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Courtesy Shoop family
Pat Shoop, center, received a fecal transplant to treat a life-threatening Clostridium difficile infection. The 75-year-old Minneapolis teacher was transplanted with stool from her husband, Bob, left, in a procedure that a new review shows is effective in 92 percent of cases. The couple's children are Doug Shoop, far left, and Teri Quamme, far right.
After 52 years of marriage, Pat Shoop thought she'd shared every intimacy possible with her husband, Bob.
But that was before she became so ill with a Clostridium difficile infection last year that doctors suggested that a spousal stool transplant -- yes, a dose of Bob’s feces -- might be the only way to save her life.
“I'd heard of intercourse, but I'd never heard of 'pooper-course,'" Shoop, 75, of Minnetonka, Minn., jokes now. At the time, though, there was nothing funny about it.
“I was so sick, I didn’t care," she recalled. "It feels like the worst case of flu you could possibly, possibly have.”
Shoop, a longtime schoolteacher, was suffering from recurrent C. diff infection, a potentially life-threatening bacterial illness that causes severe diarrhea, abdominal pain, nausea and vomiting. It comes back again and again, resisting most treatments, except, as it turns out, an infusion of stool from a healthy donor.
A new review of more than two dozen scientific reports involving 317 patients, some dating back 50 years, finds that fecal bacteriotherapy, commonly known as fecal transplant, cured the problem in 92 percent of the cases. Nearly all got better after just one treatment. That's a better record than other treatments, including probiotics, toxin-binding molecules and an experimental vaccine.
The review offers the most comprehensive evidence so far in favor of the repugnant-sounding practice in which stool from a healthy donor is emulsified, usually mixed with water or saline, and transferred via a nasal tube or enema to the gut of a seriously ill C. diff patient.
“It’s considered a treatment of last resort,” said Amee R. Manges, an epidemiologist at McGill University in Montreal, Canada, who led the review published in the most recent issue of the journal Clinical Infectious Diseases.
Once transplanted, the healthy fecal bacteria help restore balance to the patient’s bowels. C. diff infections typically develop after the intestinal flora is disturbed, usually by overuse of certain antibiotics. For most of the last decade, fecal transplants have been regarded as something of a fringe treatment by outsiders, but as a viable treatment by doctors who see desperate C. diff patients every day.
"It validates what we've thought all along," said Dr. Tim Rubin, a gastroenterologist with Essentia Health in Duluth, Minn., whose team performed its 119th fecal transplant last week. "We quote people a success rate of about 90 percent."
Shoop, who was diagnosed in May 2010, believes she contracted the infection either while in a nursing home for a broken arm or in a hospital for breast cancer treatment. Rates of C. diff acquired in health care settings have skyrocketed in recent years, climbing more than 200 percent in people older than 65 between 1996 and 2009, according to the Centers for Disease Control and Prevention. Between 20 percent and 50 percent of those patients may wind up with hard-to-treat recurrent infections, Rubin said.
For Shoop, getting an appointment with Dr. Rubin was a godsend. She and her husband stayed at a nearby hotel, where Bob, 77, was under pressure to produce a usable stool sample within 15 minutes of her scheduled appointment.
“We gave him chocolate, we gave him wine, we gave him steak,” she said.
Bob complied and the pair rushed to the clinic, where Dr. Rubin snaked a tube through Shoop’s nose and into her stomach.
“It was 20 minutes,” she said. “He told me, ‘You’re not going to taste it, you’re not going to smell it.’” And she didn’t.
That was on a Thursday. By Sunday afternoon, Shoop was better. Nearly a year later, she says she still feels fine. Her health is so much improved, in fact, that Shoop has become an ambassador of sorts for fecal transplant, sharing her story with anyone who raises the specter of C. diff.
“I tell them I know of a procedure that works,” said Shoop, who believes she would have died without it.
“Now, I’m disgustingly normal."
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Leave a Comment:
If it works should be no question.. saving lives is of the utmost importance in Our Medical World..
can't be any worse than using LEECHES!!
I was intrigued until I read "nasal tube." I'll take the leeches any day.
yea, a big PASS on the nasal tube thing ... ack!!
Definitely enema; that stuff ain't going thru my nose - I smell enough of that around here anyway.
And if it has a cure rate of upper 90% after only one treatment, why would it be considered a last resort? Sure it's gross to think about, but so is most everything else they think of to do to one's body.
Next, we'll be hearing about how they're doing fecal injections in Hollywood for skin tightening. Can't wait.
Imagine, "I don't give a sh.t", can be life threatening.
Here's some more info on this topic, including the nasal tube.
The tube is most likely post-pyloric, so it goes down and through the stomach to get the stuff where it needs to be. No worries about burping later, etc.
