Stool Fecal Transplant For Clostridium Difficile Infections Reviewed.

Just when you think you've heard it all, along comes a study that compares the type of stool samples used in stool transplants (feeding fecal material to patients) to help clear persistent  C. difficile infections.  The medical terminology is fecal microbiota transplantation (FMT).  FMT is a known treatment modality used to increase cure rates for  refractory cases of clostridium difficile colitis and diarrhea.  As a hospitalist who has seen hundreds of cases of c dif, I can't say I have ever ordered or cared for a patient who had FMT ordered.  The reasons are obvious.  Who wants to eat poop?  If I told a patient I could improve their chances of eliminating  their diarrhea by feeding them fecal stool material of some random anonymous donor, they'd think I was a quack doctor.  Most patients just aren't into that culture.  

In addition, the cost of donor screening also makes this procedure prohibitive.  To overcome this barrier, researchers studied different methods for procuring safe stool samples for FMT, one of the main barriers to making stool fecal transplantation readily available to hospitalists and gastroenterologists all across ObamaCare.  With that said, a recent study  published in the American Journal of Gastroenterology (Am J Gastroenterol. 2012 May;107(5):761-7) and titled Standardized frozen preparation for transplantation of fecal microbiota for recurrent Clostridium difficile infection (Hamilton MJ et al.attempted to evaluate outcomes based on a simplified stool donor process.

Investigators in Minnesota studied 41 consecutive patients infected with C. difficle.  Ten patients received fresh stool samples from patient-selected donors.  Can you imagine asking your mother  for a stool sample?   Twelve patients received FMT from standard donors and twenty-one patients received frozen samples from standard donors.  Rates of cure (defined as resolution of diarrhea and negative stool-test after two months was 70%, 92% and 90% respectively.  What did this research suggest?  It suggested that a standardized rigorously screened universal donor process in combination with a frozen stool bank could make fecal microbiota transplantation readily available across this country.   

A frozen stool bank? Perhaps frozen poop popsicles will be the next over the counter therapy, right next to the probiotics, for patients wishing to self medicate for their c difficile infection.  When I was a medical student donating plasma was an easy way to earn money and study at the same time.   I'm thinking medical students have just found the next best way to earn money during their four years of med school hell.    The way I see it, stool donation is a perfect match since most med students are full of crap.

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