Opinion: Fecal transplants are saving lives — but are now at risk

Twenty years ago, a respected colleague asked me to perform a “poop transplant” on a local schoolteacher with multiply recurrent C. difficile infection.  I was incredulous and skeptical, but my colleague (a friend but a forceful one) persisted until I ultimately acquiesced. 

Soon I was in a hazmat suit blenderizing stool and performing my first (subsequently named) fecal microbiota transplant, or FMT. My patient was cured, and I began two decades of care of thousands of patients with refractory C. difficile infection, a therapy that might seem counterintuitive (stool as medicine?) but in fact, is quite biologically rational:  C. difficile thrives in a disturbed, damaged colonic microbiome. The transplant repairs the damage so the bacteria no longer thrive.

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