#9: C diff, and fecal transplants

The Curbsiders Internal Medicine Podcast

Health & Fitness, Medicine, Science, Higher Education, Education

4.8 • 3.1K Ratings

🗓️ 8 July 2016

⏱️ 52 minutes

🔗️ Recording | iTunes | RSS

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Summary

Treat C. diff, choose the correct antibiotic regimen, and identify who needs fecal transplant as we “curbside” Gastroenterologist, Dr. Adam Ehrlich from Temple University Hospital. On the show, we cover the ins-and-outs of procuring, preparing and performing transplants as well as future directions in this burgeoning field e.g. IBD, obesity, metabolic syndrome and more.

Take Home Points:

Clostridium difficile infection is the only indication for which FMT is allowed by the FDA without special authorization
FMT is VERY effective in these C difficile patients compared to standard of care (approximately 90% cure vs 30%)
We are just beginning to understand the role of the microbiome in human health, and I anticipate many changes in the years ahead where modifying the microbiome will be used to help treat a number of diseases.

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Transcript

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0:00.0	So the first reported fecal transpire is around the year 400 AD.
0:08.3	It was done in China and it was literally a oral soup like concoction made to treat diorillal illnesses.
0:20.2	Welcome to the Curbsiders, an internal medicine podcast that uses expert interviews to
0:29.7	bring you clinical pearls and the practice changing knowledge you need. I'm Dr. Stewart Brigham,
0:34.7	here with my co-host, Dr. Matthew Wato and the prestigious One and Only, one of a kind,
0:39.5	Dr. Ossim Joaquim. Hello guys, thank you so much for the send-by.
0:44.3	Thanks for coming on the show, Oss. Oss is a guest, second year guest,
0:48.5	or entourage, gastroenterology fellow who works in the San Antonio area. We can't name his employer,
0:54.6	but he, he graciously decided to come on last minute. Okay, so on this episode, our guest is Dr. Adam
1:02.0	Erlich. Dr. Erlich went to Mount Sinai School of Medicine in New York, where he earned an MD and an
1:07.8	MPH. He later completed a residency in internal medicine at Mount Sinai Hospital before entering
1:13.4	fellowship in gastroenterology at Temple University Hospital, where he is now an assistant professor
1:19.1	of medicine and the director of the new FIQL Microbiota Transplant Program. This is, this is a hot
1:25.7	topic in medicine and we just think it's fun to talk about poop, so we really wanted to do the show.
1:31.4	We get pretty much all into whatever is out there right now, whatever information is out there
1:36.3	on FIQL Transplants. And I think this will be a great show for listeners, so without further ado,
1:43.1	hi Dr. Erlich, how's it going? How you doing? Great to be here. Thank you so much for coming on the show.
1:49.2	We are very excited to talk about FIQL Transplants and I know our listeners have a lot of interest
1:55.6	in this. They think it's correct. I like so. I like talking about it as well, so. Yeah, and we have,
2:02.8	with us Dr. Wassem, well, Keem, he is a second year fellow in gastroenterology. We have him sitting
2:09.4	in today because he knows a little bit about this and he's also interested in learning more from you.
2:14.4	Very little. Yeah. So how did you get, how did you get into, when I last worked with you, this was
	...

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