The Truth About Fecal Transplants: Medical Miracle?

By Jane Farrell

Fecal transplants – the transfer of fecal bacteria from a healthy person into a patient – may sound far-fetched or even bizarre. But the technique, which has been documented as far back as 4^th century China, is helping people who suffer from a potentially dangerous and even fatal bacterial infection.

First approved by the federal Food and Drug Administration (FDA) in 2013, the procedure is designed to transfer good intestinal bacteria to replace bacteria that has been killed or suppressed, most often by the use of antibiotics, according to the Fecal Transplant Foundation (FTF).

Because the good flora (bacteria) has been eliminated, the foundation says, bad bacteria, specifically Clostridium difficile, or C. diff., “overpopulates” the colon. Ultimately, that causes a condition called C. diff. colitis, resulting in debilitating, sometimes fatal diarrhea.

The condition affects hundreds of thousands of Americans each year, and an estimated 30 percent of cases are fatal. According to the federal Centers for Disease Control (CDC), people over 50 who take antibiotics and are undergoing medical care are most at risk.

Sometimes the problem can be solved by stopping the use of antibiotics or by prescribing other antibiotics such as metronidazole, vancomycin, or fidaxomicin, the CDC says. But the most effective treatment of C. difficile is fecal transplant, the agency says. The technique, officially known as Fecal Microbiota Transplant (FMT), involves mixing the feces with a saline solution and transferring the material into the patient via colonoscopy, endoscopy, enema or a pill.

At present, according to the Fecal Transplant Foundation, use remains rare, with an estimated 500 patients undergoing the procedure every year. The CDC emphasizes that the long-term safety of the procedure isn’t yet known.

FMT has also been used unofficially to treat Irritable Bowel Syndrome, Crohn’s disease, and ulcerative colitis, although its only approved use by the FDA is for C. diff. According to the Michael J. Fox Foundation, FMT is also being used to gain insight into Parkinson’s; people who suffer from the condition have lower levels of some bacteria than those who are healthy.

Besides the transfer of good bacteria, the procedure may also encourage weight loss. Experts have established that overweight people have different bacterial groups than people of normal weight.

But weight loss isn’t automatic. The donor needs to be carefully considered. One frequently cited case, published in the Open Forum Infectious Diseases, involved a mother of normal weight who got a fecal transplant from an overweight daughter. The mother then gained 34 pounds and was classified as obese.

Research into the possible benefits and drawbacks of FMT is ongoing; for a list of current clinical trials, click here.