Faecal transplants – what they can and cannot treat
First reported in ancient China, human faecal transplants have made a comeback in modern medicine. Evidence shows this treatment can be effective in treating C. difficile – a gastrointestinal infection that can cause symptoms ranging from diarrhoea to life-threatening inflammation of the colon.
In the latest edition of Australian Prescriber, gastroenterologist Dr Samuel Costello and co-authors from the Queen Elizabeth Hospital in Adelaide examine the evidence of this ‘ultimate probiotic’ and the future directions of faecal research.
Dr Costello says the first line of attack against C. difficile is antibiotics but, when this fails, faecal transplants can be used.
“Faecal transplants cure 8 or 9 people out of 10 with recurrent C. difficile infection,” says Dr Costello.
Having progressed from ancient methods where a faecal suspension was given by mouth to treat patients with severe diarrhoea, these days faecal material from a healthy donor is given via the rectum using a colonoscope or retention enema, or via a tube through the nose or by swallowing capsules.
“As well as C. difficile, many conditions have been associated with an imbalance in gut flora. There have been trials to see whether faecal transplants could be effective in treating irritable bowel syndrome, Crohn’s disease, autism and other conditions,” says Dr Costello.
“The jury is still out for these other uses and further clinical trials are needed before faecal transplants can be recommended,” he says.