The Poop Scoop

This, above, is C. diff bacteria, and it’s the deadliest infection in hospitals—surprising for something that looks as innocent as Good & Plenty candy and is caused by antibiotics that are supposed to heal you. A healthy person can contract the highly contagious intestinal infection just by visiting a hospital or nursing home, where it runs rampant, or even at a dentist’s office. Nearly half a million people get the bug every year, and it’s usually treated with medicine. If that fails, it’s time to talk surgery. The procedure removes part of a person’s colon and has a discouraging 50-percent success rate. Nearly 30,000 people died of C. diff in 2011 within a month of being diagnosed.
Now perhaps a fecal transplant doesn’t sound so bad.

 

Researchers at IU Health are getting attention for a study of 29 patients who chose a transplant to address a case of C. diff, whose spores are immune to hand sanitizers. The colon houses good microbials, key to the immune system. They rescue energy and produce important antibodies. C. diff kills these beneficial bacteria, and a fecal transplant replaces them by introducing healthy fecal matter into the colon. No one looks forward to a colonoscopy, but it’s easier on the body than surgery, especially for older patients. After checking in with the group of C. diff–inflicted transplantees every three months since 2012, Dr. Monika Fischer determined that the less-invasive outpatient procedure—which can be performed via colonoscopy, enema, or pills—cured the infection more than 90 percent of the time. Three people died from complications unrelated to the transplant, she says, but no one else reported significant side effects, including a 95-year-old—important, because C. diff strikes the elderly most frequently. Fischer’s study became the country’s first published protocol on fecal transplants and was cited in Forbes magazine this year. “I can’t tell you how many emails I get from all over the U.S. asking where they can find a provider,” says Fischer, who is part of Dr. Naga Chalasani’s gastroenterology group at IU Health.

 

No one looks forward to a colonoscopy, but it’s easier on the body than surgery.

Fischer believes thousands of fecal transplants have been done, and they recently became more affordable with the establishment of a “poop bank” in Boston. Now, instead of requiring patients to find a donor and pay for an $1,800 screening, doctors can purchase the stool for $385. The bank accepts less than 10 percent of candidates. “You have to be lean. No family diseases. Can’t even drink,” Fischer says of the standards.

 

The treatment is part of a growing interest in “gut microbials,” a trendy health subject. There’s a lot to look forward to, says Fischer. “I’m excited about how many different specialties focus on studying this, and how we can harness bacteria to treat illnesses,” she says. “It’s a very hot topic in the GI world.”