Maybe it’s the implausibility, or simply the gross visual image, or the gravitas of a study being published in the New England Journal of Medicine with “donor feces” in the title. But research showing that treating some patients with recurrent C.difficile bacteria by transplanting poop from a healthy donor into the colon of an infected patient could be more effective than drugs has sparked surprised and snarky tweets and stories.
The procedure involves processing the stool from the healthy patient to remove all nonbacterial elements. It is then introduced into the gastrointestinal tract of the patient using a tube passed through the nose, or a colonoscopy so that the healthy bacteria can be reintroduced.
Although fecal transplants have been studied and written about for years, what has aroused so much interest in this latest study is that it was a randomized trial. The study has also sparked some comment on the role of e-patients in championing this therapy. That may ratchet up if the U.S. Food and Drug Administration decides to classify stool as a drug, as a New York Times article suggests.
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— Nature Medicine (@NatureMedicine) Jan. 17, 2013
Curative fecal transplants: an exemplar for why it is so important to challenge medical dogma bit.ly/WhVedu #CDoM — Eric Topol (@EricTopol) Jan. 17, 2013
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The fecal transplant story is an e-patient narrative: doctors said “yuck” while informed patients said “gimme.” — Susannah Fox (@SusannahFox) Jan. 17, 2013
This isn’t crap. Well, yes it is. Fecal transplants beat antibiotic in treating C. diff in 1st randomized trial bit.ly/Ya72Ux — Ryan McBride (@RyanMFierce) Jan. 17, 2013
Is this April 1? @montemorin had me up to “delivered through a nasal tube”. Fecal transplants treat intestinal ailment latimes.com/news/science/l…
— Jack Dolan (@jackdolanLAT) Jan. 17, 2013
poo-plant fb.me/16RlZs5NH
— The Research Mommies (@ResearchMommies) Jan. 17, 2013
Fecal transplants are in the news…I need to read the fine print on my donor card
— jim short (@jimmeshelter) Jan. 17, 2013
It seems a natural reaction to an innovative approach to human waste that we wouldn’t normally associate with health benefits. And there’s a certain irony to it as well. Considering how hard hospitals work to cleanse their premises of bacteria and microbes, and constantly remind people to wash their hands after using the toilet to prevent hospital-acquired infections, it’s amazing to consider that the solution to a widespread medical problem would lie in excrement.
One of the biggest challenges in treating C.difficile is it’s immune to many drugs.
MikrobEX is a Minnesota-based startup developing a stool bank to provide healthy stool for patients with gastrointestinal infections. Its co-founder Mike Berman told MedCity News in an interview last year about a group of patients on antibiotics who are most affected by C.difficile infections. “There is a pool of patients that have a very difficult course where they are on antibiotics for months to get rid of it,” Berman said. “The death rate is 5 percent.”
C.difficile causes diarrhea, fever, nausea and abdominal pain and is estimated to kill 14,000 people each year, according to the Centers for Disease Control and Prevention.
[Photo sourced from BigStock Photo]
