the patient. The donor stool must be examined (to eliminate the presence of harmful bacteria and parasites), processed and the resulting product is given to the patient. This is done either by enema into the large intestine or by a nasojejunal tube, which is inserted through mouth into the small intestine.
The method is not widely used, especially because of its aesthetic disadvantages. However, the possible failure of antibiotic therapy due to growing bacterial resistance may increase the need of such natural, gentle and effective therapy of severe forms of pseudomembranous colitis.