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What Is a Fecal Transplant? (Gross, Yes, But Also Life-Saving)

What is a fecal transplant and who would want one? It all boils down to your gut microbiota. Everyday Einstein explains.

By
Sabrina Stierwalt, PhD,
July 31, 2018
Episode #295
Clostridium Difficile

What Is the Downside to Fecal Transplants?

Reading this you may think the downside to fecal transplants would be quite obvious—getting an enema or swallowing a tablet of someone else’s stool sounds pretty disgusting. But when faced with potentially life-threatening diarrhea, patients get over the “ick” factor pretty quickly. There are other factors to worry about when considering a fecal transplant.

Since doctors believe our gut microbiome affects so many aspects of our health, it’s possible that taking in someone else’s stool could bring with it other baggage. For example, there is at least one case study where a woman gained a significant amount of weight after she received a fecal transplant from her daughter who was herself overweight. Others have reported developing irritable bowel syndrome after a transplant.

Stool donors also have to be carefully screened for any diseases because even the healthiest looking person can be unwittingly harboring germs. The company OpenBiome which connects stool donors with needy recipients—and pays $40 per stool donation!—only accepts 3% of its potential donors after their initial screening is conducted.

Fecal transplants offer a promising alternative for fighting antibiotic-resistant strains of Clostridium Difficile.

The doctors at Johns Hopkins Medicine recommend that donors not have had any antibiotic exposure or tattooing or body piercing in the last 6 months, they should not be immunocompromised, have history of drug use or have recently traveled to endemic areas. They should also, of course, be free of gastrointestinal disorders themselves and will be tested for infectious pathogens like Hepatitis or HIV.

Without proper tests, a suitable stool donor cannot be identified and so medical advice says not to try fecal transplants at home without the support of your doctor. There have been reports of would-be do-it-yourselfers using the wrong kind of gelatin capsules to create their own fecal transplant pill. Some of the gelatin pill casings easily bought online dissolve far more quickly than those used in proper transplants, which causes the stool to be released in other places throughout the body before it can get to the large intestine. Rogue stool roaming the stomach and small intestine can lead to bloating, congestion, and diarrhea that can last years.

The Bottom Line on Fecal Transplants

For now, fecal transplants offer a promising alternative for fighting antibiotic-resistant strains of Clostridium Difficile. More research is needed to determine what makes the ideal stool donor, how best to prepare the stool for transplant, and the best way to transplant it to the recipient. Further studies will also have to be done to determine whether fecal transplants can help fight ailments other than C. diff, like inflammatory bowel disease (including ulcerative colitis and Crohn’s disease), irritable bowel disease, obesity, Type II diabetes and any other gastrointestinal disorders related to gut microbiota.

Until next time, this is Sabrina Stierwalt with Everyday Einstein’s Quick and Dirty Tips for helping you make sense of science. You can become a fan of Everyday Einstein on Facebook or follow me on Twitter, where I’m @QDTeinstein. If you have a question that you’d like to see on a future episode, send me an email at everydayeinstein@quickanddirtytips.comImage © shutterstock.

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