Other people’s fecal matter may save lives
Donor stool has emerged as a potential cure for seriously ill patients. Remarkably, nine out of ten individuals afflicted with the bowel disease Clostridium difficile have experienced recovery following one or more fecal transplants. This treatment involving the use of fecal matter from donors is currently undergoing systematic evaluation.
Annually, over 3,500 Danish patients fall prey to the perilous intestinal bacterium Clostridioides difficile. These resilient bacteria have the capacity to induce severe intestinal inflammation and debilitating diarrhea. Vulnerable populations, including the elderly and chronically ill individuals undergoing antibiotic treatment, are particularly at risk.
Frequent rounds of antibiotics can disrupt the delicate intestinal equilibrium, leading to an overgrowth of harmful Clostridioides difficile, which may then dominate the gut environment. This poses a grave threat to the patient, potentially escalating diarrhea into a life-threatening infection with fatal consequences.

Fecal transplant therapy
Following numerous studies and multiple endeavors to treat patients with Clostridioides difficile using various bacterial cultures, a significant breakthrough occurred in Europe in 2013. A Dutch endocrinologist meticulously documented that fecal transplant therapy, also recognized as fecal microbiota transplant (FMT), demonstrated a remarkable success rate, curing nine out of ten patients suffering from Clostridioides difficile. This innovative method entails the transfer of beneficial intestinal bacteria from a healthy donor to the patient in need.

– The influence of fecal transplant therapy is significantly better than that of the best antibiotics available which may cure only two out of ten, says Christian Lodberg Hvas.
Dr. Christian Lodberg Hvas holds the position of Chief Consultant at the Department of Hepatology and Gastroenterology in Aarhus University Hospital. Additionally, he serves as a Clinical Lecturer at the Department of Clinical Medicine, Aarhus University. Dr. Hvas strongly advocates for fecal transplant therapy as the primary choice for patients facing a recurrence of persistent bacteria after completing a course of antibiotics.
In a significant development, his research team secured a substantial grant of DKK 17 million (approximately 250,000 USD) from Innovation Fund Denmark in 2018. This funding was specifically allocated to support the effort to establish a Danish standard treatment involving the transformation of stool from carefully screened and tested healthy donors. Simultaneously, the team is actively engaged in the process of identifying suitable stool donors and establishing a stool bank.
– Fecal transplant therapy not only saves the life of the individual patient – it is also a good investment for the hospital system and, thus, for society, Christian Lodberg Hvas says.
After reviewing the initial treatments, he found significant savings over previous treatments, which typically caused the patients to be hospitalized multiple times, and for extended periods of time.
A diverse bacterial composition is the key to good health
Diversity in intestinal bacteria is considered a crucial factor for maintaining good health, according to experts. Numerous studies have provided evidence linking a limited diversity in microbiota (intestinal flora) to various serious diseases including chronic bowel inflammation like Colitis Ulcerosa, as well as conditions like disseminated sclerosis, Parkinson’s, Alzheimer’s, and colon cancer.
This association extends to conditions like autism, allergies, and type 2 diabetes, underscoring the far-reaching impact of a balanced and diverse microbiota on overall health.

There is a growing belief among researchers that fecal transplant therapy holds promise in potentially treating a range of serious diseases. As of the current time, there are approximately 200 studies underway to investigate the potential effectiveness of this treatment approach.

This is how fecal transplant therapy is performed
Fecal transplant therapy (FMT) can be administered through three equally effective methods:
- Colonic endoscopy, involves the insertion of an endoscope into the colon.
- Stomach tube delivery to the small intestine, using a probe passed through one nostril.
- Oral ingestion via capsules (typically around 30 in total).
Contested classification: Medicine or tissue?
The potential to potentially cure other severe illnesses through the utilization of intestinal bacteria has caught the attention of the pharmaceutical industry. They view donor fecal transplant therapy as a potential business opportunity. Consequently, they are advocating for fecal matter to be categorized as a medicinal product. However, hospitals are not authorized to produce medicines. In contrast, medical professionals argue that this involves utilizing tissue in a similar vein as blood or bone marrow. They would prefer to see feces classified as tissue.
At Aarhus University Hospital, there is no need to delay proceedings. The Danish Patient Safety Authority has granted approval to continue the establishment of a feces bank and to administer fecal transplant therapy to seriously ill patients.
By Christa Zenobie Dahl
Rephrased by GP Medical Devices 2023
Sources:
Aarhus University Hospital, Department of Hepatology and Gastroenterology, Patient guidelines: General guidelines on fecal transplant therapy (“Generel vejledning om fæcestransplantation”).
Article in ING.dk/Ingeniøren – ing.dk, 14 Maj 2016: “Vital aides – and new way to treatment and prevention: Bacteria control your life” (“Livsvigtige hjælpere – og ny vej til behandling og forebyggelse: Bakterierne styrer dit liv”) by Mie Stage.
Article in the newspaper Weekendavisen, 1 November 2019: “The brown gold” (“Det brune guld”) by Gunver Lystbæk
Article on the scientific forum Forskerzonen, 3 September 2019 at Videnskab.dk: “Can miracle poop cure more than one life-threatening disease?” (”Kan mirakellort helbrede mere end én livstruende sygdom?”) by Christian Lodberg Hvas – Chief Consultant at the Department of Hepatology and Gastroenterology, Aarhus University Hospital and Clinical Lecturer at Department of Clinical Medicine, Aarhus University, and Lars Holger Ehlers – Professor of Health Economics at the Department of Clinical Medicine, Aalborg University.