By Markham Heid, Prevention
That horrible thing was a recurrent Clostridium difficile infection—a type of colon infection that causes severe belly pain, diarrhea, and fever. Baker, a 33-year-old Maryland resident, says her doctors kept giving her antibiotics. But after feeling better for a week or two, the infection would return.
"I had it three
times in two months, and I ended up being hospitalized for it," she
says. "I couldn't keep anything down and I was losing weight—it was
awful."
Finally she was referred to Erik von Rosenvinge, MD, a GI researcher and associate professor of medicine at the University of Maryland School of Medicine.
"He told me [a fecal transplant] was something I needed to do to feel
better, and it was a Godsend," Baker says. "I felt better within a few
days, and I've been fine since."
(Reverse chronic inflammation and ease more than 45 diseases with the all-natural plan in Prevention's The Whole Body Cure!)
[post_ads]So,
what is a fecal transplant? "The process involves taking stool from a
healthy donor and placing it in the GI tract of the patient," says von
Rosenvinge. That's right: He means taking someone else's poop and
putting it inside your body. Just a few years ago, this concept would
have seemed next-level crazy—not to mention disgusting. And let's face
it: It's still pretty gross. Regardless, fecal transplants have quickly
become an accepted form of medical treatment.
Your gut houses a diverse ecosystem of microorganisms known
collectively as your microbiome. These hundreds of millions of organisms
play a critical role in your digestion, metabolism, immune function,
and a lot else.
If something disrupts that ecosystem—be it infection or illness or
exposure to antibiotics—your health can suffer in a lot of ways. "We
know the microbiota has metabolic effects, so it could play a role in
obesity and diabetes," von Rosenvinge says. "But there's still a lot we
don't understand."
The idea behind fecal transplants is that, if
your microbiome is thrown out of whack, introducing someone else's
healthy gut microorganisms—via their poop—will repopulate your
gastrointestinal tract with the beneficial bacteria you're missing.
Think of it like a resupply of troops when your own internal army has
been decimated. (And yes, all of this has been established by years of
scientific study.)
Are You A Candidate?
Fecal transplants—while once a fringe procedure—have become standard
care for one common health ailment, says von Rosenvinge. For now, the
FDA has only approved fecal transplants for the treatment of recurrent
colitis, another name for the C. difficile infection that plagued Tina Baker.
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But even for colitis sufferers, a fecal transplant is only approved as a "second-line" treatment, von Rosenvinge explains.
"If
the first-line treatment, which is antibiotics, isn't effective, or if
the infection returns again and again, that's when the FDA allows us to
perform a fecal transplant," he says.
In those situations, he says the procedure is effective 80% to 90% of the time.
How Fecal Transplants Are Performed
Traditionally, a healthy family member or friend would donate a stool sample, says Ashish Atreja,
MD, a gastroenterologist and assistant professor of medicine at New
York's Mount Sinai Hospital. This stool donor would first undergo
testing for harmful or problematic gut bacteria. (Here are seven things your poop says about you.)
While this is still the most common practice, a Boston-based non-profit called Openbiome
has begun supplying doctors and health systems with poop that has been
rigorously screened and sequenced to ensure its safety and proper
balance of gut microbes, von Rosenvinge says.
(Your gut bacteria could be behind your weight gain. Here's what you should know.)
Wherever the poop comes from, it's mixed with a saline solution and
then strained to remove "particulate matter," Dr. Atreja explains. From
there, the diluted poop solution is introduced to the patient's
gastrointestinal tract via colonoscopy or a similar procedure called a
sigmoidoscopy.
While some patients report improvement of symptoms
within a few days, doctors tend not to judge the procedure's success
until a couple months have passed and the donor's microbiota have been
fully integrated with the patient's.
The Endless Possibilities
While recurrent C. difficile is the only ailment for which a
fecal transplant is approved, Dr. Atreja says researchers are looking
into the procedure for the treatment of everything from obesity to
autism.
"Allergies, autoimmune diseases like rheumatoid arthritis or lupus,
metabolic syndrome—there are a whole range of possibilities," he says.
But, for now, all of these treatment options are still being validated, and doctors can't legally perform them.
PREVENTION PREMIUM: Do You Suffer From Chronic Inflammation? Here's How To Tell—And What You Can Do About It
[post_ads]The restrictions placed on fecal transplants anger many who are
desperate for relief from chronic conditions, and who believe a fecal
transplant could provide that relief.Both von Rosenvinge and Atreja say they understand the frustration
because, if the procedure is performed by a doctor using a healthy stool
sample, the downsides appear to be minimal.
"Some people are leaving the country and going to Mexico or other
places to have these performed," von Rosenvinge says. There are also
online tutorials and even some clinics that show people how to perform
DIY fecal transplants—though von Rosenvinge warns you're playing with
fire, and potential catastrophe, if you go that route.
The Risks Involved
While there's great potential in fecal transplantation, there are also risks. Some anecdotal reports—as well as published case studies—have linked fecal transplants with rapid weight gain and new-onset obesity.
"There's the potential for a donor to pass something on that could
have bad consequences down the road, or could make a condition worse,"
Atreja says.
"The procedure is so new that we don't know much about the long-term
effects," von Rosenvinge adds. "For example, if a donor is currently
healthy but is at increased risk for cancer or an autoimmune disease or
something of that nature, they may be able to transmit that risk despite
proper screening."
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It's a classic double-edged sword. If you
believe altering your microbiome can cure all that ails you—and there's
some good science to support that belief—you have to accept that such
meddling could also make your health worse.
Atreja and other researchers are currently working on an NIH-funded
"stool transplant registry" that will help nail down some of the
longer-term effects of the procedure. But for now, he says, there are
still many "unknowns."
"Already we're seeing in research the potential to treat a whole
range of diseases, and to do so in a more precise manner where a person
ingests a capsule containing certain strains of bacteria," he says. "It
may not be a panacea, but I'm hopeful we'll soon have many more approved
uses."
