Fecal transplants, in which a healthy person's poop is injected into a sick person's colon in order to reset their gut microbiota, are gaining traction in the medical community as an affordable and highly effective treatment for some historically untreatable conditions.
But while the Cleveland Clinic named fecal microbiota transplantation, or FMT, one of the top ten medical innovations for 2014, it is still overcoming some stigma. If you have Crohn's disease or a nasty case of the bacterial infection Clostridium difficile, both of which have been successfully treated with FMT, you might have trouble finding a doctor who will do it for you.
Fortunately, fecal transplants are so easy, you can do them yourself at home. Like many unconventional cures, FMT has found a cult following outside the mainstream. That means a plethora of supportive forums and Facebook groups like Fecal Bacteriotherapy is The Bomb, as well as a number of websites explaining how to prepare your at-home poop enema.
"Decide where you will do your FMT—either in a bath or lying on a towel on the bathroom floor. Avoid doing it on a bed or sofa or in a carpeted area in case you have a spill," reads the tutorial at The Power of Poop. (Another excerpt: "Frozen FMT allows you the flexibility that a donor doesn't. But it is reported not to have the same 'hit' as fresh.")
There is also YouTube.
Fecal transplants are serious business. They've been shown to vastly improve the quality of life for patients with previously untreatable symptoms. But it's hard not to giggle when someone starts spooning gobs of sludge from a plastic "poop hat" into a blender and saying things like, "I use a lot of stool."
In this video, a mother is preparing a fecal transplant mixture for her 10-year-old daughter, Emma, who suffers from ulcerative colitis, a disease that causes diarrhea and abdominal pain, among other symptoms.
Emma, who experienced at least 9 1/2 months of remission (which her mother attributes to fecal transplants), probably has the best explanation of the procedure.
"Fecal transplantation is when the donor poops in a hat and blends it together with saline or something, and puts it in an enema and gives it to you, the person who has the bowel disease, through the rectum," she explained in a video uploaded last year.
A do-it-yourself fecal transplant is pretty easy, although it's by no means a glamorous procedure. Patients mix the poop with saline until it's the consistency of paint, put it in an enema bag, and plug a tube into their rectum. The whole process can take close to an hour, with the patient flipping over from side to side and massaging his or her abdomen to work the new stuff up the colon. (Last step: try not to poop for six hours.)
There's still plenty to screw up: heat the water too high, for example, and it could kill the bacteria. Many FMT advocates maintain the procedure should also be done in conjunction with other medications and treatments as prescribed by a doctor.
Obviously, there are dangers when doing a fecal transplant at home. You want to make sure the donor is healthy, and visually comparing the sample to the Bristol Stool Scale probably won't cut it.
Putting some random person's poop into your body is not recommended, and the process does carry risks. It's recommended that a stool test be done to ensure the donor doesn't have some nefarious enteric pathogens like Salmonella, and that you don't use a donor who has recently traveled to a developing country. The donor also should not have used antibiotics in the last three to six months (estimates vary).
That last requirement is crucial. The rise of FMT is largely a response to the problems with antibiotics, which wipe out all the bacteria in a system, good and bad, upsetting the balance of the gastrointestinal system and making it easier for new strains of bad bacteria to take hold.
This video is a very straightforward, detailed explanation of what FMT is and how to do it at home. It has more than 36,000 views. The previous video of Emma's mother has more than 48,000; Emma's video has more than 8,000.
Of course, the commenters over at YouTube are having a hard time grokking all of this. While there are plenty of supportive comments from members of the FMT community, outsiders seem to have found their way to the videos as well. "THIS IS TOTALLY GROSS!!!!" is one typical reaction, as is "No one is putting their poop in me. No way."
But until fecal pills are widely available, a blender and an enema bag may be the next best thing.