Are fecal transplants the answer to C. difficile?
Published Tuesday, December 11, 2012 10:02PM EST
Last Updated Tuesday, December 11, 2012 11:27PM EST
A Canadian study is probing whether fecal transplants -- a treatment that is growing in popularity but carries a strong gross-out factor -- is effective enough to become a standard weapon against C. difficile.
C. difficile is a toxic bug that causes violent diarrhea, and is often picked up in hospitals and nursing homes. An estimated 300,000 Canadians contract C. difficile each year, and 30,000 will die from it.
A fecal transplant involves taking a stool sample from a donor in an effort to get healthy bacteria back into the patient’s colon.
Dr. Christine Lee is an infectious disease specialist at St. Joseph’s Hospital in Hamilton and a professor at McMaster University, and is also is the lead researcher on the study. She said the healing power of fecal matter became apparent quickly, when her first few patients experienced a dramatic improvement in their health.
“They were feeling better within 24 hours,” Lee told CTV News. “It really did surprise me how well it worked.”
Early data from the study suggests that a fecal transplant is more effective at treating C. difficile, with a cure rate of 90 per cent.
According to Lee, a fecal transplant is a low-tech, low-cost procedure that takes only minutes to perform. Doctors say it works because it puts healthy bacteria directly into the colon of someone whose intestinal tract has been overtaken by C. difficile.
Patient Leslie Edwards began feeling better within days of his fecal transplant.
Edwards, an 89-year-old Toronto resident, was infected with C. difficile last spring after he completed a round of antibiotics for a toenail infection. He spent the summer and fall in and out of hospital.
Edwards remembers making, “Constant journeys to the toilet. I think that’s the big thing is the diarrhea, it is absolutely awful,” he told CTV. “It is so draining. You constantly have to watch where you go, because you have to keep a toilet in mind.”
His physician, Dr. Greg Jeffries, a family medicine specialist at Oakville Trafalgar Memorial hospital, suggested Edwards try a stool transplant. Edwards’ wife, Marg, was horrified at the prospect.
“I think most people would think it’s a bit icky, for lack of a better word, a little bit gross,” Jeffries told CTV. “But not everything is on the prescription pad and this is an example of that.”
Jeffries encouraged Edwards to join Lee’s study. Edwards travelled to Hamilton for the brief transplant, and within a few days it was clear the treatment was working.
“For one thing he started to regain colour in his face. He had a very drained look in his face having lost so much weight,” Marg Edwards told CTV. “He certainly regained his sense of humour, which was good. As it progressed so did his general outlook on life get much, much better.”
Lee and her team are also studying whether the stool samples will work just as well after being frozen, which would open the door to the potential for stool banks, much like the current blood and sperm banks.
There are many potential benefits to a stool bank, Lee said, including the ability to serve community hospitals that may not have the resources to test and prepare stool samples.
She said it will also save time, as it takes two weeks to get results back from blood and stool screenings of potential donors.
“The major advantage is it will be readily available,” Lee said. “If we were to need to transmit an individual within 24 hours, then we can thaw the specimen and administer.”
With a report from CTV’s medical specialist Avis Favaro and producer Elizabeth St. Philip