The half-century old medical procedure has long been a measure of last resort, its mere mention enough to make a room full of doctors wrinkle their noses and laugh like schoolchildren: When a patient suffers from a gastrointestinal infection that keeps coming back, try transplanting someone else’s feces into the gut to restore a normal balance of healthy bacteria.
The scatological treatment may seem more medieval than modern, but over the past decade, doctors have increasingly stopped snickering and started to try it — with promising results. There is now a flurry of new trials at cutting-edge medical centers in Boston and elsewhere, and on Wednesday, a rigorous randomized trial published by Dutch researchers found that most patients with serious, recurrent infections caused by the bacteria C. difficile got better when donor feces were infused into their intestines. That study was halted early because the patients fared so much better than a group given standard antibiotic therapy.
“There’s an aesthetic factor. There’s a gross factor that wigs people out a little bit,” said Dr. George Russell, a pediatric gastroenterologist at Massachusetts General Hospital who did his first fecal transplant in 2010, on a two-year-old child with a relapsing C. difficile infection. “But I think people get over it, and it makes sense to them intuitively.”
Interest in the technique has been driven by three powerful forces: the anecdotal experiences of doctors who have found it works, the marked increase in life-threatening C. difficile infections, and the evolving scientific understanding of the role bacteria that live in and on the human body play in maintaining good health.
Since the procedure was described by a Colorado medical team that used the technique in 1958, hundreds of success stories have accumulated in the medical literature and many hospitals have begun trying the procedure in an effort to control the growing public health threat of C. difficile. In New England, a gastroenterologist at the Women’s Medicine Collaborative in Providence has done 90 fecal transplants; at Massachusetts General Hospital, 10 children and a handful of adults have been treated; and at New England Baptist Hospital, 27 patients have received donor feces.
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