# Fecal transplant for recurring C. difficile **URL:** \ **Category:** In My Humble Opinion\ **Created:** [October 6, 2014, 8:04pm UTC](https://boards.straightdope.com/t/fecal-transplant-for-recurring-c-difficile/700579 "2014-10-06T20:04:35Z")\ **Posts on this page:** 20\ **Page:** 2
**Author:** ![sara20](https://avatars.discourse-cdn.com/v4/letter/s/e79b87/32.png) [@sara20](https://boards.straightdope.com/u/sara20)\ **Post date:** [October 7, 2014, 6:05pm UTC](https://boards.straightdope.com/t/fecal-transplant-for-recurring-c-difficile/700579/21 "2014-10-07T18:05:27Z")
> [@Amberlei](#): > > I’m currently undergoing my third treatment for _C. difficile_. My gasteroenterologist has said that if this round doesn’t solve the problem, there are two more options to try. The first of these is hospitalization for ten to 14 days for IV administration of metronidazole concurrent with oral vancomycin, while the second is a fecal transplant administered via colonoscopy. He says that he’s performed three fecal transplants in the past and in each of these, the patients had almost instantaneous recovery, with no recurrences. He’s had many more patients undergo the dual antibiotic hospitalization route, with mixed success. Each of the three patients he’s given transplants to had previously gone that route, to no avail. I am leaning towards the fecal transplant, but am hoping to get anecdotal accounts from people who’ve undergone either of these procedures and learn of the successes or downfalls they’ve experienced. I am so ready to be done with this! Have you tried pro biotics? ---
**Author:** ![Typo\_Negative](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/typo_negative/32/484_2.png) [@Typo\_Negative](https://boards.straightdope.com/u/Typo_Negative)\ **Post date:** [October 7, 2014, 7:53pm UTC](https://boards.straightdope.com/t/fecal-transplant-for-recurring-c-difficile/700579/22 "2014-10-07T19:53:27Z")
> [@Wesley\_Clark](#): > > How do they transfer the feces? Do they do it rectally or orally? If orally, I really hope they have some kind of enteric coated capsules. My though was ‘where do they get the fecal matter from’? Is there a search for a fecal donor? Isn’t that how you get cholera??? ---
**Author:** ![TreacherousCretin](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/treacherouscretin/32/476_2.png) [@TreacherousCretin](https://boards.straightdope.com/u/TreacherousCretin)\ **Post date:** [October 8, 2014, 12:01am UTC](https://boards.straightdope.com/t/fecal-transplant-for-recurring-c-difficile/700579/23 "2014-10-08T00:01:35Z")
I think it has to be from a close blood relative. ---
**Author:** ![TreacherousCretin](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/treacherouscretin/32/476_2.png) [@TreacherousCretin](https://boards.straightdope.com/u/TreacherousCretin)\ **Post date:** [October 8, 2014, 12:05am UTC](https://boards.straightdope.com/t/fecal-transplant-for-recurring-c-difficile/700579/24 "2014-10-08T00:05:47Z")
> [@Senegoid](#): > > …I’ve read that it’s done both ways. It can be done with a poop enema. But I think doing it orally is the preferred way, as it gets the stuff higher up in the intestines where it’s needed. It’s done with a feeding-tube sort of thing that they run up your nose and then down your throat into your stomach… There’s a “smoothy” joke in here somewhere, but discretion prevails. ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [October 8, 2014, 12:39am UTC](https://boards.straightdope.com/t/fecal-transplant-for-recurring-c-difficile/700579/25 "2014-10-08T00:39:39Z")
> [@Senegoid](#): > > I’ve read that it’s done both ways. It can be done with a poop enema. But I think doing it orally is the preferred way, as it gets the stuff higher up in the intestines where it’s needed. It’s done with a feeding-tube sort of thing that they run up your nose and then down your throat into your stomach. I thought that said ‘group’ enema at first. I never get invited to those parties. With the feeding tube, again, do they have some kind of enteric coating or are they just dumping shit right into your stomach? How do they avoid a gag reflex? how much feces does it take to transfer microbes? The fact that it has to be done from a close relative is interesting, I didn’t know that. ---
