In 2003, a team led by Australian physician Thomas Borody published a report on successful treatment of six patients with longstanding ulcerative colitis with this approach. "Complete reversal of UC was achieved in all 6 patients following the infusion of human fecal flora," the authors reported. "These 6 cases document for the first time the total disappearance of chronic UC without the need for maintenance treatment."
"This is a fascinating idea, and the early studies show great promise, but we found that no one had looked at the social issues surrounding fecal transplantation," said Rubin. "Before we offer this, we wanted to find out how patients understood the process and take a look at the ethical issues that could also be raised by this therapy."
Like an organ transplant, fecal microbiota transplantation begins with finding a donor, often a family member. The treatment team collects a fresh stool sample, at least 200 to 300 grams. The sample is mixed with salt water in a blender and filtered to remove particulate matter. It can be administered to the recipient through a colonoscope, as an enema, orwhen the inflamed region is higher in the colonthrough a naso-gastric tube.
Rubin and colleagues Stacy Kahn, MD, and Rita Gorawara-Bhat, PhD, organized six focus groups in 2009-2010 with patients or parents of children with ulcerative colitis to "explore the attitudes and concerns" raised by this approach. They published their findings in the June issue of the journal Inflammatory Bowel Disease.
They found that 21 out of 22 patients or parents of patients were interested in trying FMT for themselves or their child; most wished it were already available. They viewed the treatment as more 'natural' than using drugs to control the disease, and easier and safer than currently available therapies. Many compared it to probiotics, a popular alternative
|Contact: John Easton|
University of Chicago Medical Center