My company published a guide to C Diff last year. The author, a GI doc and C diff researcher, had this to say about hospital-initiated transplants:
Stool transplant, also known as a fecal transplant, is a unique therapy. At our hospital, we recommend stool transplants only if all else has failed. Specifically, if a patient has had recurrence of C. diff, even after pulse-tapered Vanco treatment, or multiple bouts of Vanco, Dificid or Flagyl, it’s time to consider a stool transplant.
The idea behind a stool transplant is to “reseed the lawn,” so to speak. After exposure to weeks or months of antibiotics (including Vanco) the normal bowel flora — the organisms in your colon that help prevent infection — is weakened. They simply can’t keep C. diff out. In other words, the normal barrier function of the colonic flora is gone, and C. diff gets right back in. So putting in some normal flora from a healthy donor is like reseeding the lawn — it restores the barrier.
The author was aware of the DIY movement, as well as the rise of holistic medical practitioners who are offering transplant treatments.
He also noted that transplants are still relatively rare. Not many PCPs know much about C diff and recommended treatments; patients usually are referred to specialists in gastrointestinal and infectious disease.
One thing that I'm curious about: the GI tract is long and wiggly. Stuffing a transplant in one end only gets flora so far. Probiotics in the other end may help too. So what happens about the rest?
Is anyone making coated capsules to deliver flora further down the gut?
To your first question: In the hospital, they use a device similar to that used for a normal colonoscopy. Then:
When the scope reaches the top part of the colon, the doctor injects through the scope a feces suspension prepared from a healthy donor, usually a family member or close friend. … The scope is slowly withdrawn. As it is withdrawn, and more fecal suspension is put in from the top to bottom of the colon.
Stool transplant, also known as a fecal transplant, is a unique therapy. At our hospital, we recommend stool transplants only if all else has failed. Specifically, if a patient has had recurrence of C. diff, even after pulse-tapered Vanco treatment, or multiple bouts of Vanco, Dificid or Flagyl, it’s time to consider a stool transplant.
The idea behind a stool transplant is to “reseed the lawn,” so to speak. After exposure to weeks or months of antibiotics (including Vanco) the normal bowel flora — the organisms in your colon that help prevent infection — is weakened. They simply can’t keep C. diff out. In other words, the normal barrier function of the colonic flora is gone, and C. diff gets right back in. So putting in some normal flora from a healthy donor is like reseeding the lawn — it restores the barrier.
The author was aware of the DIY movement, as well as the rise of holistic medical practitioners who are offering transplant treatments.
He also noted that transplants are still relatively rare. Not many PCPs know much about C diff and recommended treatments; patients usually are referred to specialists in gastrointestinal and infectious disease.