Salmonella-contaminated tomatoes. E. coli-riddled beef. These are just two recent outbreaks that have made headlines and basically ruined carefree burger-eating for the rest of the summer. Bacteria-laden feces are the probable source of both.
But sometimes a stool can save a life. I know, yeccccccchhhhhh, but it turns out that doctors can actually transfer fecal material from a healthy donor to patients sick with C. difficile, a potentially life-threatening germ that strikes when antibiotics kill off the good bacteria that live in the gut. It’s called a fecal transplant or fecal bacteriotherapy.
A friend who works at a hospital recently told me (without revealing the patient’s identity or personal information) that such a transplant had saved a patient’s life. My thought was: Why hadn’t I heard about this therapy before?
Poop can cure deadly infection
You see, C. difficile is one of those emerging superbugs that has been grabbing headlines because it seems to be more deadly and more common than in the past.
But guess what? It’s treated with even more antibiotics. This seems somewhat problematic, given that antibiotics, which kill off the good germs and allow a bad germ to gain a foothold, are the indirect cause of the life-threatening diarrhea, fever, and pain.
Not surprisingly, relapse is a common problem with C. diff, and occurs in 20% of patients. And anywhere from 1% to 15% of people die from it.
To find out more, I called Lynne McFarland, PhD, a research health scientist specialist at the Puget Sound VA Healthcare System in Seattle, who’s published research on fecal transplants.
“If you can just get past the aesthetic creepiness of it, basically what you are doing is replenishing the normal flora that’s been lost to antibiotic use or other things that can disturb your normal flora,” she tells me.
The donor stool usually comes from a healthy spouse or family member and is carefully screened for pathogens. Then doctors do the transplant via the mouth (a nasogastric tube is threaded into the stomach, through the small intestine, and on to the colon) or the other end of the GI tract (a scope similar to those used in colonoscopies is used to place the sample).
The technique seems to be a success 85% to 99% of the time, she says. It’s also been tried with some success for treatment of inflammatory bowel disease, such as ulcerative colitis. (There have been about 80 published case reports of the treatment in the last 20 or so years.)
Good germs galore
There are anywhere from 400 to 400,000 different species of bacteria lurking in healthy intestines, and they help digest food, make vitamins capable of being absorbed, and break down cholesterol—all really good things.
Although there are probiotic mixtures that are used to treat human illness, they typically include only 10 or 15 good species out of thousands of potential candidates.
“The nice thing when you use someone’s stool, you have a really nice mixture of all the good types that are in there and hopefully no bad stuff,” she says.
So why is a cheap medical treatment with unlimited donor material that has a high-cure rate for a deadly illness still a doctor’s last-resort choice?
According to McFarland, it’s not due to the “Eww, that’s disgusting!” reaction (even though that’s nearly universal). Mostly it’s because no one has done the randomized, controlled trials that get the medical establishment on board.
“Companies have to make money and they can’t make money from someone else’s stool sample,” she says.
Part of the problem is that we know so little about our own gut. “It’s still a big black box,” says McFarland.
And physicians don’t like treatments that have not gone through controlled trials. “We don’t know all the pathogens and not all the pathogens can be tested for,” she says. “It’s not a risk-free procedure.”
But still. With the American health-care system groaning under the weight of pricey drugs—and the diseases caused by their overuse—shouldn’t we find someone who isn’t afraid of a little poo?
(PHOTO: GETTY IMAGES)
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Comments (3)
If I am a donor for a family member how do I store the stool sample before I take it to the lab. Please e-mail me back very important because I am going to do this for my father asap
I am trying to find somewhere they will do the fecal transplant in Tx. or some State close to Oklahoma. Please tell me of a clinic or Hospital I can call and talk to them. I would like to find out if it would help chemical sensitivity, chronic candida,or food allergies. Please help.
Thank you.
Hi All I’m also looking for a doctor , group or hospital where they will do a fecal transplant in New York or close to New York for I keep getting C Diff back over and over again. I am sick and tired of being sick and tired . Please any one who can help I would greatly appreciate it very much . Thank You !