**Author:** ![Amberlei](https://avatars.discourse-cdn.com/v4/letter/a/e56c9b/32.png) [@Amberlei](https://boards.straightdope.com/u/Amberlei)\ **Post date:** [October 8, 2014, 1:01am UTC](https://boards.straightdope.com/t/fecal-transplant-for-recurring-c-difficile/700579/26 "2014-10-08T01:01:01Z")
I went back to the Dr. today, but nothing has been determined yet. I did talk to my brother about donating “the material” and he’s fine with it, but as with any transplant, there are criteria in place for donor selection. He has to be tested for HIV, Hep A, B, and C, C. difficile, H. pylori, parasites. There actually are donor registries, but I think I’d rather have my brother donate. I am taking probiotics but thus far I don’t know if they’re doing anything to help or not. I think the reason that C. diff is proving so difficult to treat is that I have an idiopathic autoimmune disorder and have been on ciclosporin to suppress my immune system for a couple of years. That left me susceptible to every bug that comes along and I wound up taking six courses of antibiotics in a three month period, thus a massive overgrowth of C. diff. I’ve had to stop taking ciclosporin for now, but I think it probably would have been best if I’d stopped taking it when I first got sick and needed the antibiotics. ---
**Author:** ![Cub\_Mistress](https://avatars.discourse-cdn.com/v4/letter/c/ea666f/32.png) [@Cub\_Mistress](https://boards.straightdope.com/u/Cub_Mistress)\ **Post date:** [October 8, 2014, 1:08am UTC](https://boards.straightdope.com/t/fecal-transplant-for-recurring-c-difficile/700579/27 "2014-10-08T01:08:32Z")
the one person I know who has had a fecal transplant, the donor feces came from her husband. people in a household pretty much share the same gut bacteria. ---
**Author:** ![Amberlei](https://avatars.discourse-cdn.com/v4/letter/a/e56c9b/32.png) [@Amberlei](https://boards.straightdope.com/u/Amberlei)\ **Post date:** [October 8, 2014, 1:13am UTC](https://boards.straightdope.com/t/fecal-transplant-for-recurring-c-difficile/700579/28 "2014-10-08T01:13:02Z")
> [@Wesley\_Clark](#): > > I thought that said ‘group’ enema at first. I never get invited to those parties. > > With the feeding tube, again, do they have some kind of enteric coating or are they just dumping shit right into your stomach? How do they avoid a gag reflex? how much feces does it take to transfer microbes? > > The fact that it has to be done from a close relative is interesting, I didn’t know that. Whether administered by nasogastric tube or colonoscopy, a liquid is usually used and administered drop-wise. My Dr. doesn’t do the nasogastric tubes but said that the tube is inserted through your nose to your stomach. With colonoscopy, the colonoscope is inserted into the ileum. He said that some doctors use encapsulated materials administered with a nasogastric tube, but he’s never tried it. The donor doesn’t have to be a close relative and there actually are registries, but I’d rather avoid the ick factor of getting poop from some stranger. ---
**Author:** ![Red\_Stilettos](https://avatars.discourse-cdn.com/v4/letter/r/fbc32d/32.png) [@Red\_Stilettos](https://boards.straightdope.com/u/Red_Stilettos)\ **Post date:** [October 8, 2014, 1:26am UTC](https://boards.straightdope.com/t/fecal-transplant-for-recurring-c-difficile/700579/29 "2014-10-08T01:26:05Z")
I have a colleague who does fecal transplant studies. For her studies, she uses a single donor. The rationale is that different people have different gut flora and once you find one that works well, you should stick with it. Plus, all of the testing for the donor can really drive up the cost associated with using matched donors. That wouldn’t work if this ever becomes a large-scale treatment. The ultimate goal is to determine the magic combination of gut microbes, but we’re probably a long way off from that. She is also developing a pill form of the treatment. No NG tube or enema needed. ---
**Author:** ![robert\_columbia](https://avatars.discourse-cdn.com/v4/letter/r/e79b87/32.png) [@robert\_columbia](https://boards.straightdope.com/u/robert_columbia)\ **Post date:** [October 8, 2014, 2:19am UTC](https://boards.straightdope.com/t/fecal-transplant-for-recurring-c-difficile/700579/30 "2014-10-08T02:19:51Z")
> [@Red\_Stilettos](#): > > I have a colleague who does fecal transplant studies. For her studies, she uses a single donor. The rationale is that different people have different gut flora and once you find one that works well, you should stick with it. Plus, all of the testing for the donor can really drive up the cost associated with using matched donors…The ultimate goal is to determine the magic combination of gut microbes, but we’re probably a long way off from that. > > She is also developing a pill form of the treatment… What’s the difference, then, between a fecal transplant and pill-based probiotics? I would imagine that administering carefully selected dosages of specific cultures would be more consistent than simply using whatever shit came your way. ---
