St. Luke’s Monroe Campus is now offering an alternative and highly effective procedure to treat individuals with clostridium difficile infection (C diff), a serious infection that causes symptoms ranging from diarrhea to life-threatening inflammation of the colon.
In January, St. Luke’s gastroenterologist Robert Malcolm, MD, performed Monroe County’s first fecal microbiota transplant (FMT), which greatly improved the life of the patient, a woman in her 20s.
“She told me numerous times that she felt that due to her condition, her life was on hold,” Dr. Malcolm said. “She couldn’t go to work because of the symptoms. She was desperate for relief so when we talked about the option, she didn’t hesitate at all.” Prior to the procedure, Dr. Malcolm had treated the patient with three courses of antibiotics, which were not effective in relieving her symptoms.
During FMT, the patient receives stool containing beneficial intestinal microbiota from a carefully screened, healthy donor, Dr. Malcolm explains. The stool arrives in a frozen state and is then liquefied and transplanted into the patient with a syringe during colonoscopy. After the stool is placed in the patient’s gastrointestinal tract, the transplanted fecal matter delivers microbiota necessary for the gut to function properly.
“The procedure is relatively inexpensive, easily available and has more than a 90 percent cure rate. The majority of patients get results in three to five days. I think it’s wonderful that we are able to offer this procedure locally,” Dr. Malcolm says, adding that to the best of his knowledge, St. Luke’s is the only hospital offering the procedures in the Pocono area.
FMT offers hope to individuals who suffer with severe cases of C diff that cause recurrent and debilitating diarrhea. Weight loss resulting from the diarrhea can cause weakness and even death. Those most at risk are the elderly who take antibiotics.
Dr. Malcolm said he became interested in learning to perform the procedure several years ago. In 2005, he referred a patient to a Philadelphia hospital, which at the time was the closest hospital offering the procedure. In recent years, Dr. Malcolm has seen an increased incidence in C diff, due in part to the overuse of antibiotics.
Traditionally, physicians treat C. diff with a course of antibiotics and probiotics. However, the effectiveness of this treatment varies. Recurrent C diff occurs in 15-30 percent of patients after the first round of treatment, and the percentage of recurrence rises with each episode. Up to 65 percent of patients who experience C diff will have subsequent recurrences after antibiotic therapy ends. It can become chronic and lead to repeated use of antibiotics, adverse drug events, antibiotic resistance and repeated hospitalizations.
St. Luke’s also offers the procedure at its Bethlehem Campus. Performing the procedure are gastroenterologist Berhanu Geme, MD, and colorectal surgeons Camille Eyvazzadeh, MD,, and Daniel Eyvazzadeh, MD..
“Clearly, the thought of this is distasteful,” says Dr. Geme of the procedure. “The people who consider this option are at the point that they would do almost anything to rid themselves of the devastating diarrhea that has adversely affected their lives.”