Wednesday, December 15, 2010
Fecal transplantation for C. difficile
The Washington Post had an article yesterday on fecal transplantation for C. difficile colitis. I've done a number of these procedures, including one last week, and another to be done next week. It's amazingly simple--mix donor stool with water in a blender, pour the suspension through filter paper twice, and then administer 25 mL of the suspension via an NG tube into the recipient. The patient typically experiences relief of symptoms within 24 hours. As pointed out in the article, there have not been any formal trials of this treatment. And as bad as it sounds, the patients I have treated didn't think twice when offered the treatment. Some have even sought out the treatment themselves after mulitple episodes of C. difficile. Here's an interesting paper on performing fecal transplantation at home with directions for do-it-your-selfers.
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Funny - an informal "fecal transplant" is described in The Making of a Surgeon, which describes residency at Bellevue I think in the 1950s. The vehicle in that case was chocolate milk. By mouth. And it worked. (I read it high school and always stuck with me.)
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