In the journal:
Martin J. Grehan, a gastroenterology researcher at Penrith Hospital in Sydney, Australia, and his colleagues reported that up to six months after the transplants, C. diff patients' feces predominantly contained bacteria varieties from the healthy donor. Floch called Grehan's study a landmark that suggested transplants have promise "for new therapies in the treatment of colonic or metabolic disease."
Montefiore's Brandt reported on a dozen cases in which C. diff patients got lasting results. He concluded that fecal transplantation is safe and effective. In an interview Friday, he said that he and Dr. Colleen Kelly, a Rhode Island gastroenterologist, have submitted to the National Institutes of Health a proposal for a randomized, controlled clinical trial of 40 patients, which he hopes would generate the kind of data to convince "the medical community at large" that the technique works.
Dr. Neil Stollman of Northern California Gastroenterology Consultants in Oakland, Calif., reported on a study in which 18 of 19 patients with recurring C. diff infections responded to a single infusion of transplanted feces, and the treatment eradicated the C. diff in all 19.
Floch wrote that acceptance of this therapy won't be easy because "it holds certain anxieties for the patient." Another hurdle, he suggested, was defining "how this therapy can become socially accepted."
Dr. Michael S. Silverman, an infectious diseases specialist at the University of Toronto, reported in the Feb. 1, 2010, online edition of the journal of Clinical Gastroenterology and Hepatology on seven cases in which do-it-yourselfers achieved "100 percent clinical success." They received step-by-step instructions about how to mix a small quantity of stool (1.7 ounces) with slightly less than 7 ounces of saline in a blender until it reaches "milkshake" consistency, pour the mixture into an enema bag and then administer according to directions provided with the enema bag kit.
"Making this approach available in health care settings has the potential to dramatically increase the number of patients who could benefit from this therapy," Silverman wrote.