**Author:** ![Mama\_Zappa](https://avatars.discourse-cdn.com/v4/letter/m/71e660/32.png) [@Mama\_Zappa](https://boards.straightdope.com/u/Mama_Zappa)\ **Post date:** [October 9, 2014, 4:11pm UTC](https://boards.straightdope.com/t/fecal-transplant-for-recurring-c-difficile/700579/31 "2014-10-09T16:11:59Z")
> [@Senegoid](#): > > …But I think doing it orally is the preferred way, as it gets the stuff higher up in the intestines where it’s needed. It’s done with a feeding-tube sort of thing that they run up your nose and then down your throat into your stomach. [Yep.](http://www.stuffyoushouldknow.com/podcasts/fecal-transplants-gonna-drink-poop/). Dairy Queen or Sonic should open up franchises at clinics that do this procedure. They’ve already got the milkshake machines, after all. > [@finagle](#): > > Are there any downsides to the fecal transplant asides from the possibility of it not working? Any potential side effects? The main downside would be that you’d have controllable attacks of running around and shrieking EWWWWWWWWWWWW!!! which can badly impact your social life. Not as badly as uncontrollable attacks of diarrhea, mind you… ---
**Author:** ![robert\_columbia](https://avatars.discourse-cdn.com/v4/letter/r/e79b87/32.png) [@robert\_columbia](https://boards.straightdope.com/u/robert_columbia)\ **Post date:** [October 9, 2014, 4:17pm UTC](https://boards.straightdope.com/t/fecal-transplant-for-recurring-c-difficile/700579/32 "2014-10-09T16:17:17Z")
> [@Red\_Stilettos](#): > > I have a colleague who does fecal transplant studies. For her studies, she uses a single donor… It must be fun dealing with the same asshole all the time. > [@Red\_Stilettos](#): > > … > She is also developing a pill form of the treatment. No NG tube or enema needed. “Doctor, where did this pill come from?” “Some asshole that was full of shit.” ---
**Author:** ![elbows](https://avatars.discourse-cdn.com/v4/letter/e/b3f665/32.png) [@elbows](https://boards.straightdope.com/u/elbows)\ **Post date:** [October 9, 2014, 6:23pm UTC](https://boards.straightdope.com/t/fecal-transplant-for-recurring-c-difficile/700579/33 "2014-10-09T18:23:02Z")
Some time ago I recall reading about all of this, basically the facts, as presented in this thread. At the end of the article, I remember, they lamented that as it was classified as ‘experimental’ many insurance companies were not covering it. It then said, (and I shit you not!), people were having success doing it themselves, at home with an enema applicator.:eek: ---
**Author:** ![Yllaria](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/yllaria/32/3452_2.png) [@Yllaria](https://boards.straightdope.com/u/Yllaria)\ **Post date:** [October 9, 2014, 7:56pm UTC](https://boards.straightdope.com/t/fecal-transplant-for-recurring-c-difficile/700579/34 "2014-10-09T19:56:10Z")
> [@The\_Holdsworth\_Effect](#): > > . . . maybe even sampling the wort. . . You mean from home brewed beer or ale? If so, maybe they could end up with medicinal homebrew. ---
**Author:** ![iamthewalrus\_3](https://avatars.discourse-cdn.com/v4/letter/i/258eb7/32.png) [@iamthewalrus\_3](https://boards.straightdope.com/u/iamthewalrus_3)\ **Post date:** [October 9, 2014, 9:26pm UTC](https://boards.straightdope.com/t/fecal-transplant-for-recurring-c-difficile/700579/35 "2014-10-09T21:26:44Z")
I had C diff two years ago, and it took two courses of antibiotics to get rid of it. It sucked, and I feel for you. I would have jumped at the option of a fecal transplant over the antibiotics, since at that point I had been on quite a lot of antibiotics (long story). I’m sure that they told you this and you’re doing it, but many C. diff recurrences are due to self-contamination. So you should go just completely over the top on cleanliness. When I tested positive a while after the first course of antibiotics, I was washing my sheets with bleach every day and going over all the hard surfaces in my house with bleach/water. ---
