The Brave New World of DIY Faecal Transplant

You would have to be desperate to take a sample of your husband's excrement, liquidise it in a kitchen blender and then insert it into your body with an off-the-shelf enema kit. This article contains images and descriptions which some might find shocking.

In April 2012, Catherine Duff was ready to try anything. She was wasting away with crippling abdominal pains, nausea, vomiting and diarrhoea so severe she was confined to the house. At 56, in the US state of Indiana, she had come down with her sixth Clostridium difficile infection in six years. 

"My colorectal surgeon said: 'The easiest thing would be to just take your colon out.' And my question was: 'Easier for whom?'"
 
Appalled at the idea of losing her large intestine, Duff's family feverishly searched for alternative treatments on the internet. One of them turned up an article about a doctor in Australia, Thomas Borody, who had been treating C. diff with an unusual process known as faecal transplant, or faecal microbiota transplantation (FMT).

Clostridium difficile is an obnoxious microbe, usually kept in check by other bacteria in our guts. Problems arise when antibiotics remove some of these "friendly" bacteria, allowing C. diff to take over. One doctor compares it to the hooligan on the bus who is prevented from doing any harm by the sheer number of people on board. A course of antibiotics is equivalent to some of these people getting off at a stop, allowing the hooligan to run wild. About 50% of a person's faeces is bacteria, and a faecal transplant is like a whole new busload of people - the friendly bacteria - being hustled on board. 

It's an emerging, but not new treatment. Chinese medicine has recommended swallowing small doses of faecal matter for some ailments for 1,500 years. It's also a treatment option in veterinary medicine. In 1958, a Denver surgeon, Ben Eiseman, used faecal transplants to treat an inflammation of the colon. He wrote the procedure up in a journal article, which, years later, inspired Thomas Borody to try the radical treatment on patients with C. diff. Now the head of the Centre for Digestive Diseases in New South Wales, Borody has recorded some striking successes. 

Duff showed the article about Borody to her gastroenterologist, her infectious diseases consultant and her colorectal surgeon. But none of them had performed a faecal transplant and none was willing to try. When Duff said that she intended to administer the treatment herself with her husband's faeces, the gastroenterologist agreed to send a sample away to be screened for disease.

After they received the all-clear to use the stool, it was Duff's husband John that donned plastic gloves and assiduously followed the instructions they found online. He was no doctor, but as a retired submarine commander Duff considered him equal to the task.