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Huge increase in weight after stool transplantation
A patient in the USA, who repeatedly suffers from diarrhea, finally receives a fecal transplant after numerous other therapeutic attempts. For a long time, such chair transplants have been used in cases of severe diarrhea. The therapy is also successful for the 32-year-old. But enigmatic way it comes after a strong weight gain.
Faeces capsules against intestinal diseases
The importance of gut bacteria for human health has been well documented for years. From the realization that a greater variety of bacteria can be a health benefit, a medical therapy was developed, the so-called fecal transplantation. Patients get feces capsules for intestinal inflammation and other intestinal diseases. Some physicians rely on this method rather than on antibiotics, as treatment with the drugs often causes symptoms such as stinging abdominal pain, diarrhea and fever.
The stool transplantation can positively affect the intestinal flora. (Image: rob3000 / fotolia.com) Complaints after antibiotic therapy
The patient, a 32-year-old American, therefore first turns to her doctor with a bacterial vaginal infection. This gives her an antibiotic, with which the symptoms disappear quickly. However, the woman gets diarrhea and abdominal pain after some time. When the symptoms persist three weeks later, the physician suspects that antibiotic therapy may have made the woman's intestine susceptible to a particular bacterium, Clostridium difficile (C. difficile). The bacillus bacterium is usually harmless to healthy people, but can be particularly dangerous to the weakened and elderly. In Europe alone, there are over 39,000 undetected Clostridium difficile infections each year. If antibiotic treatment displaces bacteria from the normal intestinal flora, it can lead to severe diarrhea in patients.
Patient receives different medications for months
The patient is only slightly overweight with her 68 kg and a body mass index of 26 and the physical examination is unremarkable. For ten days she takes an antibiotic against the infection, after that she is even worse and the symptoms return. The doctor then detects C. difficile in her stool and also finds the stomach bacterium Helicobacter pylori. He prescribes a 14-day therapy with other antibiotics, but a few weeks later, the symptoms increase again and again C. difficile can be detected. This is followed by a 12-week antibiotic therapy, but this can not prevent the pathogens come back, as well as the change of the drug.
Chair transplant successfully performed
Finally, the doctors at the Miriam Hospital in Providence, Rhode Island, offer her a so-called fecal transplant, as reported in the Open Forum Infectious Diseases. The grafted chair of a healthy person contains billions of beneficial intestinal bacteria that are supposed to make the recipient healthy again. The method has been used successfully for years. For example, Amsterdam physicians found in a study comparing two groups of patients with C. difficile that four out of 13 subjects treated with antibiotics recovered, while fecal therapy cured 15 out of 16 patients. The transplant, for which her 16-year-old healthy daughter will be donated, is successfully completed, the abdominal pain and diarrhea of the US patient diminish, and C. difficile is no longer detectable.
Patient greatly increases after treatment
However, the woman returns to the doctor 16 months later. This time because of heavy obesity (obesity). Despite various dietary attempts, exercise programs and medically supervised, liquid protein nutrition, she has gained 17 kilograms. With a weight of 85 kilograms and a BMI of 33, she is now obese. The physicians can rule out a hormonal disorder of cortisol production or thyroid gland. The patient is now suffering from bloating, nausea and constipation. It has been reported that the internists around Neha Alang, who treated the patient, believe it is possible that the stool graft has so confused the woman's digestive system and intestinal flora that it inevitably increases. The daughter was at the time of transplantation with 63 kilos and a BMI of 26.4 only slightly overweight, but increased in the aftermath of 13 kilos, which she was then clearly obese.
In the future only stool donations of normal weight
According to the authors, it has already been observed in animal experiments that stool transplants can contribute to obesity. The doctors discuss in the journal, whether possibly the successful therapy against Clostridia have greatly stimulated the woman's appetite or whether the Helicobacter pylori treatment could be blamed. They write: "It is well known that there is a link between Helicobacter pylori therapy and weight gain." These are attributed to the increasing levels of ghrelin, an appetite-stimulating hormone. But also genetic factors and age come as a trigger in question. The physicians aim for the future to use in chair transplants only material from normal weight donors. For their enigmatic patient, however, they could neither capture the trigger nor help her: The woman has 20 months later increased another 3.5 kilograms. (Ad)