The Enema of Your Enemy is Your Friend
Fecal transplants could be a cheap and effective treatment for gastrointestinal disorders.Posted Thursday, Jan. 27, 2011, at 4:26 PM ET
Then she met Lawrence Brandt, a gastroenterologist at the Montefiore Medical Center in the Bronx who believed he had developed a procedure to cure people of recurrent c. diff infections: fecal transplant. Brandt has been inserting feces into his patients for a decade now and claims to be solving their problems nearly 100 percent of the time. If his method really works—and he's not the only doctor who believes that it does—then we may have found a viable, if weird, solution to a serious problem. C. diff infects 250,000 Americans each year and killed more than 20,000 from 1999 to 2004. (Researchers estimate that 13 out of every 1,000 patients admitted to a hospital will pick up the bug.) Antibiotics will always be the first response to such infections, but when those fail, a fecal transplant could be the next step. For Ruth, at least, the procedure was a godsend. "I'm cured," she said. "Period. End of story. Cured."
Here's the basic idea. People suffering from the hardy C. diff bacteria are generally prescribed a powerful antibiotic. Problem is, the drugs don't just kill the invaders; they also wipe out much of the beneficial bacteria in the gut. With these "good" microorganisms out of the way, any C. diff stragglers have a much easier time regrouping for a second bout of illness. If there were some way to respawn the beneficial bacteria in the intestines, such re-infections could be warded off. Some people, like Ruth, turn to expensive probiotic supplements. (At one point she was spending $350 on them every week.) But in certain cases, a patient who has lost nearly all of her good bacteria will find it nearly impossible to get them back. A fecal transplant seems to work as a sort of mega-probiotic, allowing doctors to repopulate a patient's intestines with the appropriate microorganisms by placing a robust sample directly into her gut.
Doctors recommend that the fecal donor be someone close to the patient—a family member, perhaps, or a spouse. Scientists reason that when people live in close quarters, they are exposed to similar bacteria—good and bad—and are likely to have had a similar set of bacteria living in their guts before anyone got sick.
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