Natural Alternatives to Fecal Transplants

poop

What will they think of next? The latest round of sensationalist news headlines reveals much talk about new fecal transplant procedures. Yes, that's right. Poop swaps. In classic "heroic medicine" fashion, fecal transplants are being touted as a revolutionary (or is it revulsive?) therapy for potentally lethal bowel infections by Clostridium difficile, a bacterium that tends to lurk in hospitals, where patients are rendered more susceptible to the gut bug by the use of powerful antibiotics that wreak havoc on the gut microbiome which otherwise provides natural protection against these types of pathogens.

The basic idea is to use somebody else's poop- or even artificial poop in order to repopulate the gut with probiotic bacteria that can help to prevent and fight against infection by C. diff in the intestine. Termed fecal bacteriotherapy, the transplant of stool from one person to another seems at first glance to fly in the face of everything we think we know about medicine and hygiene. Yet, it works. A recent clinical trial demonstrated that transplant of a multi-species community of probiotic bacteria is capable of curing antibiotic-resistant C. difficile colitis.

Now, I know what you are probably thinking: If probiotic bacteria cure this type of infection, wouldn't it be easier, safer, cheaper, and less humiliating to simply take some probiotics by mouth, in the normal way? Not surprisingly, the answer is yes.

A 2011 meta-analysis of prophylatic treatment of hospital patients with probiotics showed that administration of probiotics led to a risk reduction of 71% for Clostridium difficile-associated disease. Though it might sound like a no-brainer to simply give probiotics to all incoming hospital patients, that hasn't stopped the medical industry from jumping at the opportunity to develop expensive procedures to take the place of common-sense preventive measures. Nor has is stopped the sensationalist headlines from jamming up the media outlets. Though admittedly, when it comes to the subject of fecal transplants, it is almost impossible to resist.

While poop swapping procedures may indeed save many lives in the years to come, there is ample evidence for a more sensible preventive approach to hospital-acquired infection with C. diff- taking a course of probiotics before any planned hospital stay. It may not be yet covered by insurance, but it is probably worth a few bucks to lower your risk of a potentially lethal infection, or the embarassment of asking your family if they wouldn't mind sharing their poop with you.

References

Avadhani A, Miley H. (2011). Probiotics for prevention of antibiotic-associated diarrhea and Clostridium difficile-associated disease in hospitalized adults--a meta-analysis. J Am Acad Nurse Pract. 2011 Jun;23(6):269-74. DOI: 10.1111/j.1745-7599.2011.00617.x.

Petrof E.O., Gloor G.B., Vanner S.J., Weese S.J., Carter D., Daigneault M.C., Brown E.M., Schroeter K. & Allen-Vercoe E. (2013). Stool substitute transplant therapy for the eradication of Clostridium difficile infection: 'RePOOPulating' the gut, Microbiome, 1 (1) 3. DOI: 10.1186/2049-2618-1-3

Last Updated: 11 Jan 13