Frozen as Good as Fresh for Fecal Transplants for Diarrhea: Study

southernlady

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http://www.nlm.nih.gov/medlineplus/news/fullstory_145861.html

Frozen as Good as Fresh for Fecal Transplants for Diarrhea: Study
Researchers looked at recurring infections caused by C. difficile bacteria

By Robert Preidt
Thursday, April 24, 2014


THURSDAY, April 24, 2014 (HealthDay News) -- Using frozen material for fecal transplants is as effective as fresh material in curing people with chronic diarrhea caused by recurrent infection with Clostridium difficile bacteria, according to a small new study.

Each year in the United States, C. difficile causes 250,000 infections requiring hospitalization and 14,000 deaths. Fecal transplants treat C. difficile infection by restoring the normal balance of intestinal microbes, the researchers explained.

Previous research has shown that fecal transplants with fresh stool have a success rate of about 90 percent. However, recruiting and screening potential donors of fecal material can be costly and time consuming, the study authors note.

Having a supply of frozen, prescreened donor stool could make fecal transplant available to a much larger number of patients, according to the Massachusetts General Hospital team conducting the study.

The pilot study included 20 patients (three were children) who'd had either three or more bouts of mild to moderate C. difficile infection where antibiotic treatment failed, or had two severe bouts that required hospitalization.

They received frozen stool through the standard colonoscopy method or through a tube inserted in the nose and moved down the throat into the stomach. The treatment success rate was 90 percent, which matches that of transplants using fresh stool, according to the study published online in the journal Clinical Infectious Diseases.

"We found that delivery of a frozen, stored [material] through a nasogastric tube is safe, acceptable to patients and as successful as delivery by colonoscopy -- which requires a preparatory 'clean out,' sedation or anesthesia, and is quite costly," senior author Dr. Elizabeth Hohmann, of the MGH Infectious Diseases Division in Boston, said in a hospital news release.

"Without this treatment option, patients with recurrent C. difficile may have chronic diarrhea -- limiting their quality of life and their ability to maintain weight -- and need to live on chronic antibiotic treatment, which is both expensive and can have other side effects," she added.

"There aren't many things in medicine that have a success rate of more than 90 percent. Insurers may not want to pay for this, but it is very effective, makes patients better quite quickly and saves money overall. While it may never become a first-line treatment, we are starting to consider using it more and more often," Hohmann concluded.

SOURCE: Massachusetts General Hospital, news release, April 24, 2014

HealthDay
 

Larra

Well-Known Member
Anything that makes this procedure more widely available is important, so this is great news.
 

Will2014

Well-Known Member
Anyone looking for further proof of how greed and avarice have driven and control healthcare in America, need look no further than the reluctance to embrace this highly efficacious and simple solution to a very serious health problem. The AMA would much rather work with the pharmaceutical industry to develop costly antibiotics and extravagant treatment approaches. It's only because of the internet and word of mouth that this excellent and simple treatment option has been gaining acceptance. Remember the Dr. who discovered the H. Pylori bacterium and established it's relationship with stomach ulcers. His work showed that an $8 course of antibiotics could be curative in a shockingly high amount of cases. The response by the AMA?: "SHUT HIM UP! Does he realize how much we're all making treating ulcers with daily Carafate/PPI's and visits? He's trying to slay the golden goose!" This good man fought for literally decades to get his work accepted through peer reviews, etc, but even to this day it's resisted. BAH!
 

Spiky Bugger

Well-Known Member
Anyone looking for further proof of how greed and avarice have driven and control healthcare in America, need look no further than the reluctance to embrace this highly efficacious and simple solution to a very serious health problem. The AMA would much rather work with the pharmaceutical industry to develop costly antibiotics and extravagant treatment approaches. It's only because of the internet and word of mouth that this excellent and simple treatment option has been gaining acceptance. Remember the Dr. who discovered the H. Pylori bacterium and established it's relationship with stomach ulcers. His work showed that an $8 course of antibiotics could be curative in a shockingly high amount of cases. The response by the AMA?: "SHUT HIM UP! Does he realize how much we're all making treating ulcers with daily Carafate/PPI's and visits? He's trying to slay the golden goose!" This good man fought for literally decades to get his work accepted through peer reviews, etc, but even to this day it's resisted. BAH!
So...while I agree with you generically, I think some of your facts are inaccurate.

