Historically Ingenious Solution!

We are susceptible to infections caused by one reason or another; infiltration of our bodily system by a germ, an ambitiously invading pathogen, an infectious organism planning on colonizing vulnerable hosts. Most often as well, after undergoing a surgical procedure, whether slight or hugely invasive, caution is taken that we do not, as a result of that procedure, become susceptible to the predations of one of those invading germs hungrily considering us a suitable host. So we take antibiotics for a prescribed period of time as insurance against infection.

Antibiotics are great; they declare war on malicious germs and destroy them. Unfortunately, they also destroy part of our immune system in the process, however temporarily, within the period of the antibiotic's working life. They also destroy friendly microbes that belong in our system. And suddenly, we're clean of all such microbes that help in digestion, among other tasks. And when we're clear of interference that's when the most daunting, virulent of infections take their cue for invasion.

Anatomical drawing of abdomen by Elisa Schorn, circa 1900.

We live such 'clean' lives now in comparison to the kind of personal hygiene that was once practised in much earlier eras of humankind's development of its current system of civilization with all of its useful infrastructure. We are able to enjoy plumbing within our homes delivering hot and cold water on demand, and so we wash and clean more frequently, and we also use anti-bacterial soaps to ensure we're really, really clean.

Creating a heaven-sent environment for invasive germs which have cleverly engineered themselves to be resistant to all those new cleaning agents that we so rely upon. Parasites, fungi and bacteria hugely appreciate us as living hosts; they are, after all, parasites, devouring from within their living hosts. Hospitals just happen to be places as well, where people with lowered immune systems' capabilities, the elderly and the very young can handily pick up such pathogens.

Stands to reason; it is, after all, where sick people go to aid in their recovery. They enter the presumed sanitized precincts of a hospital and leave behind them bits and pieces of virulent infectious agents. It is in hospitals primarily, although not always, where people become infected with hard-to-control, vicious microbes, like C. difficile. A more powerful kind of antibiotic is used for those infections, like vancomycin.



But sometimes the pathogen is just knocked back temporarily, and it returns to wreak its misery on the unwilling host it victimizes, and then another round of the drug is initiated, knocking back the infection, but it continues to return, effectively knocking the life and hope out of the unfortunate patient. Here's an interesting little tidbit: as far back as the fourth Century, Chinese medical practitioners prescribed a successful potion to offset severe diarrhea and food poisoning.

Severe diarrhea is a symptom of serious bacterial infection. That potion that was given to compliant albeit presumably squeamish patients to drink was comprised of liquefied feces. American doctors a half-century ago experimented with fecal transplants to "reestablish the balance of nature", a protocol they pioneered to deal with recurrent diarrhea. It remained an obscure, rarely used treatment. Until the surfacing in 2000 of C. difficile.

In the U.S., C. difficule is the cause of 250,000 serious infections yearly, killing 14,000 people annually. A recent study estimated C. difficile causes 37,900 infections yearly at a treatment cost of $272-million to the health care system in Canada. After becoming infected with C. difficile, hundreds of Canadians die yearly from its effects. These are mostly elderly people whose exposure to the microbe takes place in nursing homes and hospitals.

Now, some doctors consider fecal transplant treatment a winning formula against the difficult-to-cope-with strains of bacterial infection like C. difficile. Some in the medical profession are suspicious of fecal transplant use, urging additional research to prove its effectiveness and safety. But it seems that for others this is the treatment that will be turned to most frequently in instances of severe infections; a refined mixture of key intestinal microbes or fecal material transferred to restore functionality of normal gut activity.

In Europe it has become common to spray fecal transplant material through the nasal passage. Some doctors spray it directly through a colonoscope into the colon. There are other, low-tech, less invasive approaches. Such as the one used by an infectious disease specialist at Calgary's Peter Loughheed Hospital -- Dr. Thomas Louie.

Donors are usually chosen from within a family on the theory that people who live together would have similar microbial ecosystems. The transplant material is blended with a saline solution, poured through a steel wool filter, and from there into an enema bag, where the liquid is infused into the intestine with the use of a rectal tube. Total cost to the health care system: about $120.

Best of all, it works. "There was no pain, no problem. It was nothing", said one patient who had suffered the debilitating effects of multiple relapses when she had been prescribed vancomycin, and the infection that assailed her just kept returning. Vancomycin is extremely expensive; 120 capsules comprising a six-week supply costs $2,130. She had faced the prospect of having to use vancomycin to cope with her recurring infections for the rest of her life.

Now, the infections that seemed would never leave her in peace, are history.