Stool/fecal transplant?

Yes, you heard it correctly.   A prestigious journal of New England Journal published a study using stool transplant to cure an intractable bowel infection.  Clostridium Difficile bacteria is one of the most common hospital acquired infection in the US.  Many of of these patients received antibiotics for medical reason.   The antibiotics kill bad as well as good bacteria.   The population of good bacteria in the colon becomes unstable and decreasing.  This is when the C. Difficile bacteria becomes dominant and causing symptoms such as severe diarrhea, nausea and vomiting.

The standard treatment usually is using Metronidazole or Vancomycin antibiotics.  However, the C Difficile infection sometime becomes difficult to treat conventionally.   There are even cases require colon resection to cure the bowel infection.

The most recent publication is using donor stool (from other healthy persons) which is infused into your stomach/duodenum thru a tube.  The investigators randomly assigned patients to receive one of three therapies: an initial vancomycin regimen (500 mg orally four times per day for 4 days), followed by bowel lavage and subsequent infusion of a solution of donor feces through a nasoduodenal tube; a standard vancomycin regimen (500 mg orally four times per day for 14 days); or a standard vancomycin regimen with bowel lavage. The primary end point was the resolution of diarrhea associated with C. difficile infection without relapse after 10 weeks.

The study was stopped after an interim analysis of 16 patients.  In the infusion group, 13 (81%) had resolution of C. difficile-associated diarrhea after the first infusion. The 3 remaining patients received a second infusion with feces from a different donor, with resolution in 2 patients. Resolution of C. difficile infection occurred in 4 of 13 patients (31%) receiving vancomycin alone and in 3 of 13 patients (23%) receiving vancomycin with bowel lavage (P<0.001 for both comparisons with the infusion group). No significant differences in adverse events among the three study groups were observed except for mild diarrhea and abdominal cramping in the infusion group on the infusion day. After donor-feces infusion, patients showed increased fecal bacterial diversity, similar to that in healthy donors, with an increase in Bacteroidetes species and clostridium clusters IV and XIVa and a decrease in Proteobacteria species.

Yes, it is sound like an out of the box idea.  But I praise these investigators who could think out of the box for their patients.   I still think you should only get this treatment after all other conventional treatment have been used - consider it experimental.

Reference:

van Nood E, et al. Duodenal infusion of donor feces for recurrent Clostridium difficile.  N Engl J Med. 2013;368(5):407.