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Poop: The Cure of the Future?

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Poop has been all over the news lately. (And no, I’m not talking about the recent election.) I’m referring to fecal transplant, the process of transferring a healthy person’s stool into a sick person’s colon in order to restore the bacterial balance. It sounds bizarre, and even a little crazy, but doctors and scientists all over the country are discovering just how effective fecal transplants can be.

Just last week, the Chicago Tribune wrote a story predicting that stool banks may one day be just as common as blood banks. Human stool transplants have been found to consistently cure up to 90 percent of patients who have had multiple episodes of C. difficile, an infection which causes serious diarrhea and affects about 3 million people per year. Typically, these infections are treated with antibiotics such as vancomycin, which can actually make the infection worse by killing off beneficial bacteria and allowing the resistant C diff. to survive. This recurring infection can be fatal, killing an average of 14,000 Americans every year. It’s especially dangerous for young children and the elderly who are more susceptible to the bacteria that causes the colonic inflammation and diarrhea.

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Use of the procedure is simple and shockingly effective for patients with serious bowel infections. CNN recently reported on a young girl who nearly died from the infection, and was cured immediately by a fecal transplant using stool donated from her mother. This recovery was after nine rounds of antibiotics failed to eliminate her life-threatening infection. While the idea of receiving a fecal transplant may disgust some, the sickest patients aren’t fazed by the “ick factor” of the procedure. If it helps them recover from their serious illness, they’re willing to try it.

Several studies have demonstrated the effectiveness of the procedure on treating not only C. difficile, but other conditions as well. (1) Various studies have shown fecal bacteriotherapy, to be effective in colitis, constipation, irritable bowel syndrome, and some neurological conditions like multiple sclerosis or Parkinson’s Disease. (2, 3, 4, 5) Researchers in Amsterdam are even running a clinical trial to see if fecal transplants can help treat obesity. (6) I’ve written before that the composition of the gut flora is one of many factors that affects weight regulation, and fecal transplant could very well be a future obesity treatment. (7) There may be countless other conditions that could be helped by this simple, effective, and safe procedure.

I’m fascinated by fecal bacteriotherapy and have read all the studies on it. It’s a miraculous treatment in certain conditions, and we have yet to tap into its full potential in treating a number of gut-related illnesses. I’m excited to see how this therapy develops, and wouldn’t be surprised to see the creation of stool banks in a few years. Fecal transplant may be a disgusting concept to some, but who knows – one day it could save your life!

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220 Comments

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  1. My question is… If you could have a poop transplant from anyone in the world who would it be? 🙂

    • Answer: ………from the donor who has been carefully coached with dietary choices, who has had full blood and stool pathogen and disease screening, who has undergone PCR DNA sequencing for microbiome construct, and has has bacterial supplementation where necessary to make up the shortfalls. In other words from the donor whose stool has been modified to be the most beneficial with all the right bacterial groups, species and sub species. That would be totally irrespective of age, colour, religion, gender, race or celebrity. Which Kevin, is the direction you were going – celebrity.

      I believe that you were trivialising a life changing/saving procedure for a cheap gag. You should apologise to all those people suffering from life-shortening, painful and serious gastro-intestinal diseases, to whom, this treatment might be their only chance of survival.

      • Wow if you can’t joke about poop what can you joke about? I was thinking more along the lines of some of the super healthy paleo celebrities like Robb Wolf, Mark Sisson, or maybe Chris Kressor. If these guys practice what they preach I’m sure they have great bacterial flora. I believe in this therapy and think it can and will help many people in the future but that doesn’t mean we can’t have a sense of humor about it.

    • I was wondering about this as well! I don’t have a colon anymore, and I still have digestive issues and I’m certain I have some serious gut flora imbalances. I’m honestly not even sure how many bacteria are SUPPOSED to be in the small intestine! I haven’t had any success so far with dietary or probiotic measures to improve my gut health, so fecal transplants really intrigue me.

  2. also, what about the huge spread of infection that occurs when say they didnt clean thier scopes for colonoscopy propery in new york yrs back and all of those people got like hepatitis?

