I remember all too well what it was like for my mother when she had Clostridium difficile infection. Post-surgery for colon cancer, the recovery was a breeze compared to the C. difficile she brought home from the hospital. For more than a month, she suffered from explosive diarrhea, going on and off antibiotics over and over to try and resolve the symptoms. Having lost over 25 lbs., finally she became so dehydrated and malnourished that she had to go into the hospital again to get stabilized. Ironically, she was put into a Clostridium ward– and, yes, there are enough patients who suffer from this infection to necessitate their own wards. Throughout all of this, she was also horribly sleep deprived thanks to the consistent and unpredictable nature of the diarrhea. Thankfully, with an additional round of antibiotics, alongside the use of various lactobacillus- and yeast-based probiotics, her symptoms finally came under control. It took over an additional year, and a lot of pre- and probiotics, for her gastrointestinal system to get anywhere near back to normal.
With these monster forms of C. difficile, others have not been quite as lucky, though I don’t think my mother would’ve considered herself lucky at the time. But there are patients whose symptoms never fully resolve with antibiotic treatment, some of whom have required further surgeries to remove necrotic intestinal tissue and some of whom have even died. For these people and in fact all C. diff patients, we are getting closer to a highly successful form of treatment that’s currently undergoing clinical trials: the fecal transplant.
One of the most recent studies published this month in the Journal of the American Medical Association (JAMA) reports on the success rate of frozen pill-form fecal transplant. Of the 20 participants in the study with mild-to-severe unresponsive infection, the symptoms of 14 patients resolved after a single application, meanwhile another 4 responded after a second dose. Overall, 90% of the patients in this study had symptom resolution with 1-2 doses of the fecal transplant. Those who fared poorer tended to have lower overall health scores.
Another great thing about this study was that the fecal transplants were donated from individuals unrelated to the patients, indicating that even using fecal transplants from total strangers is a highly successful form of C. diff treatment. Previously, transplants have usually come from family members in an effort to match inherited microbiomes. It also shows that freezing the pills can essentially enhance the shelf-life of transplant materials.
My family looks genuinely forward to the time when this treatment is THE treatment for C. diff infection, so that future generations of patients don’t have to suffer what my mother went through, or worse. Hopefully by that point the medical establishment and FDA will be over their fears of poop. It may be gross, but it works.