Fecal matter is normally 10-30% bacteria, so your GI tract has quite a bit of bacteria in it. Some bacteria is good, some not good. The bacteria is part of your body's defense system to keep the bad stuff from hanging around, as the good stuff competes for space as well as produces chemicals that will kill the bad stuff for some species.
So it's 92% effective after just one treatment but it is still used as a last resort? Guess there is no way for the Pharm companies to patent someone else’s sh!t so they try to stick us full of theirs first.
Haha, I too shuddered at reading "nasal tube" in the reference to this procedure. But, it appears that they simply snake the tube from the nose directly to the stomach . . . still kinda nasty though.
Kind of a random - and admittedly childish - thought, but am I the only who noticed what you'd get by swapping the beginning sounds of this gal's first & last name? Pat Shoop . . . . I couldn't help but make the mental transposition when reading a story about "fecal transplants." And, subsequently giggle like an adolescent boy ;)
RELAX on the nasal tube. It's not like siphoning gas from one tank and immediately putting the hose in the other. The crap is taken from him--mixed into a 'slurry' then a sterile tube is place through the nose into the gut and the mixture is safely (and in a totally contained way) injected into the gut.
It's not like they just pulled the tube out of his butt and shoved it in her nose!
Nothing 'nasty' about it.
Respectfully, Chopswell, I believe our respective definitions of "nasty," may differ slightly. I'm sorry, but piping "crap slurry" into someone through a nasal tube is kinda nasty in my book - even if it goes directly to the patient's stomach. Not saying it doesn't work, or that I wouldn't consent to it if need be, but it's still gross.
I had major surgery in February of this year. Around September I too was experiencing these symptoms. Of course they said I had a major infection, it could be diverticulitis. So they put me on massive doses of antibotics (as they did for my surgery). I do not feel nauseous but as soon as I try to eat I get diarrhea. Lost a lot of weight - which was never a problem for me, so now I am really skinny. I have seen a GI doctor and am scheduled for a colonoscopy in a couple of weeks. It does sound very nasty but at this point I will try anything.
I've been a RN for nearly 20 years--inserting a NG (nasogastric) tube isn't the most horrible procedure in the world.....and if you're that ill, most people will go through just about anything in order to get better.
Oops, Pat Shoop. My bad.
What a crappy situation.
So I wasn't the only one! Thanks for clearing that up for me, JM ;)
@ PDK: I guess I should have added a cautionary disclaimer:
"WARNING! BURPING WILL CAUSE HURLING!" lmao
Hahaha. Well played, Chopswell. Well played :)
I thought the headline said FACIAL transplant. LOL
As a nurse, though, not much grosses me out. Hey: whatever works.
Jeanne: Never forget that leeches are our friends.
Well, as a healthcare professional, I can see the benefits and when you get that sick, you are ready to try anything. My concern is when pulling out the NG tube, the bacteria from the end of the tube exposes the esophagus and nasal cavity. Talking about sinus infection. Just dont see how to get around that.
The tube is flushed with saline after. Anyways, does C. diff occupy the esophageal and nasal cavity? I would think that sinus infection here would be a lot easier to treat that recurring C. diff. ...although treatment with antibiotics may not be so wise?
Imagine the first time they tried this.
Imagine the first time they came up with the idea!
Doc1: I've got it! We'll put poop from one person inside another person!
Doc2: ...what?
Doc1: Trust me, it'll work.
Doc3: Dude...you been hanging around the CMAs again when they're passing out the narcs?
Doc1: ...maaaybe.
yeah, I would like to have been a fly on the wall, "Hey. I feel a deuce coming on, hand me that blender, I have an idea."
OHHH That's funny Lloyd....If you were a fly on the wall you may have had an ulterior motive for being there
good one Navyvet- you've outed me!
New meaning to the term " Sh!t Faced ".
You wanna put what, where?! Got to love true medicine... Happy it worked for her and others.
Others in the animal kingdom do it all the time.
Koala babies have to in order to get bacteria from their moms so they can digest the eucalyptus.
Is that why dogs eat @!$%# LOL
Every human being alive today has already eaten @!$%#, how do you think the bacteria got there in the first place?
It is why dogs eat poop.
@aRocketScientist
On theory is that your initial dose of bacteria comes from the appendix. They are stored there until after the birth, so as no to interfere with the baby's development.
I have been told to eat $h1t on many occasions. I will no longer refuse to do so
I've heard of fecal transplants before...didn't we transplant a junior senator from Chicago to the White House?
Zing.
coming from a true sh8thead you should know
No that would be the Governor from Texas that held the White House under seige for eight long miserable years. We all know he didn't know sh*t, didn't do sh*t, and passed this messy sh*t on to the next person!!!
