Scatological Success: Fecal Transplants to Treat Bacterial Infections?

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Here’s a real head-scratcher: would you eat someone else’s feces to treat your own diarrhea?

It sounds absurd, but according to a fascinating Reuters article published Wednesday, fecal transplants may be one of the most effective ways to treat infection with the Clostridium difficile bacterium, a potentially hard-to-cure condition that may cause severe diarrhea, blood poisoning, colitis or death. (More on Placebos Work Even if You Know They’re Fake: But How?)

Patients typically catch C. difficile in hospitals and nursing homes, Reuters’ Kate Kelland reports, and infection rates are rising in the U.S., Europe and elsewhere. Data from 2008 suggest there may be 7,000 C. difficile infections on any given day in U.S. hospitals, and up to 300 deaths. The infection, which may not respond well to antibiotics, can stubbornly last for months or years.

But in a study of fecal transplantation, published by Australian gastroenterologist Thomas Borody, 60 out of 67 patients who received a stranger’s poop were cured of their recurrent C. difficile infection. That’s a success rate of 90%.

Kelland writes:

Some jokily call it a “transpoosion.” Others have more sciencey names like “bacteriotherapy” or “stool infusion therapy.” But the process involves, frankly, replacing a person’s poo with someone else’s, and in the process, giving them back the “good” bugs they desperately need.

Feces, including important bowel flora, is transferred from a volunteer donor — screened to limit possible other infections — into the colon of the infected patient. The treatment can be administered by a colonoscope or an enema, or by the mouth or the nose.

In a 2009 study published in the Journal of Clinical Gastroenterology, researchers found that a single infusion of feces reintroduced beneficial bacteroides — bacteria that are necessary for the body to resist C. difficile infection — back into the colons of infected patients. (More on One Stop Flu Shot: Hope for a Universal Influenza Vaccine)

Given the technique’s “image problem,” Kelland reports, scientists are working on developing a kind of artificial probiotic feces that could repopulate patients’ colons with healthy flora “without the marketing issues” of donor poop. But until then, Borody told Reuters, he’ll keep using the real deal. “We’d like to get away from poo, but it works the best,” he said.