Severance Hospital has recently received the nation’s first approval for “fecal microbiota transplantation,” treatment for spreading microorganisms in healthy people’s feces to the intestines of colon disease patients, through the endoscope or enema.

The approval is based on the results of domestic and overseas clinical trials last year. The U.S. and European medical communities reported the treatment success rate of more than 90 percent.

Professor Park Soo-jung_박수정 of the Department of Internal Medicine, Severance Hospital_{세브란스병원}, added a caveat, however, stressing that doctors should administer the fecal treatment only to patients with "clostridium difficile," which is currently not controlled well by medicine.

“Clostridium difficile is a bacterium that can be parasitic on a small scale even in healthy people without symptoms in our bowel. If it increases rapidly, it releases toxins and causes enteritis,” he said. “This causes diarrhea, fever, mucus or stools to persist, accompanied by abdominal pain, nausea, vomiting, abdominal bloating and chills.”

Severance Hospital is to introduce a new medical treatment called “fecal microbiota transplantation” for the first time in the nation.

Antibiotic therapy is the first treatment of infectious disease, but the characteristics of clostridium difficile are the outbreak after antibiotic treatment, which is mainly used to treat other conditions. If these antibiotics are used continuously, patients have a high risk of developing antibiotic resistance and have difficulties in using therapeutic drugs.

Patients with recurrent cases of clostridium difficile enteritis are at great risk in their daily lives due to various comorbidities and are at significant risk of complications that can lead to deaths of colons, intestinal perforation, shock, etc.

For this reason, the idea of treating clostridium difficile, which has been increasing in balance with intestinal microbes reduced by antibiotic treatment, has emerged.

But because antibiotics are the leading cause of endocrine disruption of clostridium difficile, why not stop using antibiotics?

“It is often difficult to stop it because the primary patient is an infected patient with various post-operative infections and various infectious diseases, which are essential for antibiotic treatment,” Park said. “Also, the number of patients with clostridium difficile is expected to continue to increase in Korea, where the number of elderly people who are vulnerable to infectious diseases is growing.”

Obtaining healthy microorganisms is the key to the treatment, and therefore acquiring good stool is the first step, the Yonsei professor noted.

Medical staffs thoroughly monitor the patients’ health records, current health status, family history, intestinal pathogens and parasitic infections to prevent the spread of new diseases to patients. Patients who are excluded are the ones with hepatitis, carriers of Helicobacter, infectious diseases, obesity, and diabetes.

Through various donor tests, stools obtained from the general public who meet strict conditions are manufactured into intestinal microbial solutions through a special treatment in the department of the hospital diagnosis and examination, and then it is spread to the patient's end through the stomach or colonoscopy and enema.

“Because stool transplantation is a new medical technology that is not yet covered by health insurance, Severance will collect clinical data of accumulated fecal graft and for health insurance application,” Park said.

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