Fecal transplants work for some

http://bodyodd.msnbc.msn.com/archive/2008/12/09/1704381.aspx

Fecal Transplant: Putting Poo in your stomach
Doriott was actually relieved to show up at a Duluth, Minn., clinic, where doctors sent samples of her husband's excrement sliding into her stomach – and apparently cured the infection that threatened to ruin her life.
Doriott is among a growing number of people who’ve undergone the seemingly gross procedure in a last ditch effort to restore normal bowel function after severe, recurrent C. diff infection. The little-known technique gained new fame last month when an episode of “Grey’s Anatomy” highlighted the quirky cure that helps 85 percent of those willing to try it.
Rates of C. diff are skyrocketing in the U.S., where a recent study found 13 of every 1,000 patients in the nation’s hospitals are infected or colonized with the germ.

The antibiotics destroy good bacteria in the colon, allowing the C. diff to flourish. The bug can cause illnesses ranging from severe diarrhea and colitis to blood infection, and in worst cases, death. Most patients with C. diff can control it with powerful antibiotics such as metronidazole, sold as Flagyl, or vancomycin. But in about 20 percent of the cases, even those strong drugs don’t work.
That was the case for Doriott, who figures C. diff spores in her gut were activated when she had two rounds of antibiotics for a sinus infection and dental work within six months.

“At its worst, I’d have diarrhea every 15 minutes,” recalled Doriott. “I’d be going for two or three days. I’d have a 103-degree fever. I couldn’t make it two steps from the couch.”

After months of exhaustion and illness, Doriott became desperate enough to consider the fecal transplants she’d heard about through research. She contacted Rubin in Duluth and made an appointment for the hour-long office visit.

Typically, patients ask a close household member, usually a spouse, to produce a sample of stool, which is tested for disease and infection. In Doriott's case, her husband, Jerry, 50, a civil engineer, was on tap.

On the day of the transplant, donors provide the feces, which is blended and filtered. A tube is fed through the patient’s nose into the stomach and several teaspoons of the sample are injected through it.

“I refused to look at it,” said Doriott. “All I felt was a coolness. It didn’t smell.”

Doriott said she felt better immediately and hasn’t suffered a C. diff relapse since the treatment. Other patients take a few weeks or even months to recover, Rubin said.


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