Fecal Transplantation: What Exactly is ‘Transpoosition’?

This past week while vacationing with family, my sister, a nurse, recounted to me a hilarious story about attempting to persuade a 70-something year-old woman to poop into a plastic container so that her husband could receive a fecal transplant for C. diff.  I realized that I don’t know a lot about this concept- it’s not really something we do in the ER.  Hearing from my sister and reading a recent article about fecal transplantation has piqued my interest in what has been described as “An Elegantly Icky Situation“.

Fecal transplantation, known comically by some as ‘transpoosition’, is perhaps the grossest medical procedure I have ever encountered.  Give me blood and guts but just don’t make me touch your poop.  Providers recognize C. diff is a serious problem.  It leads to nausea, dehydration, loss of appetite, weight loss…and potent smelling hospital hallways (there’s nothing like trying to eat your lunch when there is a C. diff patient in your section).  Incidence of C. diff is increasing with about 15-20,000 patients dying of the disease in 2010.  Some strains of C. diff are becoming resistant to antibiotics.  Recurrence after treatment occurs in 15-30% of patients.  Individuals with at least once recurrence have a 65% chance of another episode.

Given the severity of the C. diff situation, naturally researchers are looking for a cure.  Who would have guessed they would stumble upon fecal transplantation.  Yes, studies and practice show that taking excrement from an individual close to the patient, blending it with saline into somewhat of a stool smoothie and transplanting it into the affected patient by enema or nasogastric tube proves an effective treatment for C. diff.  The procedure works by retstoring normal flora in the gut.  Unlike hit-or-miss antibiotic regimens, fecal transplantation boasts a mean success rate of 96%.

Here’s one DIY you won’t find on Pinterest- one research study even investigated techniques for at-home fecal transplantation methods.  Personally, if I contracted recurrent C. diff I would be willing to give this repgnant treatment a try- just please administer the fecal concoction by enema not NG tube.  I can stomach the rectal route of this concept but please, please never put anyone’s excrement, family or not, near my nose or mouth!

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