Barry Something. I'll remember it in a minute. But it wasn't the US AMA trying to silence him. He's Australian. Marshall. Barry Marshall. And it was Aussie GI docs who tormented him, because he wasn't even a board certified GI doc, so that really pissed them off. My experience differs from yours. I was recently offered, and took, an h pylori breath test...I didn't even know they existed.

Oh...and PPIs were being developed at the same time Marshall was making his discovery. So, it wasn't getting rich off of PPIs that was involved, in fact, it was socialized medicine, I think...so it was more of an ego thing.

I just remember seeing him interviewed and he was a kick (and a smart ass, so I liked him) and I remember his story.
 

Spiky Bugger

Well-Known Member
I'm not sure of the wisdom (or aesthetics) of nasogastric delivery given our rearranged everything.

And one of my GI docs is concerned that they may be introducing something WORSE. Of course, he hasn't had to shit 18 times a day, so his idea of "worse" is likely different than mine.
 
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DianaCox

Bad Cop
"I'm not sure of the wisdom (or aesthetics) of nasogastric delivery given our rearranged everything."

I would think it would be perfectly fine, if not better, because delivery past the stomach gets the stuff even closer to where it needs to be.
 

Will2014

Well-Known Member
So...while I agree with you generically, I think some of your facts are inaccurate.

Barry Something. I'll remember it in a minute. But it wasn't the US AMA trying to silence him. He's Australian. Marshall. Barry Marshall. And it was Aussie GI docs who tormented him, because he wasn't even a board certified GI doc, so that really pissed them off. My experience differs from yours. I was recently offered, and took, an h pylori breath test...I didn't even know they existed.

Oh...and PPIs were being developed at the same time Marshall was making his discovery. So, it wasn't getting rich off of PPIs that was involved, in fact, it was socialized medicine, I think...so it was more of an ego thing.

I just remember seeing him interviewed and he was a kick (and a smart ass, so I liked him) and I remember his story.
Haha! I'll be more careful when posting from memory in the future. So they were getting rich off of H2 antagonists and not PPI's...both being acid production reducers, along with protective agents like Carafate. My point was it took 20+yrs before Marshall+Warren received their Nobel prize for their important work, and they were vehemently ridiculed by the Science establishment as a whole-which of course included the Americans. The pharmaceutical industry is interested in long term or forever treatments-not cures. It's ALWAYS about the money and how to get more of it. Why hasn't the AMA come out against the lap band? Why hasn't the worlds governments stepped in to protect their people from a procedure with a 65% failure/complication rate? Because it's HUGELY lucrative and those making the dough are lobbying our ever corrupt politicians to keep it going. And there is nothing more financially rewarding than products offering pain relief. People might take their blood pressure meds because they will keep them alive even though they are asymptomatic. But they will definitely take a pain reliever if they are in enough pain...such as the kind ulcers produce.
 

Larra

Well-Known Member
I think nasogastric delivery would work fine, esp since it would ensure that the good bugs came into contact with the proximal colon, which is less likely to happen with the colonoscopy route (unless the scope is inserted all the way to the proximal colon).On the other hand, some people with c diff have only the most distal portion of the colon involved.
Clearly more studies are needed, but it's already clear that this treatment works for many patients who have already failed all other treatments.
 

Spiky Bugger

Well-Known Member
I think nasogastric delivery would work fine, esp since it would ensure that the good bugs came into contact with the proximal colon, which is less likely to happen with the colonoscopy route (unless the scope is inserted all the way to the proximal colon).On the other hand, some people with c diff have only the most distal portion of the colon involved.
Clearly more studies are needed, but it's already clear that this treatment works for many patients who have already failed all other treatments.
Good to know. Not sure how far in my first FMT went, but the second went to the cecum. That might have been the trick as to why it worked...or not...I might just be one of those pts who needed two transplants.
 
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