Where does this news come from?
In stool transplantation, diluted stool from a healthy person is passed into the intestine of a patient. This is done through a probe through the mouth or anus. The aim is to restore the composition of the intestinal flora. These are the microbes that are normally found in the intestines and in the stool. For example, this intestinal flora can become disturbed if you are ill or generally weakened. Certain microbes that are not normally found in the intestinal flora can then overgrow others, which can lead to problems.
So far, there is only scientific evidence that stool transplantation is effective for stubborn diarrhea caused by the Clostridium difficile bacteria.
- A systematic literature review was recently published that summarizes the effect of stool transplantation in Clostridium difficile diarrhoea:
- Researchers selected studies in which patients were followed up for at least 3 months after the stool transplant (1).
- The scientists found 18 such studies, in which a total of 611 patients were treated.
- In 91% of cases, patients were cured with this treatment.
- Only 5% relapsed, mainly people over 65 years old.
- Other literature studies show promising results of stool transplantation in Crohn’s disease, but not in depression (2,3,4).
However, the long-term effect of stool transplantation is not yet clear, nor are any late side effects known.
Bron
- (1) Li YT et al. Systematic review with meta-analysis: long-term outcomes of faecal microbiota transplantation for Clostridium difficile infection. Aliment Pharmacol Ther. 2016 Feb;43(4):445-57.
- (2) Liu X, Li Y, Wu K, et al. Fecal Microbiota Transplantation as Therapy for Treatment of Active Ulcerative Colitis: A Systematic Review and Meta-Analysis. Gastroenterol Res Pract. 2021 Apr 23;2021:6612970.
- (3) Cheng F, Huang Z, Wei W, et al. Fecal microbiota transplantation for Crohn’s disease: a systematic review and meta-analysis. Tech Coloproctol. 2021 May;25(5):495-504.
- (4) Hofmeister M, Clement F, Patten S, et al. The effect of interventions targeting gut microbiota on depressive symptoms: a systematic review and meta-analysis. CMAJ Open. 2021 Dec 21;9(4):E1195-E1204.
How should you interpret this news?
Researchers also conducted literature reviews on the possible side effects of stool transplantation (5,6,7):
- There were generally no differences in side effects between the intervention groups, which underwent a stool transplant, and the control groups.
- The most common side effects were diarrhea and abdominal cramps.
- About 1.4% of patients experienced serious side effects.
- 5 deaths were reported. Four out of 5 deaths occurred after stool was transplanted by mouth in subjects with oral injuries.
Conclusion
Stubborn diarrhea caused by the Clostridium difficile bacteria, and possibly Crohn’s disease, currently seems the only indication to consider a stool transplant. Knowledge about the long-term favorable and unfavorable effects of treatment is still limited. Stool transplantation can also cause serious side effects.
References
- (5) Chen C, Chen L, Sun D, et al. Adverse events of intestinal microbiota transplantation in randomized controlled trials: a systematic review and meta-analysis. Gut Pathog. 2022 May 26;14(1):20.
- (6) Rapoport EA, Baig M, Puli SR, et al. Adverse events in fecal microbiota transplantation: a systematic review and meta-analysis. Ann Gastroenterol. 2022 Mar-Apr;35(2):150-163.
- (7) Marcella C, Cui B, Kelly CR, et al. Systematic review: the global incidence of faecal microbiota transplantation-related adverse events from 2000 to 2020. Aliment Pharmacol Ther. 2021 Jan;53(1):33-42.
