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Faecal transplants for severe digestive infection sufferers

Faecal transplants could now be a better alternative than antibiotics for patients who suffer from a severe digestive infection, known as Clostridium difficile (C diff).

SINGAPORE: Faecal transplants could now be a better alternative than antibiotics for patients who suffer from a severe digestive infection, known as Clostridium difficile (C diff).

The infection causes severe diarrhoea, inflammation of the colon, blood in stools and can even lead to death in extreme cases.

The National University Hospital (NUH) conducted the first Faecal Microbiota Transplant for two such patients since the start of this year.

NUH has been seeing more patients with C diff infection in the past three years.

About 30 patients are treated each month.

More than two-thirds of the patients respond to the current treatment using antibiotics.

But one-third of them may be resistant to antibiotics.

Dr Nicholas Chew, consultant and clinical director at NUH, said: "If you were to treat C diff infection and diarrhoea with antibiotic, essentially you are using the same root cause of the condition in the first place to try and treat it.

“There is also increasing incidence of resistance to standard antibiotics that we would use to treat C diff diarrhoea, so in essence, these antibiotics may not work anymore, and that occurs in about 20 to 30 per cent of patients with C diff diarrhoea."

While it can affect patients of any age group, it tends to be more severe in the elderly and the very ill.

Studies have shown that the success rate of a faecal transplant is about 90 per cent.

The transplant involves repopulating the gastrointestinal tract with good micro-organisms to restore the normal gut ecosystem.

After collecting a healthy donor's faeces, the sample is processed to sieve out the good micro-organisms.

The micro-organisms are then transplanted through an endoscope or a colonoscope into the patient where they will multiply in the patient's colon.

Donors have to undergo a stringent screening process just like any other organ transplants.

Blood and faecal tests are done to ensure that the sample from donors are free from infections and safe for transplant.

But doctors said getting patients to agree to the new treatment method can be challenging.

"It's a treatment modality with a high yuck factor, but then we do process the samples very thoroughly and we administer the samples through endoscopic means.

“So at no point is the patient able to smell or taste the sample, and the sample has been processed,” said Dr David Ong, consultant and clinical director at NUH.

Patients can opt for either a colonoscopy which costs S$300 or a gastroscopy at S$150 after subsidy. 

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