I've heard of blood transplants, hair transplants, bone marrow transplants and all kinds of organ and
tissue transplants. But until this evening I had never heard of fecal transplants. They're being used in Canada and a few other countries to treat people who suffer from C. difficile infection.
Though C. difficile can be kept in check by good bacteria in the bowel, problems can arise when the superbug is treated by antibiotics such as vancomycin. The antibiotics sometimes wipe out the good bacteria but fail to completely kill the C. difficile — leaving enough of it that it later flourishes.
"If you wipe out the normal bacteria by taking an antibiotic, then this bug overgrows and it releases a toxin which causes severe diarrhea," Dr. Mike Silverman, an internal medicine specialist from Ajax, Ont., told CBC News. [Link]
How bad is the diarrhea? One Calgary woman had to visit the bathroom 40 times a day. I can't imagine doing that. I'd run out of magazines.
Calgary physician Dr. Tom Louie, head of infection control at Foothills Hospital, is one of the few physicians in Canada who treats patients with chronic C. difficile with fecal transplants, or fecal therapy. He has done 38 procedures to date.
The procedure involves getting a close relative of the patient, such as a sibling, to donate several days-worth of stool. Louie tests the stool for diseases such as hepatitis and HIV and then mixes it with saline to create liquid feces. He then administers the stool to the patient through a barium enema.[Link]
I like the word 'stool.' Perhaps it shouldn't be called a fecal transplant -- it should be called furniture restoration.
Louie said the technique allows good bacteria from the transplanted stool to reduce the number of C. difficile bacteria in the intestines and to restore normal intestinal function.
He said the process is fairly quick.
"It takes me about an hour and I leave it in there overnight. I'm hoping that some of these normal bugs will come and find a home, and when they find a home it will kick out the C. difficile." [Link]
Let me get this straight: he's bringing normal bugs into a home and they're all sitting on stools?
Marcia Munro, a Toronto resident, received a fecal transplant from her sister Wendy Sinukoff after suffering from C. difficile for 14 months several years ago.
"I had to collect stool samples for five days prior to our leaving Toronto, and I collected it in an ice cream container and kept it in the fridge," said Sinukoff. [Link]
An ice cream container? Please don't tell me it was chocolate fudge.
She had to then fly the samples to Calgary so that Louie could transplant it into her sister — a process that involved getting the sample through airport security.
"My biggest fear was that my samples were not allowed to be frozen, so I had to take them as carry-on luggage in the airplane and I was terrified that I was going to be asked to have my luggage searched," she said. [Link]
Security officer: "What's in this ice cream container?"
Sinukoff: "Uh ... stool."
Officer: "You got a stool in there?"
Sinukoff: "Yes. Sort of."
Officer: "It must be a tiny stool. Why are you taking it in an ice cream container?"
Sinukoff: "Well, I don't like other people looking at my stool."
Officer: "Why? Is it a family heirloom or something?"
Sinukoff: "Sort of. I've had it for a little while and now I'm passing it on to my sister."
Photo by stenbough
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