  3. funny that when they were doing this research at northshore long islannd jewish hosp on long island…a dr bernstine, i believe, the whole floor had c-diff and also a few wks later, while at thier sister hospital, mt sinai, everyone there also had it…hmmm

  4. Hey Chris,
    Great article. Quick question somewhat on topic… I have a healthy 3 month old who is exclusively breast feeding. Mom eats close to 100% organic, grass fed, ec. I catch his poops in the potty (via EC) a lot through out the day. Would using it by taking it as an enema be beneficial to improve or even recover some gut flora? Your thoughts would be very welcomed and valued for this unusual idea? Thanks

  5. As a urologist dealing with very resistant urinary infections in complex patients, I can also see a day when we will have no alternative but to super-infect the urinary tract with virulent, but sensitive organisims, that will crowd out the resistant ones, but be very amenable to antibiotic treatment. This is done routinely in water treatment facilities, where over growth of resistant pseudamonas species can only be managed by overgrowing and crowding out the resistant organism with strong, but antibiotic-sensitive species. We are losing the antibiotics battle. This defeat will have to be met with manipulation of the infective agents. It’llbe a new field: “Infectious Disease with Bacteriotherapy Specialization.” We’ll be able to use penicillin again!

  6. Great article Chris. My son has ulcerative colitis. I had found a clinical trial in Canada that is using stool from screened donors as a treatment for UC – my son met the requirements and was accepted but had to defer participation because he wanted to discontinue his Remicade treatments and so had to sit out a required waiting period for any medication changes. He plans to rescreen after the holidays. We have high hopes for the treatment – he has been keeping his symptoms under pretty good control with the Specific Carbohydrate Diet (and has been med-free for 3 months after 2 years of expensive, but ultimately useless, pharmaceutical intervention), but has yet to achieve remission and finds the diet hard to follow because he is not in a position to cook for himself due to his living arrangements (a college dorm). My expectation is that the fecal transplants will speed the healing process begun by the diet and get him over the hump so that he can finally experience remission.

  7. Chris, as a practicing FMT clinician in England, I wish to thank you very much for raising awareness of this very effective and totally natural procedure. Can I correct one or two things; Alex Khoruts is achieving total remission for Recurrent Clostridium difficile Infection in the region of 98% and Tom Borody is close to that also. My own clinic has carried out so few RCDI treatments that my sample is hardly representative. We have treated for many neurological conditions as well as gastrointestinal and we never fail to be surprised at number of conditions where FMT treatment appears to make a significant difference.

    Secondly, what we infuse, can hardly be call “poop” anymore; after careful selection of only the fittest, and healthiest of donors who have passed a long string of stringent tests and after clinical agitation, filtration, and centrifuging we have a small concentrate of almost pure active and live beneficial bacteria – believe me, it ain’t poop no more. So get the idea completely out of your heads that we are sticking raw sewage into sick people. By the way, that probiotic yoghurt you just ate, those probiotic capsules you just swallowed ….. you DO know where the bacteria they use came from don’t you?………..

    In 10 years time, Fecal Microbiota Transplants will be the treatment of First Choice and not of Last Resort. There should be an FMT suite in every hospital and they should all be funded by the national purse. The cost savings to public health would be literally huge, but a word of caution – do not expect any enthusiasm from the drugs industry.

  8. I am a huge proponent of this procedure! I have not had it done, but I used to work at a clinic that served autistic children and it was widely discussed. I think that, as a culture, we need to overcome our fear of talking about poop and consider the ways that poop can teach us so much about our health.

    I recently wrote a letter to the editor of the New Yorker after they printed an article (“Germs Are Us,” October 22, 2012) about the human microbiome that referenced fecal transplant but dismissed it as as “extreme” treatment, despite its low cost and clear benefits. The article instead lauded the option of developing drugs to mimic the effects of human gut bacteria… a huge waste of money when we already have the cure! Here is my blog post with the letter’s full text: http://paleolizzard.blogspot.com/2012/10/my-letter-to-editor-of-new-yorker.html

  9. I have been hearing about this procedure on various podcasts for some time now, so thanks Chris for writing about it and bringing this info to a wider audience. I want to invite everyone to join the American Gut Project, an effort to discover the diversity of bacteria that are in us and on us much like the human genome has been mapped. I just donated $99 to get a kit to find out what critters live either in my feces, my mouth or on my skin, whatever I choose to have tested. I’m going for poop. As an avid fermenter, I am curious to find out the variety of bacteria I am hosting. Must be quite the polyculture in there!
    Go to: http://www.indiegogo.com/americangut/x/1870646 to learn more about the American Gut Project.

