Poop transplants!?

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Kidney transplants?  Old news. 

Liver transplants?  Yawn. 

Face transplants?  Been there, done that, saw it in People

Poop transplants!?

Hah!  New I’d get you with that one.

That’s right, people.  Doctors are now transplanting “healthy” poop into the colons of patients with an intestinal infection called Clostridium Difficile (“C. Diff”) and it looks like it could actually be a very promising treatment.   Researchers in Oklahoma City performed fecal transplants on 77 patients with C. Diff that didn’t respond to standard treatment with antibiotics and had a 91% success rate in eradicating the infection

Why the heck are we talking about a medical treatment that is so gross?  Is the Student Health Center going to start offering poop transplants?  Well no, but many antibiotics that we commonly use to treat infections are associated with an increased risk of C. Difficile infection – even in young, healthy people – so it’s worth chatting about. 

C. Difficile is actually one of many “good” bacteria that normally live in our intestines, where it helps to prevent infections.  When we take antibiotics to treat other kinds of infections, they kill off some of these “good” bacteria in our gut as well as the ones they’re supposed to be killing.  This allows C. difficile to overgrow and release toxins that damage the cells lining the intestinal wall and cause severe diarrhea. 

The most common symptoms are watery diarrhea that occurs 3-5 times a day and is associated with abdominal cramping.  Symptoms usually start while you’re still on the antibiotic or 5-10 days after you stop.  Rarely, symptoms can develop up to 10 weeks later. 

In severe cases, the diarrhea will be more profuse and have blood or pus in it, and will be associated with dehydration, abdominal pain, fever, nausea and weight loss.  This is a serious condition called pseudomembraneous colitis which requires immediate treatment.

Most of the time, C. Difficile is treated by simply stopping the antibiotic that caused it to happen.  If necessary, a different antibiotic pill will be prescribed for 10-14 days.  If that doesn’t work, stronger antibiotics will be given through an IV along with the pills.  And if that doesn’t work… well, we send you to Oklahoma for a poop transplant.    

Probiotics have been shown to shorten the duration of diarrhea related to antibiotics, but research looking specifically at whether they can prevent or help treat C. difficile infection have been inconclusive so they are not routinely recommended. 

So the moral of the story, kids, is to use antibiotics as sparingly as possible.  Believe us when we tell you that your cold is just a cold or your sore throat isn’t strep.  Sometimes – in fact, most of the time – doing “nothing” is the best way to go.

John A. Vaughn, MD
Student Health Services
The Ohio State University

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