The Straight Poop (on Fecal Transplants)

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One of the better bits of banter I drew from Valerie Brown’s piece on bacteria for us a little over two years ago was the idea that the bacteria in our gut had a vital job to do, and like other important workers they could parachute into other locales when disaster struck:

Some researchers are even exploring the idea of stool transplants — that is, introducing a healthy person’s gut bacteria into a sick person’s intestines via the donor’s feces. Although there are not many peer-reviewed studies of this rather disturbing concept, a review in the July 2004 Journal of Clinical Gastroenterology by Australian researcher Thomas Borody found that in a large majority of the cases reported in the medical literature, fecal transplants resulted in almost immediate and long-lasting relief for people suffering from inflammatory bowel conditions and for those with chronic antibiotic-induced diarrhea. (There’s definitely a market for fecal transplants. When one scientist mentioned the success of the procedure in an interview with The Wall Street Journal, he was inundated with calls from desperate patients begging for the treatment, even though he does not practice the therapy.)

Now new work in the field of fecal transplants finds the technique may even work better for one tummy problem (recurrent infections by the bacteria Clostridium difficile) than the antibiotic usually prescribed (vancomycin) to treat the condition. The experiment by a Dutch team of researchers worked so well that it was stopped in midstream after 81 percent of those receiving a stool transplant saw their diarrhea end after the first infusion, compared to 31 percent just receiving the antibiotic. The transplant also improved the diversity of beneficial gut fauna.

A nice piece by The Los Angeles Times’Monte Morin describes the study, and also gives some poop history:

The medicinal use of stool to treat illness dates back to 4th century China, when the physician Ge Hong described fecal solutions for the treatment of food poisoning and severe diarrhea. The remedy was considered a "medical miracle that brought patients back from the brink of death," Dr. Faming Zhang of Nanjing Medical University wrote in the American Journal of Gastroenterology.

Later, in the 16th century Ming Dynasty, herbal healers prescribed fermented fecal solutions for abdominal ailments, calling the concoction "yellow soup" to make it more palatable.

Doctors in the West were more reticent, although it was known that certain mammals, such as dogs and camels, consumed excrement when they were ill, and that veterinarians sometimes used a fecal solution to treat ill horses. It wasn't until 1958 that the first scientific paper on the use of fecal transplants in humans appeared in the United States.

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