It's pretty moronic that some people have to make even stories like this about politics. We know you hate Obama. We just... don't care.
....
Wonderful! I am so glad that such non-invasive and no-chemical treatment exist.
Of course it's gross and makes me want to throw up just thinking about it but if I, or one of my loved-ones, would suffer a life-threatening bacterial infection that would need such a treatment and only that one, I welcome it anytime.
No chemical treatment? What do you think feces are made of?
Whatever - it's not a chemical treatment, it's a biological treatment, using the healthy levels a various bacteria in the donor stool to populate the recipient patient bowel with healthy bacteria.
But what are bacterial cells made of? What do microbes use to communicate with each other when colonizing a new environment? What do these bacteria use to attack the other species of bacteria that are causing the illness? Chemicals.
Activia's new flavor!!!
I'm just pointing out that no-chemical and chemical-free labels are silly. Everything around us is chemicals.
loghomonor-LMAO! You just made my day. That was hilarious!
Whatever, whatever2002.
So did quesa dillas come out the other end like on South Park?
That reminds me of..........was it Mr. Hanky on South Park forever ago?
That Christmas turd that danced around. Oh good Lord haha!
Jaime 777,
Yeah! Thanks. I thought I had that right. That was a long time ago. In fact, I hadn't watched that much South Park and I saw that thing and.............well, the rest is history. Yeah, it was Christmas. Now I'm LOL. :) I knew I was seeing a lot of red and green, trying to dig it out of the old memory banks, and now I know why.
What I can't remember is why the heck he was called Mr. Hanky.
Happy Holidays, whatever your holidays may be. :)
Glad to help with jogging your memory Imatthebeach (<--jealous!)
I celebrate Christmas, but thank you for taking my background into consideration :) I hope you enjoy the holidays also.
Now I may have to watch that South Park episode. I know I saw parts of it with my boyfriend and I was begging him to change the channel haha! :)
Jaime,
I know. It was pretty.........appalling. But I started laughing real quick. Thing had a little Santa Claus hat on, now that you've helped me remember. If you watch it, do let me know why he was called Mr. Hanky.
Let nothing go to . . . ahhhhh, waste.
My wife always tells me I'm full of s___t! Now I can respond that it could be my gift to her someday!
Might as well, heck, Asians in some countries use human waste for fertilizing crops.
and fish!
Not just in Asia. Water treatments plants in the USA sell the dry by-product.
Yes, gunman, it's called "humanure". Literally.
And if we Americans would stop eating so much artifically-laden garbage, most of our waste could be used to fertilize crops as well. Just not in the current state of things.
Don't worry. When our economy collapses, and people are desperate to grow crops again, we will re-visit this topic.....
"Humanure" from vegans would be totally acceptable. "IF" I were a vegan I'd have no issue with using my collected waste for growing my vegetables in an organic garden. Kindof like horsechit and cowpies are GREAT for your garden because all they eat is grass and weeds and things like that. You're never to put manure from carnivores on a garden because of nasties that fester in digested meats.
Oh, I've heard of pooper-course before....
It's wonderful they can save a very sick person. It's too bad doctors give antibiotics so excessively. This is a major concern. People also request antibiotics when they have a cold or their children sniffle.
Well I guess she can no longer say, 'My husband doesn't do s*** for me'.
lmao Mom I almost peed my pants laughing so hard at your comment!
'SGFitzsWife', I struggled to hit the send button, but I figured it fit well with the article. ;) Enjoy your day and may your digestion be worry-free.
well I'm glad you did! I know it made my day, lol @ worry free, back atcha! ;)
ummmm... i have never seen this done as yet... but i think i'd rather have this via enemas/colonoscope if i needed it rather than nasoduodenal tube.... would rather not have poo-poo water and colonic bacteria near my upperGI and lungs....
You do have a point (although I'm sure the poop gets screened for E.Coli and other nasty stuff like that prior to the transplant). Plus, since the whole point of the treatment is to restore the bacterial balance of the lower intestine, it seems to me that using an enema would be more efficient - gets the poop where it needs to be faster, and you eliminate the risk of the bacteria getting killed off by stomach acid. At least that's the way I see it, but I'm not a doctor.
It just seems grosser going in the nose
well one main problem is that when you have a nice rip roaring infection your colon becomes very friable... so if you go mucking around down there with tubes and what not... there's a risk of perforating the bowel...
I guess it's better not to get sick in the first place
Just think of it as 'smelling a fart'.
Difficult for bacteria to move upstream from the colon. Better to add from the top down.
The tube goes into your nose and directly down into your stomach.
There is no smell or taste (eww!).
Really, the concept is brilliant. I'm just sad it took western medicine this long to try it.
