Tuesday, July 9, 2013

stool donation: when your pooter is sick, this'll do the trick!


NYTimes | This spring I saved a friend from a terrible illness, maybe even death. No, I didn’t donate a kidney or a piece of my lung. I did it with my stool.

About 18 months ago, my friend, whom I’ll call Gene to protect his privacy, fell sick with stomach pain, intestinal cramps and copious bloody diarrhea. He had ulcerative colitis, a colon riddled with bleeding ulcers.
His gastroenterologist started him on steroids and anti-inflammatories — standard treatment for these ulcers. He felt better and within a few weeks was able to taper off the steroids, which can be dangerous if used over the long term. But a month later, the bleeding and diarrhea were back. He was in horrible pain that worsened when he ate or drank. He couldn’t sleep at night.

The doctor put him back on the steroids, but this time the symptoms weren’t held in check. For the next excruciating year, my friend went through episodes where he could do nothing but lie writhing in bed in pain. He lost frightening amounts of weight, became anemic from the blood loss and was forced to take medical leave from a job he loved.

According to his doctors, he was left with two options: powerful immunosuppressant drugs (the kind they give people after organ transplants) or a total colectomy (the removal of the colon). The drugs might not be effective, and they raised the risk of lymphoma or fatal infections, while with the surgical option, the tissue left behind could and often did eventually become ulcerated itself.

That’s when Gene started reading about a procedure called fecal microbiota transplant, or F.M.T.
Transplanting the stool from one person into the digestive tract of another seems, well, repulsive, but it also makes sense. The majority of the matter in stool — roughly 60 percent — is bacteria, dead and alive, but mostly alive. While bacteria can make us sick, they also constitute a large part of who we are; the hundreds of trillions of cells in an individual’s microbiome, as this collective is known, outnumber human cells 10 to 1. The bacteria serve many functions, including in metabolism, hormone regulation and the immune system.