By Bret Lashner, MD
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Just the thought of a fecal transplant – of transplanting fecal matter from one person into another – may make a lot of people think, “ick.” It’s an uncomfortable idea.
But consider that a fecal microbiota transplant can help people with stubborn, unhealthy gut flora. These are people struggling with recurring Clostridium difficile infections with longstanding diarrhea and abdominal pain. They can’t go to work or school or really function that well because of how sick they are.
These patients have tried long-term antibiotics, or in some cases, probiotics. But neither of these works very well with stubborn C. difficile infections. Yes, the antibiotics will clear up the infections temporarily, but these patients often experience recurring cycles of antibiotics and infection without any real resolution.
Antibiotics often strip the gut of the good bacteria along with the bad. In these cases, this makes it difficult for the body to keep C. difficile away.
How fecal transplants work
What really works is a fecal microbiota transplant. One theory is that it gives the recipient a boost of healthy bacteria to regenerate his or her own gut flora. This strengthens the person’s gut against future infections, and stops C. difficile from continually gaining a foothold.
After months on antibiotics, it is amazing to see how quickly a fecal transplant can help people. Patients have an excellent success rate and those that respond do so within two weeks. It is a therapy that works.
Right now, the only patients who are eligible for these fecal microbiota transplants are those with recurrent C. difficile infections. About 20% of them recur, and a lot of people come to me after four or five failures with other treatments.