The success of fecal transplant in treating certain infections including the deadly Clostridium difficile is approaching 100%. As was reported in an earlier IPA blog, stool from healthy people is delivered to the intestines of the sick, either through an enema or via a tube inserted into the nose.
A recent study from the Netherlands compares the transplant with antibiotics:
…”transplants cured 15 of 16 people who had recurring infections with Clostridium difficile bacteria, whereas antibiotics cured only 3 of 13 and 4 of 13 patients in two comparison groups.”
Its “new” popularity belies the fact that fecal transplant has been used in traditional Chinese medicine from the 4th century and is also used in animal health for gut disturbances. Now we have a guy on YouTube showing how to mix the stool in a blender and inject it like an enema.
Clinicians should be jumping to embrace the new treatment. Pills and IVs are so much easier and less messy. And it would seem that supply would greatly outstrip demand.
Deposits to the stool bank are not automatic. In fact, very few pass muster as researchers discovered recently.
Sudarshan Paramsothy and colleagues published Donor Recruitment for Fecal Microbiota Transplantation in Inflammatory Bowel Diseases in April 2015. They described recruiting methods:
- Ads in newspapers, direct mail and online ads were used.
- Potential donors advanced through: prescreen telephone, blood and stool tests, medical history, and physical exam.
Of 116 potentials, 74 failed to pass prescreen for various reasons including medical problems and genetic risks. 47 declined to participate after hearing requirements for donations
38 completed stool and blood testing: 20 failed due to presence of inappropriate organisms or toxins
Now, the researchers were down to 18 potential donors. Of these 6 more were excluded due to obesity, drug use, mental state or irregular bowel movements.
Only 12 of the original 116 were cleared for donation.
“Recruitment of fecal donors for FMT is challenging with only a small percentage ultimately serving as donors. Many were unable or unwilling to meet the donor commitment requirements. A surprisingly large proportion of healthy asymptomatic donors failed stool testing, primarily due to gastrointestinal parasites.”