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Fecal matter would seem to be just about the last thing you'd ever want to receive in a transplant. For some people, however, the new "poop transplant" treatments are just what the doctor ordered for chronic infections or IBS.

When Americans check the box on their driver's license renewals that volunteers them to become a donor for transplants, most probably aren't thinking they could contribute to fecal matter transport, also known, to use one of the politer terms, as a poop transplant.

Fecal matter transplants aren't harvested from cadavers. They're taken from healthy people. In fact, there are people who earn a substantial supplemental income for feces donation.

Why Would Doctors Think It's a Good Idea to Transplant Poop?

One of the most prominent features of fecal matter that you probably weren't ever told in a biology class is that about one-third of the mass of stool is living bacteria. The bacteria in our solid waste are the bacteria that live in our guts. There are up to 2,000 species of bacteria numbering about 10 trillion individual bacteria in the typical human adult colon. At any given time, you are probably carrying around 1000 to 1500 grams (2 to 3 pounds) of bacteria. Some of these bacteria are beneficial. They break down fibers, or they produce useful fatty acids and vitamins, or they protect against bacterial infections through sheer numbers; they don't give pathogenic bacteria a chance to accumulate in the bowel. Some of these bacteria are harmful if they grow to excessive numbers. Sometimes antibiotic treatment for an infection with one kind of bacteria can cause a "bloom" of another, disease-causing kind of bacteria. That's the problem with an infection called Clostridium difficile (or C. difficile).

Clostridium bacteria are everywhere. They're in the ground. They're in our food. They are in our bowels. Most of the time they don't cause any real problems unless they grow to excessive numbers. Then they can cause chronic symptoms such as watery diarrhea, abdominal pain more or less all the time, loss of appetite, severe fatigue, and fever. Those symptoms will make you sick, but treating Clostridium difficile infections, ironically, sometimes kills the bacteria that keep Clostridium from becoming even more abundant. A significant percentage of people who get this infection either have to have part of their colon removed, or develop a system condition called sepsis, and about 3 percent of the half-million Americans who get the infection every year die. Even if death doesn't retuls, once you have had a relapse of the infection, it becomes very hard to treat.

Since the antibiotics (vancomycin and metronidazole in particular) used to treat C. difficile can also cause C. difficile, doctors sometimes treat the infection by restoring fecal bacteria directly to the colon with a transplant. Introduced to the colon through a nasogastric tube, a colonoscopy, or an enema, hundreds or even a couple thousand kinds of helpful bacteria reintroduced to the colon can keep the infection in check. While about two-thirds of people who have one relapse will have another, and maybe another, about 95 percent of people who receive fecal matter from a donor are cured.

Fecal Matter Transplants Aren't Just for C. difficile Infections

Some other hard-to-treat bowel problems can benefit from fecal matter transplantation, notably some cases of irritable bowel syndrome (IBS). There are even reports of dramatic improvement in obesity, type 1 diabetes, type 2 diabetes, rheumatoid arthritis, Sjogren's disease, and Parkinson's disease after fecal matter transplant. Whether this procedure will work for you is something you need to work out with your doctor, but here is an outline of how it works.

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