Could A Faecal Transplant Help You Lose Weight And Treat Stomach Ailments?

That horrible thing was a recurrent Clostridium difficile infection—a type of colon infection that causes severe belly pain, diarrhea and fever. Baker, a 33-year-old, says her doctors kept giving her antibiotics. But after feeling better for a week or two, the infection would return.

"I had it three times in two months, and I ended up being hospitalized for it," she says. "I couldn't keep anything down and I was losing weight—it was awful."

Finally she was referred to GI researcher and associate professor of medicine Dr Erik von Rosenvinge.

"He told me [a faecal transplant] was something I needed to do to feel better, and it was a Godsend," Baker says. "I felt better within a few days, and I've been fine since."

So, what is a faecal transplant? "The process involves taking stool from a healthy donor and placing it in the GI tract of the patient," says von Rosenvinge. That's right: He means taking someone else's poop and putting it inside your body. Just a few years ago, this concept would have seemed next-level crazy—not to mention disgusting. And let's face it: It's still pretty gross. Regardless, faecal transplants have quickly become an accepted form of medical treatment.

Your gut houses a diverse ecosystem of microorganisms known collectively as your microbiome. These hundreds of millions of organisms play a critical role in your digestion, metabolism, immune function and a lot else.

If something disrupts that ecosystem—be it infection or illness or exposure to antibiotics—your health can suffer in a lot of ways. "We know the microbiota has metabolic effects, so it could play a role in obesity and diabetes," von Rosenvinge says. "But there's still a lot we don't understand."

The idea behind faecal transplants is that, if your microbiome is thrown out of whack, introducing someone else's healthy gut microorganisms—via their poop—will repopulate your gastrointestinal tract with the beneficial bacteria you're missing. Think of it like a resupply of troops when your own internal army has been decimated. 

Are You A Candidate?

Faecal transplants—while once a fringe procedure—have become standard care for one common health ailment, says von Rosenvinge. Faecal transplants are used for the treatment of recurrent colitis, another name for the C. difficile infection that plagued Tina Baker.

But even for colitis sufferers, a faecal transplant is only approved as a "second-line" treatment, von Rosenvinge explains.

"If the first-line treatment, which is antibiotics, isn't effective, or if the infection returns again and again, that's when the FDA allows us to perform a fecal transplant," he says.

In those situations, he says the procedure is effective 80% to 90% of the time.

How Fecal Transplants Are Performed

Traditionally, a healthy family member or friend would donate a stool sample, says gastroenterologist Dr Ashish Atreja. This stool donor would first undergo testing for harmful or problematic gut bacteria. 

While this is still the most common practice, a some non-profits have begun supplying doctors and health systems with poop that has been rigorously screened and sequenced to ensure its safety and proper balance of gut microbes, von Rosenvinge says.

Wherever the poop comes from, it's mixed with a saline solution and then strained to remove "particulate matter," Dr. Atreja explains. From there, the diluted poop solution is introduced to the patient's gastrointestinal tract via colonoscopy or a similar procedure called a sigmoidoscopy.

While some patients report improvement of symptoms within a few days, doctors tend not to judge the procedure's success until a couple months have passed and the donor's microbiota have been fully integrated with the patient's.

The Endless Possibilities

While recurrent C. difficile is the only ailment for which a faecal transplant is approved, Dr. Atreja says researchers are looking into the procedure for the treatment of everything from obesity to autism.

"Allergies, autoimmune diseases like rheumatoid arthritis or lupus, metabolic syndrome—there are a whole range of possibilities," he says.

But, for now, all of these treatment options are still being validated, and doctors can't legally perform them.

The restrictions placed on faecal transplants anger many who are desperate for relief from chronic conditions and who believe a faecal transplant could provide that relief.

Both von Rosenvinge and Atreja say they understand the frustration because, if the procedure is performed by a doctor using a healthy stool sample, the downsides appear to be minimal.

"Some people are leaving the country and going to Mexico or other places to have these performed," von Rosenvinge says. There are also online tutorials and even some clinics that show people how to perform DIY faecal transplants—though von Rosenvinge warns you're playing with fire, and potential catastrophe, if you go that route.

The Risks Involved

While there's great potential in faecal transplantation, there are also risks. Some anecdotal reports—as well as published case studies—have linked faecal transplants with rapid weight gain and new-onset obesity.

"There's the potential for a donor to pass something on that could have bad consequences down the road, or could make a condition worse," Atreja says.

"The procedure is so new that we don't know much about the long-term effects," von Rosenvinge adds. "For example, if a donor is currently healthy but is at increased risk for cancer or an autoimmune disease or something of that nature, they may be able to transmit that risk despite proper screening."

It's a classic double-edged sword. If you believe altering your microbiome can cure all that ails you—and there's some good science to support that belief—you have to accept that such meddling could also make your health worse.

Atreja and other researchers are currently working on a government-funded "stool transplant registry" that will help nail down some of the longer-term effects of the procedure. But for now, he says, there are still many "unknowns."

"Already we're seeing in research the potential to treat a whole range of diseases, and to do so in a more precise manner where a person ingests a capsule containing certain strains of bacteria," he says. "It may not be a panacea, but I'm hopeful we'll soon have many more approved uses."