A woman who was successfully treated for a recurrent Clostridium difficile, or C. difficile, infection with a stool transplant has gained considerable weight since the procedure.
Stool transplant, or fecal microbiota transplant (FMT), is considered as an effective procedure for treating recurrent C. difficile infections, which is a common reason for antibiotic-related diarrhea that can also result in death in severe cases. As the bacteria overgrow they release toxins that attack the lining of the intestines, causing what's called Clostridium difficile colitis.
In 2011, an unnamed woman underwent a stool transplant as a treatment for C. difficile infection. Prior to the procedure she weighed 136 pounds and had a BMI of 26 but gained about 34 pounds within 16 months of the procedure.
The stool donor was the woman's 16-year-old daughter, who was overweight when she made the donation.
Dr. Colleen Kelly, who is a gastroenterologist at the Warren Alpert Medical School of Brown University, suggests that it is normal for patients to gain about 5 to 10 pounds following an FMT procedure. However, it was unusual for the patient to gain more than 30 pounds and become obese.
Medical experts said the woman was supervised for a regular exercise program and given a liquid protein diet, but the weight gain continued following the FMT. Researchers said that within three years of the transplant the woman weighed 177 pounds and her body mass index was 34.5. To be considered obese, the BMI of a person should be 30 or more.
"We're questioning whether there was something in the fecal transplant, whether some of those 'good' bacteria we transferred may have had an impact on her metabolism in a negative way," says Kelly, who also wrote the case report that was published in the journal Open Forum Infectious Diseases.
Kelly reveals that the woman was never overweight before the FMT surgery. The stool transplant may be causing her to gain weight, but other factors may also have triggered the weight gain. Kelly suggests that antibiotic use to treat another infection, stress due to the illness, aging and other factors may have also resulted in the weight gain.
However, Kelly points out that a link between fecal transplant and weight gain has been supported in animal studies. Prior studies have reported that transfer of gut bacteria from obese mice to normal-weight mice led to an increase in the fat level of the normal-weight mice. The study recommended that doctors should consider the weight of the donor before fecal transplant.
Overweight people are not barred from making blood, organ, semen and stool donations. However, the latest case raises a vital question if the weight factor should be considered before accepting such donations.
