Fecal transplantation! Could it be a new method in the treatment of obesity?

Fecal Microbiota Transplantation (FMT) is the process of transferring stool from a healthy donor to the gastrointestinal tract of the diseased donor in order to establish a normal microbiota and to cure the diseases. Today, it is possible to treat diseases related to the gastrointestinal system by changing the intestinal microbiota.

Stool material was first used orally in 4th century China as "Yellow Soup" to patients diagnosed with food poisoning and severe diarrhea. It was used in the 16th century for high fever, pain, vomiting and chronic diarrhea/constipation, and in the 17th century, it was used in veterinary medicine.

For the first time in modern medicine in humans, in 1958, Eiseman et al. laid the foundations of today's FMT by transplanting fecal microbiota from healthy individuals into four patients with critical pseudomembranous enterocolitis. In Turkey, Prof. Dr. Ahmet Uygun was the first M.D that performed fecal transplantation in the Gastroenterology clinic of SBU.

It finds application in adults with inflammatory bowel diseases, Hepatic Encephalopathy, Celiac Disease and Hashimoto's thyroiditis. Studies and current cases show that fecal transplantation can be used in the treatment of many diseases originating from the gastrointestinal tract in the future.

In recent studies, it has been reported that apart from digestive system diseases, FMT has shown successful results in both neurological and gastrointestinal symptoms in children with autism.

Scientists at the Washington University School of Medicine say that the transplantation of stool samples taken from thin people to obese people paves the way for new treatments in the fight against obesity.

There are many studies on the transplantation of different bacterial populations living among lean and overweight people’s into mice, causing the mice to lose or gain weight. Thanks to the developing microbiological analyzes, it has been shown that the bacterial community structure, number and biodiversity of obese and thin people are different.

Some experimental studies show that microbiota from an obese individual is transplanted into a germ-free gut, resulting Mikrobiyota

in the recipient's obese phenotype. When gut microbiota from conventionally was raised in mice gastrointestine is administered to germ-free mice, a 60% increase in body fat and insulin resistance occurs. Researchers led by Jeffrey Gordon found that rats remained lean when they received faecal transplants from lean humans, while they gained weight when samples came from obese humans. Tests revealed that the bacteria called Bacteroides is more abundant in lean people and prevents the livings from getting too fat.

As Gordon stated in his article published in the journal Science, new treatments that treat obesity can be developed with foods that change the structure of microbes in the intestines.

There are many microorganisms living with us in the human body. Microorganisms, most of which are located in various parts of the body such as the skin, genitourinary system and respiratory system, especially the digestive system, are called the "flora" of that region, that is, the "microbiota". In a healthy individual, the human microbiota consists of bacteria, viruses, fungi and many eukaryotic microorganisms. The digestive system microbiota, which is sterile in the mother's womb, begins to take shape immediately after birth. Mode of delivery is the first factor in the formation of breast milk microbiota. Bacterial population is constantly changing with diet, stress level, past infections and antibiotics used.

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A healthy microbiota helps to protect the intestine systems against potentially harmful microorganisms and to develop the immune system. The healthy microbiota is called 'Obiosis', and the 'unhealthy' microbiota is called 'Dysbiosis'. In dysbiosis, the ratio of beneficial bacteria to harmful bacteria has changed. This leads to the deterioration of intestinal integrity. Permeable intestinal wall plays a role in inflammation caused by the entry of toxic substances into the body and in the formation of many diseases.The use of probiotics and prebiotics is recommended for the prevention of dysbiosis.

Amsterdam protocol is applied in donor selection and applications in FMT. FMT material; It can be applied by enema, colonoscopy, nasogastric/duodenal tube, esophagogastroduodenoscopy method.

As a result, as the number of healthy bacteria and biodiversity increases, the immune system will be stronger and the formation of many diseases will be prevented. For this, fecal transplantation can be performed if necessary. The subject is gaining importance, but more studies are needed.

Nutrition And Dietetics

AHPGS(Accreditation Agency in Health and Social Sciences)

Fecal transplantation! Could it be a new method in the treatment of obesity?

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