Tuesday 18 September 2018

Intestinal problems: faeces transplantation or lifestyle?

When the microbiome becomes unbalanced, this will have an impact on metabolism, the immune system and the mood. When this becomes unmanageable, will a faeces transplantation help? Or is it better to tackle the problems through lifestyle?

The gastrointestinal tract is the most important immune organ in our body and, through the microvilli, which significantly increase the surface area of the intestine, is constantly in contact with the outside world. Ten times more bacteria than present in our body cells live in the intestinal tract. The health of the intestines is the result of the battle between probiotic bacteria and pathogenic organisms in the gastrointestinal tract for the available food and for the space to attach to the wall of the intestine. Overall, human health is largely determined by how balanced the gut flora is.


Disrupted flora

However, sometimes problems arise as a result of disrupted gut flora. More than 80,000 people in the Netherlands suffer from chronic bowel disease. It has also been found that the use of antibiotics can lead to, for example, contamination with the Clostridium difficile bacteria. A new study has revealed that patients with, for example, autism and depression can also have unhealthy gut flora. Some bacteria in the intestine affect the health of the brain. Recent studies suggest that these bacteria also play a role in Multiple Sclerosis (MS).


Faeces transplantation

Faeces transplantation, currently only used in the event of contamination with Clostridium difficile bacteria, can alter the gut flora almost overnight. A tube is passed through your nose to your small intestine, administered along which is someone else’s faeces diluted with a salt solution. This procedure will therefore improve the gut flora. In the future, could faeces transplantation also be used to treat other illnesses?


Up and coming research

At the UMC in Amsterdam, research is underway into the effects of intestinal bacteria on the functioning of the pancreas, liver and muscles. The effect on diabetes and Crohn’s disease will be assessed during the study. The Haaglanden Medical Centre will soon commence a study into the effects of faeces transplantation in patients suffering from MS. In the North of the Netherlands, more than 165,000 participants are taking part for a period of 30 years in the Lifelines cohort, in which the bacterial composition in the intestines of people with and without MS are compared. They will also provide blood and urine samples and answer questions about their lifestyle.



A new microbiome through a transplantation – it is radical and to many people undoubtedly a gross concept. But if it helps? Particularly in serious illnesses, such as MS, this is extremely encouraging. However, this treatment isn’t currently available in the Netherlands. 

Looking at this matter-of-factly, this can be done differently. The gut flora can also be changed by improving the lifestyle. Fewer processed foods, plenty of fibres, as much outside air and exercise as possible. That is a proven recipe for a healthier life. Fibres contain prebiotics, which can help to restore a disrupted gut flora. Probiotics from, for example, fermented food and yoghurt can do this too. If food is unsuccessful, nutritional supplementation with prebiotics and probiotics is at the top of the list. 

Ultimately, of course, this will always involve a permanent change in lifestyle. But let’s be honest, following a faeces transplantation of this type, that same change is necessary, otherwise the recipient would be back to square one in a short amount of time. 



A lot of research is taking place into the positive effects of healthy gut flora on all sorts of illnesses. A change in lifestyle can achieve this. In the future, this change could perhaps be preceded by a faeces transplantation; a good start towards a better lifestyle, the end result being a healthier life. But then, as always, this comes down to remaining motivated and making healthy choices. And this is where there is still an important role for the nutritional therapist.