Fecal Microbiota Transplant Is Safe and Effective for Ulcerative Colitis Treatment

People with ulcerative colitis understand the pain of going to the restroom. There are many people who do not understand the pain associated with this condition.

But what if there was an opportunity for the intestinal tract to heal?

We are talking about fecal microbiota transplants, and they may bring relief to some people suffering from ulcerative colitis.

What is a Fecal Microbiota Transplant?

Long explanations made short, fecal microbiota transplant is when bacteria from a healthy person’s digestive tract is implanted in the digestive tract of a person with an unhealthy gut biome.

The bacteria are acquired from the stool of the donor. There are different ways to administer the microorganisms to the patient. It can be done via enema, during a colonoscopy, or even freeze dried and given as pills. That last method is not as effective as the direct methods, however.

But why would you want someone else’s fecal bacteria in your gut?

Deeper into the Gut

Your digestive tract contains a large number of microorganisms, mostly bacteria. This gut flora is for the most part a good thing, a beneficial relationship. You would be unable to absorb a number of nutrients without these bacteria, and your health would suffer.

The flora in your gut changes over time and also based on your diet. Certain diseases can affect your gut biome as well. You have probably heard of probiotics, which supplement your gut biome. A wider variety of microorganisms in your gut is typically a good thing.

Sometimes, this colony of bacteria can rebel against you. One of the most well-known disruptions to the gut biome is from Clostridium difficile, aka c. diff, a species of bacteria that infects to the detriment of their host.

A fecal microbiota transplant, or taking gut flora from a healthy individual and putting it inside a person with c. diff, is the most efficacious treatment for c. diff infections yet discovered. Just one such treatment can eradicate a c. diff infection. It is safe and effective.

Nobody quite knows what causes ulcerative colitis. People with this type of disease very often have a diminished diversity of bacteria in their gut compared to healthy people. Could fecal microbiota transplants be effective for ulcerative colitis, not just c. diff?

Not Just for C. Diff Anymore

If you have ulcerative colitis, chances are that your gut flora lacks diversity compared to the average person. That diversity is important to gut health, so after the success of fecal microbiota transplants for use against c. diff, researchers have turned their eye towards whether or not it can help people with ulcerative colitis.

The research into whether or not such transplants are beneficial for people with ulcerative colitis is still new. There is promise, thought it does not seem to be as effective as it is against c. diff infections. We will talk about one of the more recent studies into this promising treatment below.

The Study

The study is titled Single Delivery of High-Diversity Fecal Microbiota Preparation by Colonoscopy Is Safe and Effective in Increasing Microbial Diversity in Active Ulcerative Colitis. It was published in the Inflammatory Bowel Diseased journal in June of 2017.

The researchers were from Weill Cornell Medicine at Cornell University. They were Vinita Jacob, Carl Crawford, Shirley Cohen-Mekelburg, Monica Viladomiu, Gregory G. Putzel, Yecheskel Schneider, Fatiha Chabouni, Sarah O'Neil, Brian Bosworth, Viola Woo, Nadim J. Ajami, Joseph F. Petrosino, Ylaine Gerardin, Zain Kassam, Mark Smith, Iliyan D. Iliev, Gregory F. Sonnenberg, David Artis, Ellen Scherl, and Randy S. Longman.

Twenty patients with ulcerative colitis enrolled in the study. Each participant was administered a fecal microbiota preparation mixed from two healthy donors, administered during a colonoscopy. The study was four weeks long from transplant to when the patients were assessed.

At the end of the fourth week, they assessed multiple points of data in the participants. They checked for three main things: to see if there had been any dangerous downsides, to see if the new bacteria helped colonize the participants’ guts, and if there was any benefit to the procedures.

To determine the last two pieces of information, they took stool samples from the participants to examine the varieties of bacteria living in the colon. They also performed rectal biopsies.

The Results

At the end of the four weeks, all of the patients had an improved amount of diversity in their gut bacteria. Everyone’s gut biome had become more similar to the flora of the donors than what had originally lived inside the digestive tracts of the participants. Also important was that the new gut populations reduced inflammation in the digestive tracts.

No negative side effects were discovered. Not everyone benefited, however.

Only seven out of the twenty participants saw an improvement of their symptoms. Three of the patients went into remission, becoming asymptomatic. Two even showed signs of healing in the mucous linings of the digestive tract.

The researchers came to the conclusion that the fecal microbiota transplants were safe, and were at least effective in increasing gut biome diversity. They also noticed that the bacterial composition of the donors correlated with the effect caused by the donation.

The Future

Though it may seem like the treatment had a low rate of success—only seven out of twenty participants showed an improvement—fecal microbiota transplants may still be a great treatment option in the future.

Not all of the causes of ulcerative colitis are known, so it is possible that it could be caused by several different factors, leading this type of transplant to be effective in only some cases. Identifying the different causes of ulcerative colitis could lead to the ability to determine the most effective treatment option.

The length of time of the study was only four weeks, and the patients were only assessed once. More knowledge could be gained about the efficacy of this treatment by using a longer study with more assessments.

The scientists observed that the improvement of the patient correlated with the composition of the gut flora from the donors. Further research could determine which species of bacteria are most effective at helping people with ulcerative colitis, thereby honing this treatment and increasing the rate of success.

Also, the delivery method is a potential variable. This study utilized colonoscopies, but a different method of administering the fecal transplant may be more effective for this disease.

Overall, this treatment is in its infancy, but shows promise. The researchers have ideas of where to go from here.

The Bottom Line

For some people, the idea of taking fecal bacteria and putting it into someone else’s gut may make them squeamish. To scientists and people who are looking for help, it is a safe and effective treatment, long used to treat c. diff infections. Researchers have recently shown that it also can help people who suffer from ulcerative colitis.

While it is not yet a wonder treatment, eventually people with this disease may be able to visit the hospital to receive bacteria from a donor’s digestive tract and go home that same day. Perhaps not cured, but in remission, and healing.

References

https://www.sciencedaily.com/releases/2017/04/170427091746.htm

https://insights.ovid.com/crossref?an=00054725-201706000-00008