Patients Don’t Pooh-Pooh Fecal Transplants

Let’s start this blog with the disclaimer that what you’re about to read has a high “yuck” factor…unless it seems you’re a patient or a parent of a patient with ulcerative colitis.

A new study just published in the journal Inflammatory Bowel Disease examined the social and ethical issues associated “fecal microbiota transplantation” (FMT).

Yes, FMT is just what you’re thinking it is!  Also known as fecal bacteriotherapy, it is a provocative treatment performed in an attempt to calm a troubled bowel by reintroducing the vast diversity of collaborative bowel inhabitants after the usual mix has been disturbed. More than 1,000 different strains of bacteria co-exist peacefully in the typical healthy bowel. But when the delicate balance is altered, by antibiotics or other causes, a few strains can become dominant, leading to severe diarrhea, inflammation and tissue damage.

Although transplants of fecal matter have been used sporadically to treat gastrointestinal disease for more than 50 years, more recently, the approach has produced lasting remissions for a small number of patients with ulcerative colitis.

The first fecal transplants date back to 1958, when they were used to treat life-threatening bowel infections. They did this by collecting fecal matter from a healthy donor and injecting it into the patient’s colon.

Then in 2003, an Australian team published a report on successful treatment of six patients with longstanding ulcerative colitis with this approach.

And although you may be feeling a little squeamish by now, it seems that patients with severe inflammatory bowel disease develop a high tolerance for therapies that others might consider unorthodox. According to study author David Rubin, MD, Associate Professor of Medicine at the University of Chicago, “Once patients get past the yuck factor they find the concept appealing.

Like an organ transplant, fecal microbiota transplantation begins with finding a donor, often a family member. The treatment team collects a fresh stool sample of at least 200 – 300 grams (7-10 ounces). The sample is mixed with salt water in a blender and filtered to remove particulate matter. It can be administered to the recipient through a colonoscope, as an enema, or, when the inflamed region is higher in the colon, through a nasogastric tube.

The researchers organized six focus groups with patients or parents of children with ulcerative colitis to explore the attitudes and concerns raised by this approach.

They found that:

  • 21:22 patients or parents of patients were interested in trying FMT for themselves or their child
  • Most wished it were already available
  • They viewed the treatment as more ‘natural’ than using drugs to control the disease, and easier and safer than currently available therapies
  • Many compared it to probiotics, a popular alternative therapy among patients with colitis.

The major concerns were focused on how donors would be selected and screened. Patients wanted healthy donors, usually family members, and asked that even their diet and medications be considered. A donor who had eaten peanuts recently, for example could be hazardous for a recipient with peanut allergies.

The “yuck” factor came up in the focus group discussions of bacterial delivery. Patients and parent were comfortable with the idea of a “spray” colonoscopy or delivery via enemas, but were disturbed by the idea of using a nasogastric tube for the transfer of fecal bacteria.

What our study ultimately tells us is that patients are not only tolerant of this therapy but are eager for it to become available,” Rubin said. “A few have already tried this strategy at home, using ‘protocols’ they found on the internet and tools available at any drug store.”

The team plans to begin offering FMT this fall.

Would you sign up for a poop transplant or consider being a donor?

5 thoughts on “Patients Don’t Pooh-Pooh Fecal Transplants

  1. Hello my sons has been sick for about four years. He was prescribed a very strong antibiotic and ever since, his life has never being the same. He stopped working and going to school. He found out about the fecal transplant but we do not know anyone that

    Hello my sons has been sick for about four years. He was prescribed a very strong antibiotic and ever since, his life has never being the same. After taking the antibiotics his stools became undigested and he began loosing a lot of weight. He also developed allergies to gluten, eggs, nuts, and milk. He is very sensitive to carbs and sugar. His diet consist of a green vegetables, protein, one fruit a day and water. He stopped working and going to school. He found out about the fecal transplant but we do not know a Doctor that performs this procedure here in Los Angeles. Please help my son and our family. It is extremely difficult as a mother to see him suffer. I would change places with him in a heartbeat. He is very smart, caring, loving, hardworking (when he has the energy) and compassionate. He has done extensive research about health and has forever change our lives. We eat very healthy and exercise regularly because of him. He believes that fecal transplant will help him get his health back. Please Help us and give him a chance to go do some good in the world. Thank you

  2. Pingback: Oh S**t! – Don’t Try This At Home | SRxA's Word on Health

    • SRxA’s Word on Health cannot provide specific physician recommendations.
      However, we have heard that the procedure is available in Duluth (Minnesota), Integris Digestive Center (Oklahoma), Fairview Maple Grove Medical center(Minesota), Montefiore Med.Center (New York), Rogue Valley Med. Center (Medford Oregon), Harborview Gastro Clinic (Settle, Washington), Hines Va Hospital (Chicago).
      You may also want to take a look at:

  3. Fecal Transplant Studied for Kids With Bowel Disease
    (Ref: U.S. News & World)
    April 17th, 2013

    Study results published in the Journal of Pediatric Gastroenterology & Nutrition suggest that faecal microbial transplantation may help reduce or eliminate symptoms of ulcerative colitis in most children and young adults, as reported U.S. News & World on Wednesday.

    In the study, which included 10 participants, aged 7 to 20 years, with mild to moderate ulcerative colitis, enemas were used to give the patients lab-prepared stool samples from a healthy adult donor.

    Each participate received five such treatments within one week and 78 percent of the patients had a reduction in ulcerative colitis symptoms within a week.
    Also, 67 percent of participants had reduced symptoms a month after faecal transplantation and 39 percent of the patients no longer had any symptoms of ulcerative colitis after the process.

    According to the study, no serious side effects were noted.
    Lead investigator Sachin Kunde said that “we believe that the procedure may restore ‘abnormal’ bacteria to ‘normal’ in patients with ulcerative colitis,” adding that faecal transplantation could offer patients a natural, inexpensive treatment option.

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