It may sound unusual, but fecal transplants have been found to be a valuable therapeutic strategy for multiple medical situations. Fecal samples from healthy individuals can be processed and used as microbiome transplants for individuals with various GI diseases. For example, this type of treatment has been shown to be extremely valuable in treating infectious C. difficile, a recurring hospital-acquired bacterium that causes diarrhea (1).
There is also potential for this type of therapy to be used for those with inflammatory bowel disease such as Crohn’s disease or ulcerative colitis. One study found that 27% of individuals with ulcerative colitis could achieve full remission of the disease after fecal transplant (2). This encouraging evidence shows that transplantation of the microbiome has potential to cure at least a portion of individuals suffering from chronic gastrointestinal disorders.
We continue to learn more about the microbiome, its role in GI health, and its potential for targeted therapeutics. A double-blind clinical trial looked at the effects of fecal transplant versus placebo in individuals with ulcerative colitis (3). Once again, some of the individuals who received fecal transplants went into remission. Interestingly, those who achieved remission had greater microbiome diversity both before and after the transplants. In addition, remission was associated with higher levels of two specific bacteria (Eubacterium hallii and Roseburia inulinivorans) and increased short chain fatty acids (SCFAs). Comparatively, individuals who did not go into remission had higher levels of three other specific bacteria (Fusobacterium gonidiaformans, Sutterella wadsworthensis, and Escherichia species).
In fact, upon further analysis, it was found that remission of ulcerative colitis was more likely when the samples used for the fecal transplants contained higher levels of Bacteroides species, whereas the transplants that did not lead to remission were higher in Streptococcus species.
This fascinating research suggests that changing the microbiome through fecal transplant has the potential to cure chronic gastrointestinal diseases, and that assessment of the transplant recipients and transplant donors could identify ways to enhance the likelihood of success.
Personalized treatment may also be part of the future of treating such chronic diseases. As in the study described above, researchers have found strains of bacteria that associate with the likelihood of remission after fecal transplant. Such work might make it possible that health providers can use specific strains as treatment strategies in and of themselves. It is clear that a personalized approach is the future of health care, whether the intention is to target weight loss or disease management.