  10. My brother and his flatmates used to sell their poo! About ten years ago they would poop every morning and deliver it to a specialist in Sydney Australia. They made $100 a week for doin what comes naturally. He loves telling that story, lots of great potential joke lines such as my first job really gave me the *****. One of his flatmates couldn’t join in tough cause he’d lived in PNG growing up so didn’t have good enough poop to sell! Specialist was Dr Borody if anyone is in need in Sydney…. he’s been doing this transplant for a long time.

  11. Have they considered fecal transplants from animals? I would imagine it is much easier to find healthy candidates from say goats versus humans. Thoughts?

  12. I’m wondering if fermented foods and high quality probiotics could help people who don’t qualify for the fecal transplants / aren’t in life threatening situations. Anybody know anything about populating the colon by starting in the mouth?

  13. I had human Faecal implanted in my bowel for IBS. Very reputable clinic in Sydney,Australia.
    Didn’t work. Perhaps because I was told to eat lots of soluble fibre to feed it. One thing the ‘wrong bacteria’ like is soluble fibre. Spent of $2000 getting it done.
    The only think that has worked for me for IBS is a strict low carb diet with no caffeine or alcohol of any sort.

    • I’ve also heard that it may not work unless a longer period of treatment is done, however the cost is definitely prohibitive. Many are now turning to home transplants (with guidelines from the CDD) either as a standalone treatment or as a “top-up” after treatment at the CDD.

      I’m considering going to the CDD but not sure I qualify as my issues are mental health and fatigue, more so than any severe digestive complaints….even my issues are absolutely tied to gut dysbiosis (confirmed with stool testing for bacteria levels and antibiotic treatment)

      • Hi Allison,

        My son has experienced headaches for many years. A year ago we started trying to find the route cause. He has modified his diet and was treated for parasites (Blastocystis Hominis and Diaentomeba Fragilis), while this helped his brain fog, digestive issues and joint pain, he has had chronic headache (everyday) and has missed a year of school. His fecal testing showed a severe dysbiosis, so like you we are looking at FMT to resolve non-gut issues. Did you go down the FMT route? Was it successful in your quest to resolve non-gut issues. We are talking to the CDD in Sydney about this treatment. Any comments would be greatly appreciated, we are besides ourselves with our 15 yo going through all this.
        Also Chris and other, if anyone has knowledge of FMT to resolve chronic headaches/migraine, we’d appreciate your input. Thanks.

    • So how long did it take for you to feel better after you got the “strict low carb diet with no caffeine or alcohol of any sort” diet established? One thing I dispair is managing to stay on it long enough for effect. My cravings are overwhelming unless I have some carbs and when I do there it goes, gone down the drain.

  14. My wife who is now 70 years old has COPD and for the last 6 years has had regular courses of antibiotics with steroids to treat chest infections/exacerbation’s. Her gut flora must be seriously compromised. I am sure that here in England, I could not convince her GP to contemplate a fecal transplant.
    I’ve been “archevore” in my diet for more than 6 years and have not had antibiotics in that time. My stools are and have been through this time optimal. Is there a way that I can self administer a transplant, possibly by a rectal enema that could help improve her gut flora?
    She’s on a downward slope, now on full time oxygen. Would it do any harm to try this? Surely it would improve her immune system and help the overall situation.
    I recently discovered that she was vitamin D deficient, even though she’s been taking 2,000 iu per day for 10 years. I upped her dosage to 10,000 iu per day for 6 weeks which raised her level to 55 ng/ml. She’s now on a maintenance dosage of 5,000 iu with another test next month.

    • Hi Bill
      There is a clinic in the UK called Taymount that may be able to assist. Glenn Taylor is the contact there.
      All the best,
      Allison

      • Thank you Allison, I’ll contact Glenn.
        I would however like to hear what Chris has to advise. COPD is a massive problem and I’m sure that the conventional treatment could be improved.

  15. First, I will say that I am not averse to this because of some sense of revolt or disgust.

    I am averse to this because of one single reason: short cutting.

    Short cutting is for lazy people – these are the same people that get gastric bands fitted, that take the “magic pill” for weight loss.

    Short cutting is someone else doing all the right things, all the hard work and then other benefit from it. I find that, in itself, revolting!

    Want something? Save! Work! Strive towards! Ultimately, get it.

    Got poor digestion? Stop eating crap (there’s an ironic joke in there somewhere) and eat real food. Boost your own gut and benefit from a new life well fought for.

