Faecal transplants?

Escherichia coli, a rod-shaped bacterium commonly found in the lower intestine (Source: Agricultural Research Service, US Department of Agriculture)

Faecal microbiota transplantation (FMT) is the infusion of faecal matter from a healthy person into the colon of an ill person, usually by enema, with the aim of re-establishing a balanced intestinal flora to the digestive system. Apparently, the first use of faeces in this way was described around 1700 years ago in China, while the first mention of the technique in English was by Eiseman and colleagues in 1958.

Today, FMT is most commonly used to treat Clostridium difficile infection; indeed, it is the gold standard treatment for patients with recurrent C. difficile infection when conventional antibiotic treatment has failed. However, a new review from Tianjin Medical University in China suggests broadening its application beyond intestinal disorders – to other chronic diseases, including autoimmune conditions and ME/CFS.

They point out that one clinical trial has been conducted on FMT in metabolic syndrome (which can lead to diabetes and heart disease), showing that the infusion of microbiota from ‘lean’ donors increased sensitivity to insulin and raised levels of ‘good’ butyrate-producing intestinal microbiota. They also describe case reports showing favourable outcomes in Parkinson’s disease and multiple sclerosis. And they mention one uncontrolled study (pdf) on 60 long-term ME/CFS patients with gastrointestinal symptoms (52 with irritable bowel syndrome), which suggested that 42/60 (70%) patients “responded to treatment” with FMT, and 7/12 (58%) patients who could be contacted for follow-up after 15–20 years reported a “complete resolution” of symptoms.

We can’t conclude much from one retrospective uncontrolled study, of course. Yet, the idea behind FMT does chime with recent scientific discoveries about the importance of the human ‘microbiome’ (the hidden yet extensive world of the microbes that live in our bodies), and it may eventually come to be a useful, if possibly a rather unpleasant, therapy for ME/CFS patients with gastrointestinal problems as a major symptom.

Fecal microbiota transplantation broadening its application beyond intestinal disorders. Xu MQ, et al. World J Gastroenterol, 2015 Jan 7; 21(1): 102–111. Read more (full text)

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