INTRODUCTION.

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FECAL TRANSPLANTATION USMAN AISHAT (U11AN1060).

Introduction.2It is a procedure in which fecal materials containing bacteria and natural antibacterial are transfer from a healthy donor into a diseased recipient (Bakken et al., 2011).The purpose is to replace good bacteria that has been killed or suppressed, usually by the use of antibiotics, causing bad bacteria, specifically Clostridium difficile to over populate the colon. This infection causes a condition called Clostridium difficile colitis, resulting in often debilating, sometimes fatal diarrhea.

History.3The concept of treating fecal disease with fecal matter originated in China millennia ago.Fourth century Chinese medical literature mentions it to treat food poisoning and severe diarrhea. 1200 years later, Li Shenzhen used yellow soup to treat abdominal diseases (Henning Gerk, 2014).The yellow soup was made up of fecal matter and water, which was drunk by the patient (John Hopkins University, 2013).

History continued4The first description of fecal transplant was published in 1958 by Ben Eiseman and colleagues, a team of surgeons from Colorado, who treated four critically ill with fulminant pseudomembranous colitis using fecal enemas, which resulted in a rapid return to health (Eiseman et al., 1958).Stool transplant, are about 90% effective in those with severe cases of Clostridium difficile colonization, in whom antibiotic have not worked (Burke and Lamont, 2013).

Clostridium difficile colitis.5It is the inflammation of the large intestine resulting from infection with Clostridium difficile, a type of spore forming bacteria (Moreno et al., 2013). The colitis is thought to occur when this bacteria replaces normal gut flora that has been compromised, usually following antibiotic treatment for an unrelated infection (Curry et al., 2007).The disturbance of normal healthy bacteria may provide Clostridium difficile an opportunity to overrun the intestinal micro biome.

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Signs and symptoms.7It range from mild diarrhea to life threatening inflammation of the colon (Joshi et al., 2012).In adults, the symptoms are, significant diarrhea, abdominal pain, fever (up to 40.5C), distinctive foul stool odour (Katz et al, 1996).In children, the most prevalent symptoms is watery diarrhea with at least three bowel movements a day for two or more days, which may be accompanied by fever, loss of appetite, nausea and abdominal pain (Moreno et al., 2013).

Procedure For Fecal Transplantation.8A team of international gastroenterologists and infectious disease specialists have published formal standard practice guideline for performing the transplant which outline in detail the procedure (Bakken et al, 2011). These are:Donor selection: This requires careful selection and screening of the donor and excluding those who test positive for certain diseases as well as any donor carrying pathogenic gastrointestinal infectious agent. Donors must be tested for a wide array of bacteria and parasitic infections (Bakken et al, 2011).

9Specimen preparation: The solution is being prepared by mixing of stool sample collected from healthy person with saline or distilled water, homogenization with blender to achieve a liquid slurry, and then filtration to remove particulate matter to facilitate administration. Fresh stools have been recommended to be used within six hours; however frozen stool samples can also be used without loss of efficacy (Hamilton et al, 2012).Administration: Choice depend on suitability and case. It involve single to multiple infusions of bacteria by enema (Eiseman et al, 1958), through colonoscopy (Lund et al, 1998) or through nasogastric or nasoduodenal tube (Perskey and Brandt, 2000).

Bristol stool scale.10

Risk associated with fecal transplant.11The biggest immediate risk is contracting an illness from your donor.Bacteremia: This is where the new bacteria travel into blood via abrasion in the gut wall and cause fever, septic shock and if untreated, death.Use of enema which can cause perforation or infection.There is also links between disruption of the intestinal flora and autoimmune illness. This means that the mass arrival of new microbiota may aggravate an existing autoimmune illness or trigger a new one, in predisposed individual.

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Poop pills.12

A noninvasive method of delivering a promising therapy for persistent Clostridium difficile infection appears to be as effective as treatment via colonoscopy, enema, and nasogastric tube (Younger et al, 2012).Cdn.inquisitr.com.

Conclusion.13Several studies have demonstrated the effectiveness of the procedure on treating not only Clostridium difficile colitis, but also constipation, irritable bowel diseases, irritable bowel syndrome, and some neurological conditions like multiple sclerosis or Parkinson's disease. Researchers in Amsterdam are even running clinical trial to see if fecal transplant can help treat obesity since the composition of the gut flora is one of many factors that affects weight regulation, and fecal transplant could very well be a future obesity treatment.

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References.15Benet JD, Brinkman M. Lancet(1989), Treatment of Ulcerative colitis by implantation of normal colonic flora. 1: 164 Elizabeth L. Hohmann, MD et al (2014),oral, capsulized, Frozen Fecal microbiotal Transplantation for Relapsing clostridium difficile infection. JAMA, Dol:10.1001/jama.2014.13875 G. Riegler (2001) _spinge, Bristol scale stool form. A still valid help in medical practice and clinical research, I Esposito Techniques in coloproctology.You DM, Franzos MA, Holman RP(2008), successful treatment of fulminant Clostridium difficile infection with fecal bacteriotherapy, Ann Intern Med.148:632_633.

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