    • Paul you clearly haven’t read the article or engaged your critical faculties. Tell that to the people that contracted c.difficile in hospital or developed ulcerative colitis after antibiotic use. Count yourself lucky.

        • Paul before you judge anyone get your facts straight!!!! Not everyone who has a gut problem eats badly- I have gut issues and I’ve eaten healthily my entire life unfortunately severe food poisoning, from a RESTAURANT meant multiple rounds of antibiotics as I had also contracted a parasite, ever since then I’ve had gut issues. Did I ask for them- NO! So unless you have anything of benefit to say then don’t say anything at all!!!!! And by the way I do work and yes luck is involved- I’d say getting food poisoning was beyond my control!

          • I am sorry … I do hope you are on the path to full recovery and can benefit from a normal and healthy life soon.

            I am not talking about how this procedure can resolve issues for people who are sick and can benefit from it; I am talking about all those people who, quite self-destructively and serially abuse themselves with poor lifestyle choices and then, rather than invest the same time and effort into righting themselves simply take the shortcut.

            I envisaged those self-same people who get so far there’s no turning back and have liposuction, gastric bands and so on. I envisaged that the wide(r) spread use of this procedure might well wind up quite simply being a “quick fix” for people who will not take the choice to actually eat right.

            That is what I was speaking about.

            • Apology accepted. I’m sorry for the angry response but I’ve literally struggled for almost 5 years to turn my digestive issues around with no luck so for me a fecal transplant is my last option and certainly not a short cut. I’ve tried everything else- SCD, GAPS, raw food. I don’t tolerate probiotics at all they make me worse so a fecal transplant may be my last hope.

    • Oh if only it were so simple. I do eat well. I eat no grains. I avoid sugar. I use grass fed butter and ghi. I mostly eat organic vegetables. I eat grass fed and pastured meat and wild fish. I eat bone broth. take collagen, take probiotics, and ginger. I eat drink kefir from raw milk and drink kombucha tea. And my symptoms have gotten a lot better. But they have gotten a lot worse since recovering from the flu. Not as bad as when I ate grains, but bad enough that sometimes I have to go to the bathroom 5 times in one hour because of liquid diarrhea.

      I have had numerous antibiotics over my life for many bladder infections and childhood illnesses.
      I would take the shortcut at this point.

      Tracy

    • This is easy to say for someone that doesn’t have a life long, chronic illness through no fault of their own. This treatment could be used for people with autoimmune disorders like MS, which I have. I don’t eat crap, I do crossfit 3-4 times a week, even when I lose so much strength in my hands that I can barely hold on to the bar. Look someone like me in the face and tell me I am taking the easy way out! I am willing to do almost anything to be able to walk into my 60s and be able to hold my grandchildren someday.

      People like you INFURIATE me. Did you even read the article and what this treatment could mean for people?! Go scratch.

  16. For those interested, a support group has started up on Facebook with a specific focus for supporting those that, for some reason or another, need to source their own donor. Details here: http://thepowerofpoo.blogspot.com.au/2012/11/fmt-hits-facebook.html

    Some of the stories of those who have done this treatment, either via official channels or from sourcing their own donor (using strict screening process) are just incredible. Here is just one: http://thepowerofpoo.blogspot.com.au/2012/12/genevieves-success-story.html

    For all the naysayers, before you criticise, just be thankful you haven’t had a life threatening condition that has not responded to any other treatment.

    Thank you Chris for covering this treatment. It is something I am considering myself since I had panic disorder that responded to treatment with erythromycin – turned out the panic disorder was caused by a streptococcus overgrowth in the gut. I do not want to be on an antibiotic+probiotic merry-go-round for the rest of my life.

  17. My neice had 80% of her colon removed because of Crohn’s disease. The other 20%, the distal segment, is still painful. If the doctors used fecal transfer, which is not new, but was used 50 years ago, all this could have been prevented. Even now, it could help her if it were available. So far, doctors don’t think about it other than last resort for C. difficile. It should be first therapy for bowel problems.
    Weston A. Price principles are also very useful.
    I use the term “endobiome” for the ffunctional gut contents, in place of the less specific term “microbiome.”
    Ira Edwards author of HONEST NUTRTION

    • Please do not try this without supervision. It’s potentially dangerous without the proper screening of the donor ahead of time.