Studies Explain What 'Good' Microbiota Do to Clear C. Diff Fecal transplant success may depend on bile acid metabolism

Researchers are now closing in on an explanation of what it is, on a molecular level, that fecal transplants do to cure persistent infection with Clostridium difficile, according to several studies presented here. The key appears to be that the transplants change patterns of bile acid metabolism in the gut, making the environment inhospitable to C. diff colonization. In three studies reported at Digestive Disease Week (DDW) 2017, it was demonstrated that individuals with C. diff who respond to fecal transplant showed a different pattern of microbiota species composition compared with baseline and/or with those who fail to respond. But that's not all: the responders also showed distinct, altered profiles of those elements involved in bile acid metabolism. These and other studies point to bile acid metabolism as the basic mechanism by which fecal transplants help abolish C. diff, and perhaps exert their effects in other conditions for which they are clinically effective.