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Is Fecal Transplant Suggestible For C.difficile Infection?

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Posted on Fri, 16 May 2014
Question: My daughter has suffered from c difficile for a number of years. She's had major surgeries including total colectony, pancreatectomy, splenectomy and half her stomach removed. The cause was severe pancreatitis fom a mitochondrial disease. She's been on vancomycin for two years, 500mg 4x/day. Her pain, nausea and diarrhea are tremendous. She went to her obgyn yesterday because of severe pain with periods. She said the bacteria is in her vaginal wall, she believes the bottom of her colon is causing the c diff to go through. My question is what other damage can be caused in her? We're trying desperately to get her accepted for a fecal transplant. The FDA doesn't want patients with little intestines to have it. We're worried and scared that we're not doing everything we can for her. She's a beautiful 27 year old girl who wants to live a full life. Thank you for any help you can give.
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Answered by Dr. Enrique Molina (2 hours later)
Brief Answer:
any colon left?

Detailed Answer:
you mention she had a total colectomy, therefore there is no point in treating C Diff, as it only affects the colon (large intestine). I don't understand why she would be on vancomycin or even thinking about a fecal transplant if she has no colon left and just "little intestine" (small bowel). If she does have any colon left then it could be appropriate to do a fecal transplant, if indeed she still has the C Diff in her system. She needs a specialist to do a sigmoidoscopy or colonoscopy to evaluate how much colon she has remaining if you are unsure.
Based on the provided information, she has other reasons to have diarrhea as well: half of stomach removed can cause diarrhea; having a pancreatectomy can cause malabsorption and therefore diarrhea.
If the bowel inflammation is affecting her vaginal wall, and causing what is called a "fistula" (a connection between two organs that should not be there), then the treatment would be with a surgery (placing a temporary ileostomy), which esthetically nobody wants it, but it is the right treatment.
Hopefully that helps, let me know if i can assist with anything else.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Enrique Molina

Internal Medicine Specialist

Practicing since :2004

Answered : 364 Questions

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Is Fecal Transplant Suggestible For C.difficile Infection?

Brief Answer: any colon left? Detailed Answer: you mention she had a total colectomy, therefore there is no point in treating C Diff, as it only affects the colon (large intestine). I don't understand why she would be on vancomycin or even thinking about a fecal transplant if she has no colon left and just "little intestine" (small bowel). If she does have any colon left then it could be appropriate to do a fecal transplant, if indeed she still has the C Diff in her system. She needs a specialist to do a sigmoidoscopy or colonoscopy to evaluate how much colon she has remaining if you are unsure. Based on the provided information, she has other reasons to have diarrhea as well: half of stomach removed can cause diarrhea; having a pancreatectomy can cause malabsorption and therefore diarrhea. If the bowel inflammation is affecting her vaginal wall, and causing what is called a "fistula" (a connection between two organs that should not be there), then the treatment would be with a surgery (placing a temporary ileostomy), which esthetically nobody wants it, but it is the right treatment. Hopefully that helps, let me know if i can assist with anything else.