Ruth, a college professor in suburban New York, knows this all too well. The 55-year-old, who asked that she be identified only by her first name, took a course of antibiotics in late 2006 for a bladder infection. A few months later, she needed antibiotics again, this time for a dental procedure and that is when her problems began. She had terrible diarrhoea, and began losing weight and strength. Most troubling for a woman whose students still gave her credit for being hot on an online rating system: her hair started falling out in chunks. By May 2007 she was diagnosed with a C. difficile infection and started taking antibiotics to treat it. More than a full year later, she was still taking antibiotics in much higher doses and still getting sick every time she stopped.
She was feeling increasingly desperate when, doing some internet research, she came across the idea of a fecal transplant. In a faecal transplant, the faeces from a healthy person is inserted anally into the colon of another. The idea is that the bugs from the healthy person will restore the microbial balance of the sick one.
Though the concept of a faecal transplant may seem disgusting at first, being infected with C. difficile was far worse, she says. The indignity of it is profound. You really feel dirty and contagious. Youre just walking around feeling like a freak. Getting a faecal transplant felt like no big deal after dealing with C. difficile for so long.
Faecal donors, usually a family member or significant other, are screened for infectious diseases such as HIV and syphilis, and for lifestyle patterns that might endanger the recipient, like high-risk sexual activity.
Ruth says she felt different almost immediately after the transplant, done during a colonoscopy, and felt almost normal within three weeks. She was able to go off antibiotics at last, and the hopelessness she had felt for months slowly disappeared. Today, her hair has grown back, and she has recovered fully.
Her doctor, Lawrence Brandt, professor and emeritus chief of gastroenterology at Albert Einstein College of Medicine in New York, has been doing faecal transplants since 1990. He says he is struck by how successful, inexpensive, and apparently safe the procedure is with no major adverse reactions reported. His
research, some of it still unpublished, suggests faecal transplants have been 91% effective in several hundred cases worldwide. There has not yet been a gold standard, double-blind, placebo-controlled study of transplants, but there is a growing consensus that faecal transplants are a good idea for people with persistent C. difficile infections.
Someday, he predicts, the procedure will be tested and used against many more ailments, too. And eventually, drug companies will figure out how to bottle the right bacteria, and faecal transplants will not be necessary, he says. Today, we use stool, because we havent yet worked out the precise formulaic combinations of organisms that are deficient in each of the diseases we are talking about.
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