In 2008, gastroenterologist Colleen Kelly had a patient with a recurring and debilitating infection of the gut with a microbe called Clostridioides difficile. Nothing Kelly did could ease the woman’s severe abdominal cramping and diarrhea.
So Kelly — at her patient’s urging — decided to try something highly experimental: transplanting a fecal sample from a healthy donor into the large intestine. And it worked.
Kelly, of Brown University School of Medicine in Providence, Rhode Island, is now one of the leading doctors performing the procedure. She has done about 300 fecal transplants in the last decade, with good success — and has even, she says, seen ICU patients with the most severe form of the infection sit up and ask for food within a day of their transplant.
Today’s data show that fecal transplants cure 80 percent to 90 percent of patients with recurrent C. diff infections — and doctors across the globe have accepted them as a legitimate medical treatment. The procedure is considered experimental (no regulatory body in the world has officially approved it outside of investigational protocols), but hospitals now perform fecal transplants for up to 10,000 cases of recurrent C. diff infections per year in the US alone. OpenBiome, a nonprofit in Cambridge, Massachusetts, that collects and rigorously tests fecal donations from volunteers, has shipped more than 48,000 such samples in the last six years.
A recent death — likely the first one caused by a fecal transplant — from an inadequately vetted sample underscores the need for scrupulous screening, experts say. That’s especially so now that researchers are assessing whether fecal transplants can effectively treat other gastrointestinal disorders, or even conditions less obviously related to the microbes that live in our guts.
