Comments about the Editorial “Fecal Transplants”

Published in the British Medical Journal (October 20, 2015). First of all it is highly suspicious that up to this date we have not seen a good clinical trial comparing FMTs against any other therapy used for example in Ulcerative Colitis or Crohn´s disease. There seems to be a clear decision to avoid any comparison between the already proven poor and dangerous treatments applied to IBD patients against this safe and a priori useful method.

It is clear that in IBD patients (and there is where at least our medical team has the highest experience) the treatment with fecal bacteria has changed the lives of the patients we have had the chance to treat. Under a continuous infusion of balanced bacteria we can control the inflammation. We know this fact because we regularly measure Fecal Calprotectin that has become the standard parameter to check inflammation behavior.

We have seen no side effects, only minor symptoms on the early stages of the treatment. Also we have learned how to select the candidates, the ones that have better responses are the ones that have the shortest history with the disease, anyway we see over and over that the patients treated with our method can control the most disturbing symptoms, less defecation urgency, less bowel movements, less bleeding, less pain. They regain lost energy and also sleep better.

One basic element is the usage of proven donors, not only the “clean” ones, but donors that already shown their efficacy on previous patients.

I totally agree with the authors that there is a need to prove which is the effectiveness of this method, that it should be available through physicians with good experience that can detect any problem or deviation while using fecal bacteria with the possibility of advising on medication, nutritional aspects and any possible complications that could arise during the treatment.

I imagine a parent trying to learn about this therapy through the internet videos, isolated from medical advice and if something goes wrong being terrified by the stigmatization that the medical community might pose over them for doing such a risky and “unnatural” method at home.

So this situation should be immediately clarified. Based on good protocol that could just follow the same pattern as any immune or biologic drug: induction and maintenance doses.

If we think on drugs, there is not one single researcher that would think on doing three consecutive doses of any biologic drugs and early in the treatment say, “this thing does not work”, most of the FMT trials have been based on a small number of sessions and that has been proven to be ineffective, now let’s go for the real thing, it takes a good number of implants to control IBD cases, and then maintenance on a regular base can provide a good control of the inflammation. We see that every day and patients have the right to use this therapy as their first choice, way before putting their immune system at risk.

Link published