How a poop transplant could someday save your life

Illustration for article titled How a poop transplant could someday save your life

A recent Henry Ford Hospital study has shown the effectiveness of an unconventional therapy in which donated human stool can be used treat the deadly and contagious Clostridium difficile (C. diff) bacterial infection. The procedure, which works by revitalizing healthy intestinal microbial activity, could eventually replace the widescale use of antibiotics and surgery for treating the condition.

The technique, called intestinal microbiota transplantation (IMT), is another strong indication of how important our gut and intestinal flora are to our overall health. Essentially, by introducing uncontaminated microbes from a donated stool sample (typically from another family member), doctors have shown that a healthy intestinal microbiome can be re-established.

To conduct a microbial transplant, doctors take the stool from a healthy person and mix it with warm water. Mercifully, the solution is delivered directly to the patient's colon by use of a nasogastric tube — so they don't have to taste or smell it. And it works incredibly quickly; patients have been known to start eating and feeling better within a few hours after the transplant.


Indeed, according to lead researcher Mayur Ramesh, more than 90% of patients who were given the procedure were cured of their C. diff infection (from a sample of nearly 50 patients over the course of two years). IMT stimulated their immune system, allowing them to once again properly digest and absorb their food.

And this is a good thing; C. diff causes diarrhea and other problems like fever, loss of appetite, nausea, and abdominal pain. The infection is transmitted from person-to-person contact or from touching contaminated objects. And it is associated with 14,000 deaths each year.


Moreover, treating it has not been easy. Antibiotics like metronidazole or vancomycin have proven effective, but doctors are trying to reduce their reliance on these sorts of therapies. Part of the reason is that antibiotics may actually disrupt the normal balance of bacteria in our intestines, making it easier for C. diff to thrive.

As a result, what often ends up happening is surgery to have the infected part of the intestine physically removed. Having a poop cocktail directly administered into your colon, therefore, doesn't seem like such a bad alternative. The study was presented on Friday October 19, 2012 at the annual Infectious Diseases Society of America meeting in San Diego.


Image: Julien Tromeur/

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Dr Emilio Lizardo

There are a lot of inaccuracies here. First of all, the procedure has been around for over a decade, but done as an enema rather than through n NG tube. I have seen hundreds of C. diff infections in my 21 years of clinical medicine. One patient required a stool enema and off the top of my head, maybe three required surgery, all either immunosuppressed, after perforation or both. So to say patients "often" require surgery is not accurate. It won't even save many surgeries. Patients that perforate will still need surgery and I don't know if it would work in immunosuppressed patients, although I don't know why it wouldn't.

Overall, the best way to limit morbidity and mortality from C. diff is to limit antibiotic use to the minimally effective drug, to take the whole prescription and to avoid empiric use except in specific situations where it is necessary. That means stop demanding antibiotics for colds and sinus infections, among other things.