Courtesy Tatum Williams

Tatum Williams, 28, didn't flinch when doctors told her the only cure for her son Jesse's terrible gut infection was a fecal transplant from mother to son. Today, the 2-year-old's C. difficile infection is gone.

As a young mom with a very sick toddler, Tatum Williams would have done anything -- no matter how odd -- to make her baby better.

So when doctors told her that 20-month-old Jesse’s last chance to cure a life-threatening gut infection was to transfer a stool sample -- yes, poop -- from mother to son, Williams didn’t blink.

“I was all for it,” recalled the 28-year-old mother of two from Baltimore.

After some research, she quickly agreed to what’s known as Fecal Microbiota Transplantation, or FMT, an unusual treatment used to battle serious, recurrent diarrhea and other symptoms caused by a nasty bug called Clostridium difficile, or C. diff.

“We had been dealing with his C. diff for nine months,” said Williams. “He was losing weight because of everything he would lose in his diaper.”

Jesse may have been the youngest child ever to undergo the treatment that transfers feces from a healthy donor to help repopulate the beneficial bacteria in an infected colon. But as far as Williams was concerned, there was no choice.

“It couldn’t get any worse,” she said.

Dr. Sudhir K. Dutta, the head of the gastroenterology department at Sinai Hospital in Baltimore, agreed. The curly-haired toddler was suffering all of the signs of the dangerous, contagious infection that has become increasingly common, sickening more than 300,000 patients a year in U.S. hospitals and causing some 14,000 deaths, according to federal health officials.

Jesse, who was born at 27 weeks’ gestation, has grappled with several problems since birth, including respiratory distress and feeding troubles, all made worse by the C. diff infection.

The child already had received powerful antibiotics, even an intravenous immunoglobulin -- blood products -- injection to battle the infection, to no avail. 

“They really had no other option,” said Dutta, who performed the transplant in March. His assistant is Dr. Ritu Walia, also of Sinai Hospital. The pair presented their report on Jesse's case at the American College of Gastroenterology's annual scientific meeting in Las Vegas. Dutta has gained attention for his fecal transplant work, including a clip that aired on Comedy Central's The Colbert Report. 

C. diff infection occurs when the spore-forming bug invades the intestine, often after heavy use of certain types of antibiotics kill off other healthy bacteria in the gut. It's an infection often acquired in hospitals, though patients in nursing homes and other care centers get C. diff, too. It's not clear how Jesse acquired his infection, though he has been hospitalized often during his short life.

Fecal transplants increasingly have been used in adults with success rates as high as 90 percent or more, according to recent reviews. A new study released last week by researchers at Henry Ford Hospital found that 43 of 49 patients with C. diff infections recovered swiftly after fecal transplants and had no problems up to three months later.

Still, performing the procedure on a toddler was different. The stool is typically transferred through a tube that runs from the nose to the stomach, or through a colonoscopy.

“The concerns were basically perforation of the bowel in such a young child,” explained Dutta. “So fragile, so delicate.”

Pediatricians at Johns Hopkins Hospital were reluctant to perform the transplant themselves, so they referred Jesse to Dutta, who had to get special certification to work on a child.

Once the procedure was approved, a donor had to be found, preferably someone from the same household. Tests showed Jesse’s mom was a good match.

Despite the early worries, the procedure went smoothly, Dutta said. Even better, Jesse started to improve almost immediately.

“Within two days, I saw changes,” his mother said. “It was unbelievable.”

Since the fecal transplant, however, he hasn’t been admitted to the hospital and seems to be healing better, his mother said.

“Now, he’s a typical 2-year-old,” she said. “He loves playing with cars, Mickey Mouse.”

Williams credits the doctors at Johns Hopkins and Sinai for arranging the unusual procedure that helped her family, which includes Jesse’s dad, Chad Snyders, and his brother, Kaiden, 9.

But, she added, her youngest son’s health is nothing less than a blessing.

“I want all Jesse’s success to go to the glory of God,” she said.

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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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