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Faecal Transplants

Faeces have beguiled science for centuries. Still widely used in agriculture as a fertiliser, the stuff has been padded into the soil for 8,000 years. It can even be transformed into a culinary delight, as anyone who has indulged in a cup of kopi luwak will tell you; the £400-per-kilogram coffee is famous for its preparation after passing through the digestive system of a civet cat. It seems that the humble turd has many uses, but could it be coming soon to a hospital near you?

The technique called faecal transplantation has gained popularity due to several studies that assert its success. The stomach-churning therapy has mainly been indicated for cases of Clostridium difficile, a bacterial infection that leads to diarrhoea, fever, and abdominal pain. Whilst C. difficile infections can be mild, in England and Wales alone, over 1,600 people died from C. diff in 2012. But a faecal transplant to cure it?

The thought of consuming someone else’s poop may be difficult to stomach, but its nauseating nature is key to its function. The principle is that “healthy” stools can be used to recolonise the gut with beneficial bacteria, which would outcompete the C. diff bacteria. It makes scientific sense, as it is believed that antibiotics removing good bacteria may provide C. difficile with the perfect environment in which to thrive in the first place.

Dr MacConnachie from Gartnavel General Hospital in Glasgow has carried out 20 faecal transplant procedures since 2003. “Ultimately all the patients I’ve treated, bar one, has got rid of their C. difficile,” he said. This huge success rate, albeit from a small sample size, is not unheard of. A study in America reported a 90% success rate across 100 patients.

The procedure involves blending a relative’s stool sample in a household blender with some salt water, and then filtering the mixture through a coffee filter. The fluid is then poured into the stomach through a nasogastric tube, which is inserted through the nose, and passes into the stomach, where the bacteria can repoopulate the bowels.

Now if your gut reaction to that was sheer terror, then try not to crap yourself when you find out that this transplant may even be used to treat irritable bowel syndrome, diarrhoea, and constipation. The idea might be revolting to some, but for others who suffer from such illnesses, this may be a cheaper and more-effective therapy with much less side effects, aside from maybe loss of dignity. But now the question is – if a family member becomes ill with C. difficile or irritable bowel syndrome, would you give a crap?

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