Fecal Transplant Studied for Kids With Bowel Disease

WEDNESDAY, April 17 (HealthDay News) -- Fecal transplantation -- an innovative enema treatment -- may help reduce or eliminate symptoms of ulcerative colitis in most children and young adults, according to a small study.

The process, formally called fecal microbial transplantation, involves placing stool from a healthy donor into a recipient's intestines in order to restore healthy bacteria.

The early clinical trial -- the first in the United States to study the process in children -- was conducted by a team at Helen DeVos Children's Hospital in Grand Rapids, Mich.

The study included 10 participants, aged 7 to 20 years, with mild to moderate ulcerative colitis. Enemas were used to give the patients lab-prepared stool samples from a healthy adult donor. Each patient received five such treatments within one week.

Seventy-eight percent of the patients had a reduction in ulcerative colitis symptoms within a week, and 67 percent still had reduced symptoms a month after fecal transplantation. Thirty-three percent of the patients no longer had any symptoms of ulcerative colitis after the process.

No serious side effects were noted, according to the study, which was published online and in the June print issue of the Journal of Pediatric Gastroenterology & Nutrition.

Ulcerative colitis is a type of inflammatory bowel disease that affects the lining of the large intestine, or colon, and rectum, according to the U.S. National Institutes of Health. Symptoms can include abdominal pain, cramping, bloody diarrhea, pus in the stool, fever, rectal pain, weight loss, nausea, vomiting, joint pain, mouth sores, skin lesions and slow growth in children.

The disease often forces children to miss school and limit their social activities.

Fecal transplantation "has been proposed as a promising new treatment option for recurrent C. difficile infection and possibly for ulcerative colitis," lead investigator and pediatric gastroenterologist Dr. Sachin Kunde said in a hospital news release.

"We believe that the procedure may restore 'abnormal' bacteria to 'normal' in patients with ulcerative colitis," Kunde said. "Our short-term study looked at the safety and tolerability of [fecal microbial transplantation] for these patients."

Larger and longer studies are needed before the process could be recommended for clinical practice, the researchers said.

As many as 700,000 Americans have ulcerative colitis, and approximately 25 percent are diagnosed during childhood, according to the Crohn's and Colitis Foundation. Kunde said fecal transplantation could offer patients a natural, inexpensive treatment option.

-- Robert Preidt
Copyright © 2013 HealthDay. All rights reserved. SOURCE: Helen DeVos Children's Hospital, news release, April 2013

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Deep Brain Stimulation Studied as Last-Ditch Obesity Treatment

No major side effects seen in 3 patients over nearly 3 years

By Amy Norton

HealthDay Reporter

THURSDAY, June 13 (HealthDay News) -- For the first time, researchers have shown that implanting electrodes in the brain's "feeding center" can be safely done -- in a bid to develop a new treatment option for severely obese people who fail to shed pounds even after weight-loss surgery.

In a preliminary study with three patients, researchers found that they could safely use the therapy, known as deep brain stimulation (DBS). Over almost three years, none of the patients had any serious side effects, and two even lost some weight -- but it was temporary.

"The first thing we needed to do was to see if this is safe," said lead researcher Dr. Donald Whiting, vice chairman of neurosurgery at Allegheny General Hospital in Pittsburgh. "We're at the point now where it looks like it is."

The study, reported in the Journal of Neurosurgery and at a meeting this week of the International Neuromodulation Society in Berlin, Germany, was not meant to test effectiveness.

So the big remaining question is, can deep brain stimulation actually promote lasting weight loss?

"Nobody should get the idea that this has been shown to be effective," Whiting said. "This is not something you can go ask your doctor about."

Right now, deep brain stimulation is sometimes used for tough-to-treat cases of Parkinson's disease, a movement disorder that causes tremors, stiff muscles, and balance and coordination problems. A surgeon implants electrodes into specific movement-related areas of the brain, then attaches those electrodes to a neurostimulator placed under the skin near the collarbone.

The neurostimulator continually sends tiny electrical pulses to the brain, which in turn interferes with the abnormal activity that causes tremors and other symptoms.

What does that have to do with obesity? In theory, Whiting explained, deep brain stimulation might be able to "override" brain signaling involved in eating, metabolism or feelings of fullness. Research in animals has shown that electrical stimulation of a particular area of the brain -- the lateral hypothalamic area -- can spur weight loss even if calorie intake stays the same.

The new study marks the first time that deep brain stimulation has been tried in that brain region. And it's an important first step to show that not only could these three severely obese people get through the surgery, but they also seemed to have no serious effects from the brain stimulation, said Dr. Casey Halpern, a neurosurgeon at the University of Pennsylvania who was not involved in the research.

"That shows us this is a therapy that should be studied further in a larger trial," said Halpern, who has done animal research exploring the idea of using deep brain stimulation for obesity.

"Obesity is a major problem," Halpern said, "and current therapies, even gastric bypass surgery, don't always work. There is a medical need for new therapies."

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