Can You Cure Your IBD with a Poop Transplant?

Can You Cure Your IBD with a Poop Transplant?1

Animal poop is a good thing

Since time immemorial we’ve used it to nourish the ground and grow our food.

But human poop?

We’d just as soon not talk about it, but these days, doctors can’t seem to talk about it enough.

Not because it might be a good alternative for growing food (that’s an entirely different discussion), but because it’s been found to be a miracle for some patients suffering from stubborn and life-threatening infectious diseases in the gastrointestinal tract.

That’s right. Patients who have been near death’s door suffering from recurrent C. difficile colitis have been able to recover by receiving a special donation—the transfer of human stool from a healthy donor.

The Rise of Antibiotic-Resistant Infections Requires New Treatment Approaches

The idea of transplanting poop from one person to another—officially called “fecal microbiota transplant (FMT)”—is actually not as radical and new as it may sound.The Fecal Transplant Foundation notes that the practice was first documented in fourth century China, that it’s been used for over a century in veterinary medicine, and that it’s actually been used to treat C. diff infections for decades in many countries.

FMT to the Rescue for Patients with C. Diff Infections

Doctors typically try one antibiotic after another in an attempt to treat C. diff, but recent studies have shown that FMT is a much more successful and tolerable therapy.

Why would it help to transplant poop from a healthy person to a sick person?

Because that healthy poop is full of good bacteria that can go to work on the C. diff and show it who’s boss.

It works. So far, studies have shown that FMT has a 90 percent success rate for patients who have failed to respond to typical antibiotic therapy. Most all of the cases were resolved with just one treatment, and adverse side effects were very rare.In a 2015 case study, researchers found that FMT not only cured C diff. in a 66-year-old man, but it also eliminated other drug-resistant organisms in the man’s gastrointestinal tract and several other body sites.

In a 2012 study review, for example, researchers noted that FMT “is becoming increasingly accepted as an effective and safe intervention in patients with recurrent disease, likely due to the restoration of a disrupted microbiome.” They added that cure rates of over 90 percent were “consistently reported from multiple centers,” and that FMT for recurrent C. diff infections (CDIs) had a primary cure rate of 91 percent.

In a 2015 study, researchers reported that FMT not only cured CDIs, but made long-term healthy changes to the gut bacteria of infected patients, lasting for at least 21 weeks after the procedure. And in a 2015 case study, researchers found that FMT not only cured C diff. in a 66-year-old man, but it also eliminated other drug-resistant organisms in the man’s gastrointestinal tract and several other body sites.

FMT May Help Treat Ulcerative Colitis and Crohn’s Disease

But it’s not only life-threatening infections that may benefit from FMT.

More recent studies have also shown that FMT has promise in treating a number of other health issues, including inflammatory bowel diseases (IBDs) like ulcerative colitis and Crohn’s disease.

In a 2016 study, for example, researchers reported that FMT helped 44 percent of patients with treatment-resistant ulcerative colitis to go into remission at eight weeks, compared to only 20 percent in the placebo group.

Two other studies the year before found similar results, with FMT creating significantly greater levels of remission over placebo.

So with all this good news, we have just one question—exactly how is FMT performed?

Scientists Working on an FMT Pill

The good news is that the standard FMT procedure saves you from the “ick” factor.

The most common approach involves gathering a fecal sample from a healthy donor—often a family member— who must pass screening tests to be sure he or she is free of any infections or viruses that could prove unsafe for the recipient.The most common approach involves gathering a fecal sample from a healthy donor—often a family member— who must pass screening tests to be sure he or she is free of any infections or viruses that could prove unsafe for the recipient.

Once a healthy donor is found and approved, he or she donates a cup of stool, which is then put through a process to prepare it. Clinicians mix it with a preservative-free saline and strain it through a filter to create a solution that they can then infuse into the sick patient via a colonoscopy.

The patient must “hold” the stool as long as possible—at least two hours—and that’s it.

Some doctors have also used a nasogastic tube (inserted through the nose into the stomach) or an enema to deliver the solution into the gastrointestinal tract, but so far, the colonoscopic delivery remains the gold standard.

If this still sounds a bit too yucky for you, consider how you might feel if you were suffering a life-threatening diarrhea. You probably wouldn’t mind so much.In late 2015, MIT-trained researchers created a new pill called the “FMT Capsule G3” that is intended to help treat recurrent CID infections. It’s made with a new technology that preserves the bacterial communities in the sample while ensuring long-term stability.

But meanwhile, researchers are looking at other, less nauseating and more efficient ways to provide the treatment. A 2016 study found that frozen stool samples worked just as well as fresh—meaning that the samples could be stored longer and used more quickly, potentially eliminating the need to find a donor.

Even more exciting is a possible fecal transplant pill.

The capsule degrades within minutes, and was found in a pilot trial to have an initial efficacy rate of 70 percent, and a higher rate of 94 percent when used at a higher dosage in those who didn’t respond the first time.

Once you get past the squeamishness, you realize that the future of this treatment is extremely exciting. We’re learning more every day about how the bacteria in our bodies affects our health, and we may find that FMT has a lot more applications the more we learn.

Meanwhile, if you want to prevent these types of infections, take care of your microbiome by regularly consuming foods with health probiotics, including yogurt, kefir, miso soup, kombucha, and sauerkraut.

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