Wednesday, November 13, 2013

FMT & How This Treatment Will Evolve

Another report on poop that's not that shitty.  The only stuff that smells in this article is the way the AMA and FDA have responded (or lack thereof) to FMT's.  This post is about good ol' FMT's or otherwise known as - Fecal Matter Transplant's, if you're not familiar with the abbreviation. I prefer FMT when talking about this.  
So yeah, this is an article that I found on a local CA online publication. It provided a lot of information, so I decided to do a blog on this.  I read a lot of articles about FMT's, with some that have produced study data and some that do not. There's not much data out there to be found, that's probably why.  All of the articles that I have read however, have been on the positive side in regards to the results with FMT's. This is the first article that I have read to date that reports an extensive {if you want to even go that far as to call it "extensive"} follow-up with patients who had received a FMT.  This information is super important in order to show the effectiveness of the procedure and to give people the confidence to consider such a treatment.  People get grossed, they just do. It's the way our culture handles stuff like this. The point I want to make here is that because of the lack of testing and trials for FMT's, being able to know if this procedure is effective and safe, is to follow-up with patients that have been treated with FMTs. Those patients, in a sense, will provide helpful and needed information that cannot be found in clinical trial data because the data doesn't exist.   This procedure is so new {well,to us Westerners that like to deny and refuse anything "natural"} and not tradition, the patients receiving this treatment are essentially the trial subjects. Seriously, there should be a consent that patients must sign before they receive this treatment that allows the doctors to use their information anonamously, especially follow up data, so it can be published for learning purposes.  To have that information available is crucial.  We are talking about working with US FDA here! As we have seen and continue to see, the FDA doesn't always make the most logical/reasonable decisions in the best interest of the people.  To be able to show data that makes a difference, will make this life saving treatment available to people that would otherwise die. There is no reason why there should be  hundred of thousands of people suffering from c-diff, thousands who end up dying and BILLIONS of dollars spent on ineffective treatments!  That's insanity when there's a treatment that has shown to be 90% effective.  
A patient that suffered from c-diff states the following -  "It's a beast that keeps storming back," he said. "It affects the mind and emotions, too — 90 percent of serotonin is in the gut. You worry quite a lot."  The doctors in this article state that the infection disrupts a person's life.  Doctor Stollman states that FMT's are "the most patient-driven treatment he's encountered in his twenty-plus years of practicing medicine".  It's not surprising that when you have a condition that won't go away, no matter how many rounds of treatment you take, that people end up seeking out the strange and unusual if it means being healthy again.  
The AMA needs to make a billing code !  Doctors need to get paid for treating people AND  doctors need to consider offering FMT's as an option that they know they will get paid for.  After all, the FDA has allowed people with a difficult case of c-diff to get treated with this procedure.  Which means = if you're most likely going to die from c-diff, THEN you can receive the treatment. *smh* Yup, only if you have suffered long, spent a lot and have no more fight in you, will you be able to get an effective treatment.  Does this make any sense whatsoever?  
One last point.  The 4 patients out of the 77 that were followed up with after the FMT who had developed one of the health issues listed (I highlighted the paragraph in purple), in my opinion probably has no relationship to the FMT.  People could have other health issues brewing that just happen to appear after this procedure.  The 4 health conditions are all very different from each other which also leads me to believe that these illnesses weren't brought on by the FMT.  I just feel that as long as the sample donor is screened and cleared for all the diseases that could make a donor  not qualified, then the chances of something negative happening is probably very low.  It's like receiving blood.  The benefit of getting it is high (because if you're getting a blood transfusion, there's a need for it) and the risk is low. Whether it's in a form of transplant or pill, if  it makes people better, this should start to be considered THE most effective treatment rather than the alternative when all else fails.  That's my take on it.