Fecal bacteriotherapy

Fecal bacteriotherapy, also known as fecal microbiota transplantation (FMT), is a medical procedure that involves the transplantation of fecal bacteria from a healthy individual into a recipient. Its primary purpose is to restore the balance of the microbiome in the gastrointestinal tract of patients suffering from certain disorders, most notably Clostridioides difficile infection (CDI). This article provides an overview of fecal bacteriotherapy, including its history, methodology, applications, and considerations.

History

The concept of fecal transplantation dates back to ancient China, where it was known as "yellow soup" and used to treat food poisoning and severe diarrhea. The procedure gained modern scientific interest in the 20th century, with the first documented case in the Western medical literature occurring in 1958. Since then, fecal bacteriotherapy has evolved, with significant advancements in the understanding of the human microbiome and its impact on health.

Methodology

Fecal bacteriotherapy involves several steps, starting with the selection of a donor. Donors are typically screened for a wide range of infectious agents to ensure safety. The fecal material can be processed in several ways, including homogenization, dilution, and filtration. The resulting preparation can be administered through various routes, such as colonoscopy, nasogastric tube, or capsules containing freeze-dried material.

Applications

While the most well-documented use of fecal bacteriotherapy is in the treatment of recurrent CDI, research is ongoing into its potential applications for other gastrointestinal disorders such as inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), and obesity. The therapy's effectiveness in these conditions remains under investigation.

Considerations

The safety and efficacy of fecal bacteriotherapy are subjects of ongoing research. Potential risks include the transmission of infectious agents and the unintended transfer of antibiotic resistance genes. Regulatory considerations also play a significant role, with different countries adopting various approaches to the oversight of fecal microbiota transplantation.

Conclusion

Fecal bacteriotherapy represents a promising area of medicine, offering potential benefits for patients with certain gastrointestinal disorders. As research continues, the procedure's applications may expand, further integrating the therapy into clinical practice.