Feces Transplant to Fix Your Refractory D. difficile

July 22, 2013

Feces Transplant 

Reference:  Jr. of Clinical Gastroenterology Khoruts June 2013 

 Yuck!  Warning.  You may be grossed out so just skip this week.  Or you may be fascinated.  Here are the facts about your colon.  90% of the cells in the human body are in the colon.  Said another way, there are 10 distinct cells in your colon for every cell in your body.  99% of the DNA variety in your "body" is in your colon.  Said another way, you have 100 times the genetic variability of your own genes and DNA in the bacteria in your colon.  That variety and number come from the bacteria resident in your colon. 

 We thought the colon was just the organ that concentrated waste products and conserved water so that we could live on dry land.  How naïve!  There is a whole emerging science to the value of the “biome” or variety of DNA and bacteria in our colon and the contribution they make to our good health.  It is increasingly apparent that our colon biome acts like a separate organ.  Each of us has our own “condo association” that is determined in part by the food we eat, the first inoculation we had when we started life, and all the other exposures and toxins we are exposed to during our lives.  

As much as it may give you pause, each of us who started life with a vaginal birth breathed our first breath and opened our mouths to scream and cry with a small amount of our mother's feces smeared on our faces.  Folks delivered by C-section don’t have that exposure.  When followed clinically, C-section babies have higher rates of allergic and autoimmune diseases years later.  We are also becoming increasingly aware of the contribution of nutrients that we extract from the biome of our colon.  Not just Vitamin K but the essential amino acids are all created by our colonic friends.  

The interplay of our colonic biome and our immune system is the next frontier. That’s where this week's study comes in.  Dr. Khoruts describes how he cures refractory C. difficile infections with a stool transplant.  C. difficile is a bacteria most of us likely have in tiny amounts in our gut.  When we alter the natural balance of bacteria in our gut with antibiotics, C. difficile occasionally blossoms and flourishes like nothing else.  It can often be controlled and contained by new antibiotics, but on occasion, it can’t be.  Continued diarrhea and weight loss follow.  

In this case, the C. difficile was cured almost immediately after many months of failure with other traditional therapies. What was the procedure? Simple.  A healthy donor, without  HIV or hepatitis who had a “healthy diet” and normal gut health gave a sample of stool that was diluted in normal saline and injected via a colonoscope into the colon, essentially transplanting a whole new biome of bacteria in such quantity that it took over from the traces of the host original damaged biome that couldn’t recover from the C. difficile infection.  

This story has now hit the standard media. Youtube is full of stories and anecdotes of people saving themselves from Crohn’s and Ulcerative colitis.   Are we moving to a world of discovery outside of traditional medicine? 

 WWW. What will work for me?  The worst damage to our own biome comes from taking antibiotics and eating lousy food. “Good food”, from a colon's point of view has lots of fiber, vegetables, few sugars, healthy fats like coconut and olive oil, a wide variety of fruit and nuts.  Hmmm.  Sounds like a good healthy diet for all of us.  As the head of my own condo association, I’m going to make sure my fellow condo dwellers (my gut biome) are well cared for.  I’m having quinoa, ground flax, and blueberries for breakfast, with coconut milk.  And if you want to know how to conduct your own transplant, give me a jingle.   

 Pop Quiz 

 1.  Your colon has more cells in it than the rest of the body by an order of  4,  10,  100,   1000?                         Answer:   10 cells in your colon for every cell in the rest of the body 

 2.  The best estimate we have is that you have how much more distinct DNA genes in your colon compared to your body?   10 times, 30 times, 100, 200                        Answer:  100 

 3.  We damage our colons' biome when we take antibiotics?  T or F                 Answer:  True 

 4.  There are both traditional doctors and home inventors administering stool transplants with successful outcomes?  T or F                         Answer:  True 

 5.  You can protect and nourish your own biome most effectively by eating lots and lots of?   Sugar, french fries, ice cream, flax seed or green beans.                         Answer:  Flax seed and green beans (because of all the fiber they carry).

This column written by Dr John E Whitcomb, MD, Brookfield Longevity, Brookfield WI