Faecal replacement therapy

Discussion in 'Survival Medicine' started by chelloveck, Jan 19, 2013.

  1. chelloveck

    chelloveck Diabolus Causidicus

  2. UGRev

    UGRev Get on with it!

    What the crap?
  3. CrufflerJJ

    CrufflerJJ Monkey++

    What's even better, is that the FDA has decided (in its infinite wisdom) that feces, when used for fecal replacement therapy, must be regulated as a drug. Idiots.
  4. chelloveck

    chelloveck Diabolus Causidicus

    Care to explain why theraputic faeces used in that treatment should be unregulated, and why the FDA are idiots for regulating it as a drug?? I'd be interested in reading your reasoning.
  5. CrufflerJJ

    CrufflerJJ Monkey++

    The use of feces in such a therapy is nothing new. It's been reported in research since at least 1958.

    By regulating transplant feces (interesting phrase!) as a drug, the FDA essentially makes the current use of such feces in the treatment of C. diff. illegal. In my post, I did not suggest that such use be totally unregulated. If it is relegated to "investigational" status, then health insurance will typically not pay for "experimental" therapy. If labeled a drug, then feces must be proven safe and effective. "Safe" is an interesting word, for a fluid chock full of bacteria. While the FDA dithers with the use of feces for this purpose, people continue to die.

    I agree that before pts suffering from recurrent C. diff. receive a big whopping feces milkshake, the donor feces should be screened for a variety of unpleasant diseases/parasites. This was done in recent a study performed in the Netherlands.

    MMS: Error

    I've seen patients die from C.diff. related infections in my ICU (as a RN). A quick consult to Dr. Google suggests that 15-20K people die each year as a result of C. diff. infections. In my ICU, I've started seeing more patients infected with drug resistant strains of that bacteria.

    The "standard" therapy generally uses two antibiotics: Flagyl and oral vancomycin. Sometimes it works, sometimes it does not. In the meantime, my pts get weaker and sicker. They may have some or all of their colon removed.


    HowStuffWorks "How Fecal Transplants Work"

    (especially that article's Sources page)
    chelloveck likes this.
  6. Brokor

    Brokor Live Free or Cry Moderator Site Supporter+++ Founding Member

  7. kellory

    kellory An unemployed Jester, is nobody's fool. Banned

    Like watching a train wreck....you can'y just....stop! Now can this also be used to treat Anal-optica ?;)
    Brokor likes this.
  8. chelloveck

    chelloveck Diabolus Causidicus

    A well reasoned reply.

    Clostridium difficile colitis (C. difficile) Causes, Symptoms, Diagnosis and Treatment by MedicineNet.com

    Apparently there is some research being done into producing a synthetic version of the human product. The advantages being in eliminating (pardon the unintended pun) the risk of cross infection (with diseases such as AIDS, Hep C, Typhoid and any number of other diseases spread by faecal matter) and making the manufacture and use of the medicine (for want of a better word) easier, effective, and safer to make and administer. The synthetic versions of the traditional treatment will need to be tested for efficacy and safety before approval for general use.

    As to the traditional faecal replacement therapy, it seems not so much that it has been deemed a drug, but that the FDA has not run the treatment through its testing protocols for approval with some sense of urgency. Balancing the need to get effective treatments into the health system quickly against the risks of people dying or becoming worse off if the treatment is not adequately tested is often a difficult and contentious call. Government health agencies tend to be conservative, and although the wheels of public bureaucracy grind exceedingly small, unfortunately in many cases it grinds exceedingly slowly also.
    CrufflerJJ likes this.
  9. mysterymet

    mysterymet Monkey+++

    Well, crap...
  10. kellory

    kellory An unemployed Jester, is nobody's fool. Banned

    Why yes, in point of fact, it IS well-crap. Like pinching off a bit of bread yeast to grow a new batch. In this case they pinch off a loaf to help someone pinch off a loaf. :D
    CrufflerJJ and mysterymet like this.
  11. CrufflerJJ

    CrufflerJJ Monkey++

    Research into creating a synthetic poop (for lack of another phrase) will certainly take some time. The human creature is covered/inhabited/colonized by thousands of species of bacteria).

    Current "state of the art" treatment for repopulating GI flora following antibiotic induced diarrhea uses such products as Culturelle. These products typically include only a single species of bacteria.

    For a synthetic poop to be effective, it must be shown to repopulate a gut nuked (sterilized of normal GI flora) by antibiotics and prevent overgrowth of C. difficile. This could easily be drawn out into a multi-year, multi-million dollar research program. In the meantime, people continue to die.

    For some articles re: normal human bacterial flora, see:

    The Normal Bacterial Flora of Humans

    Bacterial biogeography of the human digestive tract : Scientific Reports : Nature Publishing Group

    It's interesting to note that the bacterial flora of stool is distinct from that of the colon tissue surface itself (from the second article listed above).
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