It's probably the e.coli in the fecal sample which are the most beneficial. Only certain strains of e.coli are dangerous and cause disease. We are all filled with billions of 'em and you couldn't digest your food without them.
Mikey, I didn't know that. When I posted my comment above, I was referring to the variety of E.Coli that causes people to get very sick (e.g. food poisoning).
I believe the word on the street for this is "chunneling"
This procedure was used in an episode of Grey's Anatomy.
I saw that one. The best part was when the guy was like "No poo for you!"
ohhh sooooooooooooo that's what they were doing in 2girls 1cup
OMG you saw that too !! I'm still throw-up when I think (and believe me I don't want to think about it it just pops into my head agggggggggggggggh) It's is the worse thing I"d ever and will ever see in my lifetime aggggggggggggggggh....
This is why you don't follow links without being sure where they are leading you. Not even links from your friends, who are probably perfectly capable of being evil.
I can't wait for the episode on the TV show House, MD.
I'm sure they plate it and check for potential troubledoers like Salmonella and the like before the nasal tube option. But yes, the enema option probably is less troublesome.
I mean, at least until the medical industry decides on figuring out the "ideal" mix of cultures, orders a bunch from ATCC, grows them in mixed media, spins them down in a centrifuge and resells them with a "just add water and add to enema mix" label. It will however cost a lot more...
It seems logical, to me at least, that you would want to administer this type of treatment as high in the intestinal track as possible to avoid the problem being above the cure. This would mean running the tube through the nose and down through the small intestine which is substantially shorter than the colon. If given the choice of having a few feet of tubing fed in or have a few yards pushed in, you might well consider going the nose tube route too.
Better go back to medical school. The small intestine is around 20 feet and the large intestine (or colon) is closer to 5 feet.
Why is a treatment with a 92% cure rate and - at least based on lack of mention in this article - no negative side effects considered a "treatment of last resort" or a "fringe treatment?"
That, sir, is the million-dollar question.
Because of the eeew factor, probably!
Because the population of patients who make up the cases is too small, there is no identifiable mechanism for why it works (except to say that some bacteria is fighting the C.diff infection), and because it is fairly new.
Things take time to catch on even in medicine. Of course some will insist there is a conspiracy since pharma can't sell it so they are squashing it. That's ridiculous. If it works as well as they say then we can expect it to continue to be used more widely. Of course what would be better is to not have gotten the C.diff in the first place. If some researchers identify the bacteria that provide the protection, it would seem much easier to simply give the bacteria in a pill form to at risk patients upon entering the hospital. This could easily prevent most of the infections from hospitals. I'm fairly certain a pill of that kind would be pretty cheap.
well there are risks and possible side effects... but also medicine is practiced in a step-wise escalating approach not just necessarily attacking with shock and awe!! Think of it like foreign relations... you got a rogue state (infection in your big toe)... you start with a diplomatic approach, talks and embargos (antibiotics, etc.).... if nothing works then you might eventually have to drop the bomb (amputate the toe).... this is last resort because you're going to try some of the other standard antibiotics and treatments that work for a lot of people.... before trying to give them another person's poo-poo platter
Its a treatment of last resort because its inexpensive and a doctor can't charge $5000 to their insurance company for the procedure.
poop transplant doesn't make any pharmaceutical companies money, as poop is easy to get and nobody really wants it anyway, much less want to sell it to you.
Can't package it and sell it for......one millllllion dollars
Who-of-thunk it! Eat @!$%# - a new medical treatment! Learn something new every day! {:-)}
I guess we can't say 'Eat s*** and die' any longer.
No. More like "snort sh1t and live." As long as it's organic sh1t. Though I'd personally prefer to smoke sh1t.
I'm way ahead of you. I've already got a line of "Eat @!$%# and Get Well Soon" cards coming out.
I am disgusted beyond belief, but I do have to say that this is pretty damn cool.
Or, as we used to say in the 80s, "sh1t-hot."
Nature can be pretty cool
1) poop transplant - fixes severe clostridium dificile infection, painless
2) Leeches - can remove discoloration and scarring from severe bruising, painless
3) maggots - can clean up necrotic tissue far better than any surgeon ever could, painless
That was my first question, too. Mostly, I hope, because it's just a relatively new thing to most of the medical industry (despite having been known about for decades).
Legitimately, there could be some valid unknowns and contra-indications that should be tested before fully embracing the procedure - but with results like that, I hope whatever testing is needed is done quickly.
That said, I'm surprised there haven't been a ton of cynics posting that it's just another thing that big pharma discourages because they can't make money off it. (FYI, I work for a big pharma, so I get a kick out of those posts. They're extremely uninformed.)