Cured by Poop

Though it sounds like something out of a South Park episode, fecal transplants exist and they’re saving lives. Yep, it’s what it sounds like: feces are “donated” by a healthy person and are put into the colon of another. While you may squirm of the idea of putting a close relative’s poop inside your body, it could save your life one day, and prevent months of suffering through the pain and symptoms of infections or colon and bowel conditions.

The idea is that the healthy bacteria from the healthy fecal matter will replace the good bacteria that can be weakened or wiped out by a Clostridium difficile (C. diff) infection. C. diff can develop in the colon and cause severe stomach pain, diarrhea, and vomiting. It often hits people who are on antibiotics because the medicine can weaken the healthy bacteria in the colon. With the colon’s defenses down, C. diffs can move in. Since C. diff is caused by bacteria, the treatment is more antibiotics. See the problem? Without the healthy bacteria needed to fight the C. diff alongside the antibiotics, “C. diff grows rampant, releasing a toxin and inflaming the colon,” according to CNN. The Center for Disease Control reports that 14,000 people die of C. diff infections every year, a dramatic increase over the past decade.

Fecal transplants, also known as fecal microbiota transplant (FMT), stool transplant, or fecal bacteriotherapy, may be the answer to curing C. diff. In fact, a study that followed some of the most severe cases of C. diff found a 91 percent cure rate in those who had a fecal transplant. The cure rate increased to 98 percent when the transplant was followed up with a round of antibiotics. All of the 77 participants had recurring C. diff infections, and all went through five failed rounds of antibiotic treatment over a period of 11 months before they had a fecal transplant.

I know that you’re wondering how exactly a fecal transplant happens. Most donors are close relatives because they are the easiest to get and test donations from, but it is believed that those with genetic similarities may be able to supply a donation for a successful transplant. It’s one thing to donate blood, but can you imagine donating a bowel movement that will be put into a stranger? No wonder it’s easier to get a close relative to donate. Donors are tested for various bacterial infections and parasites to ensure the donation won’t put more harmful things into the sick person’s colon. Once the donation has been made, doctors prepare it and dilute it before pumping it into the recipient.

Now what you’ve all been waiting for: how the donated poop gets into the patient. There are a few methods, but the one that allows the most feces to be deposited is by colonoscopy. It can also be inserted by an enema, but that only allows a small amount to be deposited. In the grossest method, it can be inserted into the body through a nasogastric tube. Yes, your relative’s poop will go through a tube into your nose. The fecal matter travels through the nose, down the throat, into the stomach, and finally into the colon. Forget South Park; this is starting to sound more like The Human Centipede. One woman profiled by CNN had a failed nasogastric fecal transplant (donated by her father) before undergoing a successful transplant from her mother by colonoscopy. As gross as it sounds, the procedure saved her life.

This procedure is still in its early stages; the gastroenterologists pioneering the procedure believes that there will one day be a cleaner method, likely using commercially developed suppositories.

While you may be shuddering at the idea of your father’s poo coursing through your intestines, keep in mind that you’re not suffering from C. difficile. The infection is so awful that patients are probably willing to do just about anything to cure it. "…For people that have recurring C. diff, it doesn't really much matter, because these patients are so ill and so much want to get better,” said Dr. Lawrence Brandt, the lead author of the fecal transplant study. “The fact that it's stool, it doesn't matter to them." So be glad that you don’t need a fecal transplant, but also be glad that it’s out there if you ever need it.

Now to wait for South Park to mock it.