Stool transplants in case of severe diarrhea

Patients with severe diarrhea healed by stool transplantation

02/20/2015

At the University Hospital Cologne infectiologists of the Clinic I for Internal Medicine have now succeeded in the first successful intestinal flora transfer with the help of capsules. Two patients who suffered from severe diarrhea as a result of Clostridium difficile infection were treated successfully at the University Hospital Cologne "with the help of encapsulated bacteria of a healthy intestinal flora", according to the Uniklinik. The procedure opens up completely new options in the treatment of such infections. So far, a colonoscopy was always required for the stool transplantation, which can now be dispensed with thanks to the capsules.

Stool transplantation without colonoscopy
For over a year, the University of Cologne offers according to their own information already chair transplants. "In order to transfer the intact intestinal flora, however, a colonoscopy was always necessary so far", so the announcement of the hospital. For this purpose, a probe had to be placed in the upper small intestine on the day before the transplantation, and on the following day the flora of a suitable donor was processed and administered as quickly as possible. "The precise timing of these processes is not always easy, especially since the timing of the Darmfloraspende of course, can be difficult to influence," said the Privatdozentin Dr. med. Maria Vehreschild. In addition, some patients are "in such poor condition that placing the probe under anesthesia poses a certain risk to their treatment."

Donors for stool transplants are being extensively studied
Thanks to the new administration in capsule form, the conventional problems with the stool transplantation, according to the University of Cologne, now bypass. With the help of freezable capsules, the treatment can be carried out much easier and safer planned, reports the university hospital. For the preparation of the capsules, however, first a suitable Darmfloraspender must be found, with both related donors and strangers come into question. Beforehand, the donors are tested for a wide range of infections - similar to a blood donation, reports Dr. med. Maria Vehreschild. "So we prevent a possible infection in the context of transplantation," said the expert further.

Outpatient stool transplants possible?
As part of the processing, the donated intestinal flora is diluted with saline and then the bacteria of the flora are isolated by a multi-stage filtration process. This is followed by various centrifugation steps before the bacteria are filled into capsules. s the message of the university hospital. The capsules can also be frozen in case of doubt, with the addition of glycerol to prevent the death of bacteria during the freezing process and to allow rapid thawing within minutes before ingestion. So the capsules can be stored for several months. Finally, with the help of capsules even outpatient treatments are conceivable, explains Dr. med. Maria Vehreschild. "The ability of intestinal flora transmission based on frozen capsules offers us and our patients a whole new temporal flexibility and security in the planning and implementation of intestinal flora transmissions," the conclusion of the physician.

An American research group had already described the method of stool transplantation based on capsules last year, but patients in Germany have so far not been able to benefit from this treatment option as it was not offered by German clinics, reports the University of Cologne. (Fp)

Image: Dieter Schütz