Almost 30% of patients with acute alcoholic hepatitis die within 90 days, which is an extremely high mortality rate.

Researchers have discovered that fecal microbiota transplant (FMT), which is superior to the existing steroid treatment and offers hope for those with severe alcoholic hepatitis, a devastating disorder in which long-term drinking affects the liver.

The FMT treatment includes processed feces from a healthy donor administered to the gut of a sick patient to assist them in enhancing their gut microbiome. The survival of patients with a fecal microbiota transplant was 18.4 % greater than that of those who received the steroid Prednisolone, as evident from a study of 112 patients with severe alcoholic hepatitis conducted by Delhis Institute of Liver and Biliary Sciences (ILBS).

Also fewer secondary infections were seen in these patients. According to the ILBS study, 19.3% of people who received steroids died from an infection, compared to only 3.6% of people who had a fecal microbiota transplant.

Among patients who are not at a very late stage, the effectiveness rate of steroid treatment is 60% to 70%. Because administering steroids lowers the immune system and makes patients more susceptible to infection, only one in five persons who require the treatment can receive it.

In the stomach, harmful microorganisms like proteobacteria frequently proliferate. When patients consume alcohol, their gut flora breaks it down, generating toxins that harm the liver. The consumption of alcohol also contributes to a leaky gut, which allows germs to enter the bloodstream, enter the liver and damage it, move around freely, and create infections. 

Following a fecal microbiota transplant, the beneficial and the harmful bacteria compete to gain dominance. The FMT lessens intestinal leakiness, keeps bacteria from the body, enables normal food processing, and improves patient′s nutrition.

The ILBS team′s approach involved using a nasal tube to administer processed slurry containing 30 gms of fresh feces from the donor to the recipients intestines. The donor is chosen from among those who live nearby the recipient, ideally a relative. Before donating, the donor is placed on a prescribed diet and must be young, healthy, not obese, a non-drinker, not on antibiotics, and free of pathogenic germs. 

(Source: https://indianexpress.com/article/health-wellness/how-faecal-transplants-can-save-the-liver-in-patients-of-alcoholic-hepatitis-8491195/)