2023-07-03 16:30:00
Poo can also help heal. This Thursday, June 8, at the gastroenterology department of the Saint-Antoine hospital (Assistance publique-Hôpitaux de Paris, AP-HP), Benjamin – who did not wish to give his name –, a 30-year-old developer, feels a little tired but seems relieved. In the morning, Sandrine Truong, nurse coordinator of fecal microbiota transplantation (FMT), injected two syringes filled with filtered human stool (100 milliliters, or 25 grams) into her intestines using a nasogastric tube. He had to follow an antibiotic treatment for four days, so that his intestines might receive this product, and do an enema the day before.
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Two weeks later, her very disabling symptoms completely disappeared. He had been suffering from an infection since the end of February. Clostridioides difficileformerly called Clostridium difficile – the famous It’s hard, a bacterium that produces a toxin that alters the intestinal wall. This infection causes very severe diarrhea declared itself opportunistically, following several antibiotic treatments which weakened its intestinal microbiota – all the micro-organisms (mainly bacteria) which colonize the digestive tract. Two new cures having not come to the end of this multi-resistant bacterium, Benjamin was directed to the Saint-Antoine hospital, a pioneer of TMF for ten years. Healthy bacteria from the donor help restore the balance of bacteria in the recipient’s gut and prevent re-infections.
There are several hypotheses to explain the effectiveness of TMF. The donor microbiota might develop in the recipient and prevent the infectious bacteria from recolonizing the colon. Other mechanisms may come into play regarding the interactions between donors and recipients.
“I had to take antidiarrheals for two months to treat severe watery diarrhea that forced me to stay at home”, says Benjamin, who also suffered from powerful abdominal pain. In some cases, this kind of infection is also accompanied by loss of appetite and nausea. He had no reluctance to accept the stool transplant, while admitting that « [s]his friends made fun of [lui] initially, and were a bit skeptical”. The most embarrassing for the young man was above all to keep the probe for several hours, without anesthesia. TMF can also be given vaginally, most commonly by enema, but this is less common. From now on, taking capsules, better accepted by patients, is developing.
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