To paint it with a very broad brush: it could be that many maladies — from intestinal problems to obesity to disorders like multiple sclerosis and Parkinson’s and Alzheimer’s and perhaps even cancer — are related to damaged or missing gut bacteria; the solution therefore may lie in transplanting healthy bacteria into a sick person.

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How is this accomplished? (Okay, hold your nose for a moment.) A fecal transplant. Yes, you read right: taking the stool from a healthy person, mixing it with a saline solution, and injecting it into an ill person. 

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A suitable donor shouldn’t have any history of gastrointestinal disease,  any malignancy, or a history of antibiotic use or hospitalization within the past three months. The donor’s blood gets tested for hepatitis A, B, and C, HIV, and syphilis. And, their stool is tested for pathogens, parasites, and C. difficile. Typically, a family member is selected since they have been in close proximity with the patient and share the same infectious risk factors, which minimizes risk.

Alternatively, health stool samples can be obtained from the independent stool bank like OpenBiome located in Massachusettes.

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To perform the procedure, you need the following items in addition to a fresh stool sample:

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• A probiotic that should be taken before the transplant by the patient (not the donor), and for at least 60 days following. Many people stay on one for life.

• A four-day prescription taken by the patient for either metronidazole 500 mg (orally three times per day), or vancomycin 125 mg (orally four times per day) to sterilize or wipe out the bacteria in the colon. The antibiotic needs to be stopped 24 to 48 hours before the procedure.

• At least 200 mL of normal sterile saline solution (found at any pharmacy or online).

• A standard 2-quart enema bag kit.

• A kitchen blender.

 

The best time to perform the procedure is in the morning following the  first bowel movement of the day.

• Combine 50 mL of solid stool obtained from the donor immediately before the transplant (less than 30 minutes) with 200 mL saline solution in the blender.

• Mix in the blender until liquefied.

• Pour the entire mixture into the enema bag.

 

Have the patient lie on the left side and administer the enema per kit instructions. The patient should remain in that position for as long as possible to avoid defecation. The patient should not feel any pain or discomfort outside of the normal sensations experienced during an enema. If diarrhea occurs within one hour, the procedure can be immediately repeated, but a fresh stool sample will need to be used.

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