For 18 years, she needed steroids to control her colitis. Now, with poop therapy, she has got rid of them

It may be difficult to understand why the poop bacteria of a person may have use for another’s gut health to the point of improving the latter’s quality of life but a 27-year old woman has breathed a sigh of relief after 18 years because of it.
Suffering from severe ulcerative colitis since her childhood, she had repeated bouts of blood diarrhoea, requiring her to visit a hospital. But after a stool transplant, her gut health has been restored, her condition has been controlled and she is free of heavy medication.
The Fecal Microbiota Transplant (FMT) was conducted Dr (Col.) Avnish Seth, Head of Medical Gastroenterology, Hepatology and Manipal Organ Sharing & Transplant, at Manipal Hospital in Dwarka, along with his team.
“Her entire colon had ulcers and she required repeated hospitalisation for episodes of uncontrolled loose stools mixed with blood. To keep this condition under control, she was on strong doses of Corticosteroids and immune modulators like Azathioprine. As part of the disease, she also had severe arthritis and skin rash,” said hospital officials.
That’s when Dr Seth went for a Fecal Microbiota Transplant (FMT). Also known as a stool transplant, it is a process of transferring fecal bacteria and other microbes from a healthy individual into another individual through colonoscopy. FMT is an effective treatment for Clostridium difficile infection, which causes colitis. This procedure corrects the imbalance between bad and good bacteria, called dysbiosis, and tends to improve gut health. Dr Seth used the stool of her 37-year-old elder brother, who was in good health and physically fit after protocol blood and stool screening.

The patient responded very well to the treatment. There were no further episodes of relapse or hospitalisation and all her strong medications, including Prednisolone and Azathioprine, were gradually discontinued. “She has been placed on maintenance FMT protocol and is doing well only on a low dose of oral Mesalamine,” said the hospital officials.
According to Dr Seth, the woman was completely dependent on steroids to keep her colitis under control. “This was adversely affecting her body. We did her first FMT in 2020 and were able to wean her off steroids and Azathioprine over the following months. Her colonoscopy is normal for the first time in 18 years. She is only on a low dose of oral Mesalamine and comes to us for maintenance of FMT every six months,” said he.
Speaking about her experience, the patient said that she tried all sorts of home remedies, ayurveda and naturopathy but no treatment was working for her. “I have been through various treatments, whether it was allopathy, naturopathy, ayurveda or homoeopathy, but none of them seemed to work. I was passing frequent stools mixed with blood and developed extracolonic manifestations of joint pains and rash, requiring a high dose of steroids. Now, after FMT, for the first time in 18 years, I feel great. My lifestyle and diet are now normal and I can finally live my life without any restrictions,” she added.
Research worldwide has shown that a fecal transplant can restore healthy bacteria in the lower intestine which can help control Clostridium difficile or C.diff. According to the Johns Hopkins University School of Medicine, FMT can be more effective than antibiotics for keeping C.diff in check in some cases.

FMT is also done for certain disease conditions like Graft Vs Host disease. Most people who undergo a bone marrow transplant suffer from blood cancer. The Graft versus Host disease can occur at any time after an allogeneic transplant where the donated bone marrow or peripheral stem cells can attack the recipient’s body. It can develop in the GI tract, skin or liver.
Who can be donors? They are selected based on certain parameters. They should not be immune-compromised or have taken antibiotics over the past six months.
Procedures on the transplant delivery methods may vary like colonoscopy and use of nasojejunal tube. The recovery may take a week or more and most times there are at least two weekly installations of the stool (in liquid form).
FMT is being touted as a treatment option for many gut health issues. In an opinion article published on June 30 in the journal, Trends in Molecular Medicine, a team from Harvard Medical School and Brigham and Women’s Hospital (BWH) proposes that individuals bank samples of their own gut microbiota when they are young and healthy for potential use later in life in an autologous FMT.
A report in Science Daily quotes corresponding author Yang-Yu Liu, an Associate Professor of Medicine at Harvard and an Associate Scient in the Channing Division of Network Medicine at BWH, as saying, “The idea of ‘rewilding’ the human microbiome has taken off in recent years and has been hotly debated from medical, ethical, and evolutionary perspectives. It is still unknown if people in industrialised societies can gain some health benefit restoring their microbiome to an ancestral state. In this paper, we proposed a way to rejuvenate the human gut microbiome.”