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If that title doesn’t grab your attention, then I don’t know what will!

Depending on the scope of your imagination, fecal transplant may or may not be exactly what it sounds like, but it is a procedure that is trending upwards in terms of its ‘discussability’.

It’s no secret to the IBD world that gut flora, the vast colonies of bacteria that live in our colons, play a significant role in overall systemic health. More specifically, imbalances within the gut flora are believed to be one of the defining characteristics of Crohn’s disease, and one of the foundations behind the Specific Carbohydrate Diet.

If you’re reading this blog, there’s a good chance you’ve already read Breaking The Vicious Cycle, by Elaine Gotschall, but for the benefit of all, I’ll summarize the thought behind SCD and gut flora. It goes something like this: At some point, for reasons that aren’t entirely understood, the immune system begins to characterize certain species of bacteria as invasive rather than symbiotic. As a result, it sets to work attempting to eradicate colonies of that type. One of the immune system’s most powerful tools is inflammation. It uses that tool in the gut, attempting to make it an inhospitable place. An unintended consequence of this is that the gut’s ability to process carbohydrates is reduced. Those carbohydrates then become available as food for the very colonies that the immune system is fighting. These colonies then grow thanks to the surplus of food. The immune system increases inflammation in response to the growing ‘attack’, making more carbs available to the bacteria.  This is the essence of the vicious cycle…. a spiral of inflammation, gut injury, and out of control colonies of specific bacteria (and reduced colonies of others). The goal of SCD is to starve those out-of-control colonies by removing most carbohydrates from the diet. The thought is that by eliminating these colonies, the immune system will no longer see them as a threat.

Obviously, there are myriad ways of changing the makeup of gut flora beyond just diet. Antibiotics are a popular tool among allopathic providers. Many people (including myself) take probiotic supplements to introduce greater numbers of beneficial bacteria to the gut. Colonic irrigation, enemas, and laxatives are other ways that people attempt to flush out and reset the gut flora.

But what if these don’t work? What if the colony you’re trying to eliminate is so virulent that antibiotics and starvation don’t kill it? What if it’s so aggressive that other colonies aren’t able to establish themselves? What if the undesired colonies always re-establish themselves before anything else can take hold? What then?

This is when most allopathic doctors start shrugging and shooing you out of their office. More and more often (or perhaps less and less infrequently?), people are turning to fecal transplantation as a method for restoring their gut flora to a healthy and diverse population. The process is pretty simple, really. The transplant recipient chooses and recruits a healthy person to be the donor. The recipient goes through the same prep as for a colonoscopy, flushing out their gut and eliminating as much of the current population as possible. The donor takes a laxative to assist with producing a donation. The doctor facilitating the procedure makes a solution from the donation and, using some of the same equipment as for a colonoscopy, injects that solution deep into the colon. The hope is that this will serve as a ready-made population of gut flora that is already established, thereby crowding out the undesired colonies before they can regrow.

Let’s be clear: This is not an FDA-sanctioned procedure! In fact, there are a variety of reasons that the FDA may not even be able to review it, much less approve it. An interesting article discussing some of the regulatory hurdles related to fecal transplantation is here. If this is a therapy you’d like to consider, then your first challenge is going to be finding a doctor that’s willing to perform it.

Another significant hurdle to mainstream acceptance is the obvious ‘ick factor’.  I mean, it just sounds gross. This technique, like helminthic therapy, violates some serious social taboos. But I give you this for your consideration: If you are so sick that this therapy sounds intriguing to you, you are probably past the point of being grossed out by poo.

Not surprisingly, there have been no controlled, double-blind clinical trials into the efficacy of fecal transplantation as a treatment for anything. Not only would it be difficult to recruit participants, but who’s going to pay for it? It’s not as if Big Pharma could make money off selling poo. That said, there have been several very interesting studies and loads of anecdotal evidence that point to extraordinarily high cure rates.

A google search yields a surprising amount of information, which I won’t duplicate here.

Are you familiar with this procedure? Have you used it? What were your results? Any other thoughts? I’d love to hear them!

Update: On another post, reader DD provided the following link, which is a fairly extensive list of clinics and docs that perform this procedure. I post this here for your own research, and do not/will not provide any endorsement of the information provided here. http://www.cdiffdiscuss.org/phpBB3/viewtopic.php?f=9&t=9976