Recently, the Journal of Clinical Gastroenterology published research suggesting that, in certain cases, patients suffering from the nasty clostridium difficile bug may need fecal transplants or "transpoosions."
"C. Diff," as it is commonly called among the gastric groupies, is a tough little bug that patients are increasingly catching in hospitals and nursing homes.
Although antibiotics are now the first mode of attack, a growing number of gastroenterologists like Dr. Lawrence Brandt of the Montefiore Medical Center, in New York, believe that, in some cases, injecting excrement either by enema or through a gastric tube inserted in the nose is more effective.
"At the moment, it's a treatment of last resort," Brandt said. "But it's very efficient, with a cure rate of 90 percent for first-time users. Plus, it's safe with no adverse effects, and it's fast, sometimes solving the problem within hours."
Currently, the accepted treatment for C. Diff is to take an antibiotic called Vancomycin. Brandt says this is not only expensive -- about $60 a pill and $2,000 for the complete treatment -- but is also not as effective as one would like at killing a bug that can cause chronic painful diarrhea.
"There's a failure rate of 10 to 20 percent for the first round of treatment," he said. "If that happens, there's a 60 percent chance of recurrence.
"Basically, we screwed up nature by giving all these antibiotics," Brandt said. "People can carry C. Diff without getting sick, until they take antibiotics for something else."
No wonder many patients affected by the bug who have found antibiotics ineffective go gaga for the excrement enemas.
"The people who are infected are usually so ill that they're willing to try anything," he said.
However, the poop prescriptions aren't completely mainstream yet, and that makes it hard for people to, well, get their hands on feces.
"There are some donor banks in Australia, but here in the U.S., we use fresh stool from donors," Brandt said.
Just as blood donors are screened, so, too, are those who supply doo-doo.
"We screen them for AIDS, syphilis, hepatitis, pathogens and parasites," he said.
But while Brandt believes that poop as medicine has "poo-sibilities," other experts like Dr. Saad Habba, a gastroenterologist at Overlook Hospital in Summit, N.J., isn't ready to flush the use of antibiotics down the toilet.
"Few of us can imagine using [stool], and it is unconventional," he admitted. "Clearly, this is an end-of-the-road approach for recurrent C. Diff infection because of the obvious logistics of it."
"The donor stools have to be very carefully screened, as this method may create a new problem for cross-infection to the receiving patient," he said.
"All of the case histories show it to be effective, but there haven't been any randomized studies," Abousaif said. "Plus, we don't know about the long-term effects."
Still (or should it be "stool"?), Brandt believes more and more that prescribing poop for patients with bowel problems is a way of "doo-doo-ing" the right thing.
"At first, we did it for the very ill, but I'm starting to recommend it earlier and earlier," he said.
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