The thought of having someone else’s poop … sorry, stool … put into your body may be a disgusting one. But a specific treatment has become all the rage in the gastroenterology world, especially for those suffering from something called C Diff. It’s called a stool transplant.
“Stool transplants are becoming very popular because people are interested in this as a natural approach that doesn’t use antibiotics, so there’s a tendency to want to use it for all kinds of things,” said UW Medical School gastroenterologist Dr. Christina Surawicz.
“But the one thing that it’s very effective for is C. difficile diarrhea that produces toxins that makes the colon very sick, and thus makes the people very sick,” she said. “So if it doesn’t respond to multiple courses of antibiotics, then a stool transplant is 90 percent effective. In my practice, this is one of the most effective treatments I have ever used for any patient population.”
How a stool transplant works
There is an obvious gross out factor. So does Dr. Christina Surawicz have to convince her patients?
“Surprisingly, no,” she said. “But that’s because I was seeing people who were coming to me with episodes of C. difficile that had gone on for months, or in some cases years. But the first patient I did in 2004, I had to overcome the yuck factor myself. I thought this was really kind of a yucky thing to do. But in this woman, nothing else was working. She was in her 40s and the idea of keeping her on antibiotics for the rest of her life made absolutely no sense. So her husband was a donor, her C. difficile was resolved after over a year of having recurrences. She was cured and I was cured of my disgust factor.”
Surawicz says patients who have been sick for months or years can feel better just hours after a stool transplant.
“Because of how effective it is for C. difficile, people are very interested in wanting to use this for all kinds of things from Crohn’s disease and ulcer colitis to irritable bowel syndrome, to autism, to obesity, Surawicz said. “In my opinion, FMT shouldn’t be used in any of these situations unless the patient is enrolled in a clinical trial. So it’s being studied, scientifically, which is good. But until then people shouldn’t be doing this at home.”
The magic ingredients are microbiomes which used to just be called bacteria or gut flora. Some people have lost a lot of the important microbiomes that keep them healthy and the stool transplant replenishes that.
“Over the last few years, most of us have moved to using stool from a stool bank in Massachusetts where they actually screen the donors,” Surawicz said. “Only about three percent of people actually qualify to be donors. They collect that stool and then freeze it. You can thaw it and put it into the colon through either an enema or a colonoscope. But they also have oral capsules of frozen stool.”
There have been theories that stool transplants could also help with depression and mood disorders, since there is a gut-brain connection. Dr. Surawicz says there is a lot of research going on now and only time will tell.