A simple procedure to help patients with the Clostridium difficile, or c.diff, infection is being used across the country, including at the Mayo Clinic in Rochester, Minn.
Known as a fecal transplant, it's also been described by an expert as "kind of an outpatient colonoscopy."
The procedure is not fully approved by the U.S. Food and Drug Administration, but it is used widely because it is a relatively simple process that has been shown to be effective. Hospitals label it a "clinical practice," and the treatment has the support of many experts, including Dr. Sahil Khanna, a gastroenterologist at the Mayo Clinic.
Khanna studies and works with the c.diff bacteria in epidemiology as he conducts fecal transplants, in his laboratory work and while evaluating its environmental effects. The transplants are given to those who have multiple recurrences of the infection, or about 5 percent of all those diagnosed with c.diff.
"That's because normal bacteria gets destroyed every time you get the infection and are treated for it. When a transplant is done, you are given someone else's healthy bacteria, and it's from a person who has been screened for infections in the blood and in stools. The donor can be from the family or outside the family," he explained.
Unlike other transplants, there is no need for tissue matching in fecal transplants. The need is simply for "good" and protective bacteria.
The transplant process goes basically like this, Khanna said:
- The donor is screened.
- The recipient stops all antibiotic treatments 24-48 hours before the procedure.
- The recipient gets a colonoscopy to get rid of all fecal material in the body.
- The donor supplies a fresh stool the morning of the procedure.
- A portion of the stool, less than 2 ounces, is processed in the laboratory and inserted in the bottom part of the patient's large intestine.
"Most patients feel better in one to three days," the doctor said.
The success rate of the procedure at Mayo is 85 percent to 90 percent, and, according to Khanna, those figures are consistent across the United States.
— Deirdre Cox Baker