Clostridium Difficile (C. Diff) and Fecal Microbial Transplantation (FMT)
What is Clostridium Difficile colitis (C. Diff)?
Clostridium Difficile (C. Diff.) is a common bacterium that has been featured prominently in the news media recently. C. Diff. is considered to be one of the hospital “superbugs” and is rapidly becoming resistant to a wide range of powerful antibiotics. It is a form of infectious colitis, which is an inflammation of the colon. Whereas in the past, C. Diff. was only acquired in the hospital setting, it is now being transmitted in settings outside of the hospital. In a C. Diff. infection, the infectious colitis may become chronic and long lasting. Treatment is required. The standard antibiotics used for this infection, vancomycin and metronidazole, are not always effective at treating the newly emerging, hyper-virulent strains.
At Los Angeles Colon and Rectal Surgical Associates, a Fecal Microbial Transplantation (FMT) protocol is now in place, which offers this new form of treatment. You may read further, or call our offices at (310) 273-2310 for additional education and treatment.
What is Fecal Microbial Transplantation (FMT) and How Does It Work?
Fecal microbial transplantation is an alternative therapy for the treatment of chronic, drug-resistant Clostridium Difficile infections. Traditional treatment with antibiotics has become less effective.
Due to the increasing prevalence of resistant C. Diff. infections, alternative and effective treatments have been researched and developed. FMT is one such therapy, having been used in veterinary medicine since the 17th century. The first recorded use of FMT in human beings dates back to 1958. It does not sound like the most elegant treatment, as it involves taking a stool sample from a healthy person, creating a suspension (mixing it with saline to make it more fluid), and transplanting it into the gastrointestinal tract of a patient with a resistant C. Diff. infection. The transplantation is performed with traditional colonoscopy by injecting the stool suspension through a side channel in the colonoscope. The procedure is performed in an outpatient setting under the same anesthesia that is used during a standard colonoscopy.
The colon and rectal surgeons of Los Angeles Colon and Rectal Surgical Associates perform the transplant procedure using a custom designed protocol and treatment plan.
Studies have shown that FMT cures this chronic infection in over ninety percent of patients with chronic C. Diff infections. Other investigators in countries around the world have reproduced this success rate. This is a higher cure rate than has ever been achieved using conventional antibiotic treatments.
While a stool transfer may not be a treatment that you would ordinarily choose for yourself, FMT is the most effective treatment for C. Diff colitis. In the setting of failed treatments, FMT is clearly worth considering.
What are the risks associated with FMT?
The known risks of FMT are low, but should be taken into consideration, as no treatment is entirely risk-free. The biggest risk is that a single stool transfer will be insufficient to cure the patient of the C. Diff. infection. 92% of patients are cured with the first FMT. However, if a second transfer of the stool suspension is performed, the success rate has been noted to increase to 98%. Stated in other terms, 98 of every 100 patients with resistant C. Diff. are now curable.
There is a potential risk that the stool donation may allow for the transmission of infectious disease from one person to another. To reduce this risk, it is recommended that the patient be closely related to the donor, who should be screened for disease prior to the procedure. There are no known cases of disease transmission from donor to patient using FMT.
The risks involved in this procedure are very low and the cure rate is higher than for any other treatment for this increasing prevalent and difficult to treat infection.
Strict protocols developed by the colorectal surgeons of Los Angeles Colon and Rectal Surgical Associates are in place to begin the evaluation and treatment process for C. Diff.
Contact Your Los Angeles Colorectal Surgeons If You Feel You Can Benefit From FMT Treatment
Although this is a brief overview of a complex and stubborn problem, Doctors Gary Hoffman, Eiman Firoozmand, Liza Capiendo, Stephen Yoo and Allen Kamrava of Los Angeles Colon and Rectal Surgical Associates are well versed in the treatment of Clostridium Difficile infections and fecal microbial transplantation. They can provide you with the education necessary for you to make an informed decision as to how you wish to proceed.
Calling to schedule an appointment will be the first step in hopefully eradicating a stubborn and difficult problem.
Our offices can be reached at (310) 273-2310 and we are open Monday to Friday, from 9:00 AM to 5:00 PM.
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