**Author:** ![Senegoid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/senegoid/32/6606_2.png) [@Senegoid](https://boards.straightdope.com/u/Senegoid)\ **Post date:** [October 10, 2014, 12:54am UTC](https://boards.straightdope.com/t/fecal-transplant-for-recurring-c-difficile/700579/36 "2014-10-10T00:54:42Z")
> [@sara20](#): > > Have you tried pro biotics? C diff is serious stuff. I wouldn’t trust amateur biotics to deal with it. ---
**Author:** ![Red\_Stilettos](https://avatars.discourse-cdn.com/v4/letter/r/fbc32d/32.png) [@Red\_Stilettos](https://boards.straightdope.com/u/Red_Stilettos)\ **Post date:** [October 10, 2014, 1:49am UTC](https://boards.straightdope.com/t/fecal-transplant-for-recurring-c-difficile/700579/37 "2014-10-10T01:49:05Z")
> [@robert\_columbia](#): > > What’s the difference, then, between a fecal transplant and pill-based probiotics? I would imagine that administering carefully selected dosages of specific cultures would be more consistent than simply using whatever shit came your way. The current thinking is that proper gut function requires many microbes working in concert. Each microbe fills a specific metabolic niche. There may be more than one microbe for any given niche, so there is some flexibility in what makes a ‘good’ gut flora. It is also thought that the microbes must be present in certain ratios, but this is less well understood. As has been said, recurrent C. diff is thought to be a disease of gut flora imbalance. Basically, C. diff out grows everything else and you lose all of those other metabolic functions. You can try and put them back individually with pro-biotics, but you won’t know beforehand if that’s the microbe that you’re missing. Fecal transplants take the approach of reintroducing an entire, functioning flora. It eliminates the guessing game of which microbe is needed which is important for two reasons: 1) it’s likely to be different in each person, and 2) we don’t understand the roles of each microbe well enough to predict which one is missing in any individual. ---
**Author:** ![GrumpyBunny](https://avatars.discourse-cdn.com/v4/letter/g/bc8723/32.png) [@GrumpyBunny](https://boards.straightdope.com/u/GrumpyBunny)\ **Post date:** [October 10, 2014, 2:42am UTC](https://boards.straightdope.com/t/fecal-transplant-for-recurring-c-difficile/700579/38 "2014-10-10T02:42:42Z")
> [@TreacherousCretin](#): > > I think it has to be from a close blood relative. Oh gods. If I needed this, My Idiot Brother (his official title) would be first in line to donate. And for the rest of my life, he’d claim that I ate his shit (yes, I know that for donations, it’s given rectally, truth doesn’t stop My Idiot Brother). Seriously, would anyone else’s family give them, um, shit about this, _ **forever** _? ---
**Author:** ![GrumpyBunny](https://avatars.discourse-cdn.com/v4/letter/g/bc8723/32.png) [@GrumpyBunny](https://boards.straightdope.com/u/GrumpyBunny)\ **Post date:** [October 10, 2014, 2:44am UTC](https://boards.straightdope.com/t/fecal-transplant-for-recurring-c-difficile/700579/39 "2014-10-10T02:44:29Z")
[Ok, the DIY movement has officially gone too far.](http://thepowerofpoop.com/epatients/fecal-transplant-instructions/) (Warning, yeeeech.) ---
**Author:** ![TreacherousCretin](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/treacherouscretin/32/476_2.png) [@TreacherousCretin](https://boards.straightdope.com/u/TreacherousCretin)\ **Post date:** [October 10, 2014, 4:51pm UTC](https://boards.straightdope.com/t/fecal-transplant-for-recurring-c-difficile/700579/40 "2014-10-10T16:51:03Z")
[Originally Posted by TreacherousCretin] I think it has to be from a close blood relative. > [@GrumpyBunny](#): > > Oh gods. If I needed this, My Idiot Brother (his official title) would be first in line to donate. And for the rest of my life, he’d claim that I ate his shit (yes, I know that for donations, it’s given rectally, truth doesn’t stop My Idiot Brother). > Seriously, would anyone else’s family give them, um, shit about this, _ **forever** _? Other posters have since corrected my error. Irrelevant but True Fact: About your _Idiot Brother_… for the past 20 years my maternal parent’s official title has been My _Idiot Mother®_. [Previous page](https://boards.straightdope.com/t/fecal-transplant-for-recurring-c-difficile/700579.md?page=1) [Next page](https://boards.straightdope.com/t/fecal-transplant-for-recurring-c-difficile/700579.md?page=3)