CentraState - Healthy Directions

Novel Therapy for a New Lease on Life Although his infection started causing problems in April 2011, it wasn’t until last Thanksgiving that 69-year-old Bert Goldberg of Marlboro recognized his need for dramatic treatment. By February 2012, his care team at CentraState Medical Center had developed the necessary protocols to perform the hospital’s first fecal microbiota transplantation (FMT). Bert had developed clostridum difficile colitis (C. diff), an antibiotic-induced infection that results in toxic fever, dehydration, and diarrhea. In the United States alone, the symptoms from this infection cause approximately 14,000 deaths per year. Although antibiotics can kill the germ that causes the infection, any spores that develop in the intestine may remain, causing the disease to recur. “In November, I had to visit CentraState for my third or fourth hospitalization, and each time, my stays were getting longer,” Bert says. “My condition was clearly deteriorating, and after a 10-day stay, I realized I was totally debilitated.” Bert’s condition had progressed to the point that he was unable to walk up his stairs at home, and he thought he would need to move into a long-term care facility for help dealing with his 15 to 20 daily bowel movements. He began to receive visits from home health while hoping for the possibility of undergoing a new procedure at CentraState. A Natural Disinfectant “When I was in the hospital, my son and three daughters came to visit me, each one using a laptop or smartphone to research potential cures for C. diff,” Bert says. “Dr. Ludwig [Shelly Ludwig, MD, board-certified gastroenterologist with Central Jersey Gastroenterology, on the medical staff at CentraState, and clinical associate professor of medicine at Robert Wood Johnson Medical School] was familiar with a new, intriguing option, and we all decided it was worth a try.” The procedure they agreed upon was FMT, which attempts to rebuild a normal environment in the large intestine by adding the natural substances—including bacteria—that protect against diseases. Because stool is the large intestine’s primary source of these immune system protectors, the procedure requires cleansing the bowel and adding stool that contains the natural immune system boosters. “FMT had only been performed a few times in New Jersey, but the actual process is very similar to a typical colonoscopy. We introduce helpful bacteria across the large and distal small intestine and populate the colon with natural bacteria,” Dr. Ludwig says. “Although this procedure is not widely practiced, I’m very optimistic about its possibilities.” To perform FMT, Dr. Ludwig removed uninfected fecal matter from Bert’s wife and performed a simple colonoscopy on Bert, which uses a scope inserted through the rectum into the colon to examine the colon. During this procedure, Dr. Ludwig placed the liquefied fecal matter from Bert’s wife into Bert’s colon. Bert came to the hospital in the early morning, underwent the procedure, and went out for breakfast a short time later. Now, Bert feels terrific. He traveled to Florida in March to watch the New York Mets spring training games. With his condition so improved, he is free to enjoy time with his wife, four children, and 10 grandchildren. For more information about services available at CentraState, visit www.centrastate.com or call (866) CENTRA7 (866-236-8727). HD

• Cover