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Poop transplants are catching on again

How do you feel about poop? Most people prefer not to talk about it. Yet, despite our reticence about this essential bodily function, fecal transplants are now a very hot research topic in the field of gastroenterology. Scientists are investigating the beneficial effects of moving microbes from healthy individuals into the digestive tracts of patients suffering from a variety of severe chronic conditions.

People who receive certain broad-spectrum antibiotics, such as clindamycin (Cleocin), sometimes end up with life-threatening diarrhea brought on by bacterial overgrowth from Clostridium difficile. The resulting C. diff colitis can be very hard to treat.

A study published in the New England Journal of Medicine (Jan. 31, 2013) reported that transplanting healthy donor feces into patients with recurrent C. diff infections was more effective than standard treatment with an antibiotic like vancomycin.

In the past decade, gastroenterologists have rediscovered the effectiveness of this unusual treatment approach. It was actually written about in 1958 in the journal Surgery (November 1958). Denver doctors were faced with a number of patients experiencing life-threatening colitis brought on by antibiotics. These desperate patients received donor feces via enema to “re-establish the balance of nature” in the lower GI tract. They reported “immediate and dramatic” improvement. The physicians concluded that “this simple yet rational therapeutic method should be given more extensive clinical evaluation.”

It took more than 50 years, but many gastroenterologists are now employing this strategy. Although such microbial transplants may seem like a new concept, Chinese physicians practiced fecal transplantation as far back as the 4th century (PLOS Biology, July 12, 2016). The practice continued at least until the 16th century, when the reconstituted “medicine” was known as “yellow soup.”

There is a significant “yuck” factor to such a treatment. That may partly explain why it has taken Western practitioners so long to explore the benefits of fecal microbiota transplantation (FMT), as it is currently termed.

Although FMT is used most often for treating C. diff infections and intractable diarrhea, doctors also are experimenting with its use for inflammatory bowel conditions, such as Crohn’s disease (World Journal of Gastroenterology, Nov. 7, 2013) and ulcerative colitis (PLOS One, June 27, 2016).

One visitor to our website related her own story: “I suffered with C. diff that was not fazed by Flagyl or vancomycin. My insurance company spent thousands of dollars on medications for my C. diff, but it came back each time as soon as I stopped using the meds.

“I wound up in the hospital and a gastroenterologist was brought in. He tried more vanco and Flagyl, with the same lack of results. Then he said that, since I was 50 and should have a colonoscopy screening, he would do a fecal transplant at the same time.

“My husband was the donor, and his blood and stool was tested for multiple things to make sure he was not giving me something bad. The day of the colonoscopy transplant came and I never had diarrhea again. Not even a watery stool! I felt it was miraculous and would do it again before I try any medication.”

Joe Graedon is a pharmacologist. Teresa Graedon holds a doctorate in medical anthropology and is a nutrition expert. Their syndicated radio show can be heard on public radio. In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of this newspaper or email them via their website: www.PeoplesPharmacy.com.

 

Poop transplants are catching on

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