得到了UC？你应该了解粪便移植

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如果你正在处理uc，没有人需要告诉你多么不舒服 - 划伤，彻头彻尾可怕- 可以有时。当它没有造成疼痛时，可能仍然造成尴尬的社会时刻和严重的压力，因为你花了你的生活，确保你知道最近的浴室。

If you’ve tried the traditional path of immunomodulators and biologics, and you’re still doing battle with your gut, your doctor may have mentioned surgery, a procedure that could put an end to some of your challenges—but also create a host of new ones.

但是，尽管如此，您还有另一种选择：粪便移植。我们知道，我们知道幽灵笑话。但是，当你完成笑时，考虑一下：粪便细菌的移植是一种相对较新的和潜在的有希望的领域，旨在重新编程你的肠道微生物组，以便在其他治疗失败时可能缓解UC斑点，也许是逆向疾病进展。那么它是如何工作的？阅读。

粪便移植101.

虽然术语“粪便移植”被公众随便使用，但程序的全部医学术语是“粪便微生物群移植”（FMT）。这重要的是，因为第一个术语让你从一个人从一个人移动到另一个人的精神形象，第二个描述了真正发生的事情：含有肠细菌的粪便材料（和其他微生物的纯化样品）从健康的捐赠者移植到有UC的人。

It may seem like an odd path of investigation, given that UC has long been thought of as an autoimmune disease, where the body’s immune system—normally responsible for killing off invading bacteria and viruses—attacks its own gut tissues instead, resulting in chronic inflammation. But recently, scientists have begun considering evidence that the disease is associated with a dysfunctional gut microbiome. (In a healthy microbiome, good gut bacteria typically protect the intestine from harmful bacteria that could invade.)

“患有UC的患者的粪便异常的微生物种群，细菌多样性降低，”凯尔维尔凯尔夫兰凯斯西部大学医学院医学教授杰弗里A.卡茨说。“用更”正常“粪便更换这种异常粪便可能会通过在结肠内建立更健康和更​​多样化的细菌人群来减轻疾病严重程度。”

换句话说,UC患者铁的勇气wer types of bacteria, as well as fewer numbers of beneficial bacteria (such as乳酸杆菌那伯曲面， 要么喇叭形球菌）。此外，科学家认为，与健康的人相比，患有UC的肠道可能含有更多的细菌种类造成的疾病造成者。

寻找粪便移植候选者

如果您对UC的粪便移植有兴趣，您需要先满足某些标准：食品和药物管理局（FDA）保留具有特定细菌感染的人的程序（Clostridium艰难术要么C.艰难岩）。UC增加了这种可能致命感染的风险，这可能在服用某些抗生素后发生。

如果你没有C.艰难岩感染，你仍然可以获得粪便移植，但它更复杂。在加利福尼亚大学洛杉矶大卫·佩芬医学院的副临床教授，M.D，Ph.D，博士，博士，博士学位，博士，博士，博士，博士博士，博士博士，博士博士，博士学位教授。（确定做FMT研究的机构，去ClinicalTrials.gov/并寻找“粪便微生物群移植”。安排与医生运行研究的预约，看看你是否可以参加。）

If you qualify for a fecal transplant, you’ll be happy to know the poop you receive has gone through quite the vetting process. All donor stool is screened for disease-causing bacteria, viruses, and parasites to reduce any risk that these pathogens could transmit a potentially life-threatening infection to the recipient. As for where it comes from, most institutions either rely on stool from commercial vendors (donor banks) or, says Dr. Katz, “a group of stool donors may be used.”

粪便移植方式如何工作

Once you’ve been accepted as a transplant recipient, here’s what you can expect (warning: we’re about to get graphic.) The procedure falls into one of two broad categories: those that deliver the poop (frozen, then thawed) from above, and those that deliver it from below. The former includes capsules that you swallow or receive as liquid via a naso-gastric or NG tube that’s threaded from your nose into your gut. The second category either involves your physician inserting the fecal material using an enema or delivering it via a colonoscopy (the more common method).

如果使用胶囊，您可能需要在一天或几天内吞下几十种粪便材料填充的豆荚。当使用结肠镜检查方法时，将粪便材料放入插入直肠中并蜿蜒到大肠中的范围。随着范围被拉退出，粪便材料被释放。

Is one method better than another? Hard to say just yet. Of the four controlled studies that have been published, those using colonoscopy or an enema “showed a clinical remission of symptoms by 24% to 50%—that’s a significant benefit,” says Dr. Limketkai, adding that 55% of those using a colonoscopy had no inflammation in the colon after the procedure.

如果您读到了这一点，您仍然倾向于提供尝试，您的下一步将是与您的医生讨论程序准备的细节，这可能是一个门诊。例如，您需要在48小时内停止所有抗生素以确保您收到的粪便材料中的微生物组没有被杀死。

通常，您的医生将讨论如何确保您的肠道是空的，例如，建议您不要在手术前24小时左右吃任何固体食物，并且只饮用透明液体。(For the colonoscopy method, the bowel prep is what you would expect for a typical colonoscopy.) If you’re undergoing the NG tube procedure or taking the capsules, you may be told to take a proton-pump inhibitor such as Prilosec (omeprazole) a day or so before the procedure. This is done to reduce stomach acids, which could knock off the beneficial microbes in the stool sample.

粪便移植后的生活

那么你的身体将如何对别人的“大便”引入？“Most reactions are mild and self-limited, but may include abdominal discomfort, nausea, and changes in stool frequency,” such as constipation or diarrhea, according to Benjamin Cohen, M.D., co-section head and clinical director of the Inflammatory Bowel Disease, Digestive Disease & Surgery Institute at the Cleveland Clinic in Ohio.

如果结肠镜检查完成，则存在出血或肠道撕裂（穿孔）的风险。如果您对结肠镜检查进行了镇静剂，您将在门诊设施中监控，直到它磨损，然后朋友或亲戚将陪伴您回家。如果你拿起胶囊或有NG管方法，你可能会被告知在程序后一小时左右。

由于其相对的新性，专家们仍然不确定粪便移植如何影响你的五年或十年。“我们不知道长期效果。到目前为止，他们一直相对安全，“利马克凯博士说。很少有报道患者感染耐药性微生物，从供体的粪便物质中感染，并且还有一些死亡。尽管它承诺，但程序不是治愈的。凯兹博士说：“有患有其结肠炎的患者实际恶化的患者的报道，”凯兹博士说。

由于科学家继续学习INS和出局，所以要说的FMT程序，粪便中的微生物仍然可以“品种”，有助于重新设置有UC的人的肠道微生物。“我们不知道Bugs的最佳组合 - 有些人的大便似乎比其他人更好 - 所谓的”超级捐赠者“，”Katz博士说。#superpoopers？通过UC的人们不会丢失讽刺。