September 25, 2017

How do I get my donor screened for Fecal Transplant?

This is a question I have been asked a few times before. How did I get my donor screened? I ended up NOT having any testing done, simply because I realized from my donor’s medical history and the incidence of such cases within the U.S. (epidemiology) that there was basically no chance that they had any of the diseases, bacteria or parasites that they would test for. Some might say this is crazy, however these are my reasons.

1) I could NOT simply go to a lab and request testing to be done, even if I were willing to pay out of pocket. I called a few labs and was told that I could not just request testing, I would have to have a doctor request this. Even if they had covered it, it becomes more complicated when you consider the out of pocket costs for such tests.

2) You can know with a high degree of confidence whether or not your donor has the illnesses you are testing for by getting a good idea of their medical history, this includes blood born pathogens and bacteria often found in Traveler’s Diarrhea. Most of the blood born pathogens are relatively uncommon in the population as a whole and are most commonly found in people with certain risk factors relating to sexual behavior.

The testing recommended in “Success of Self-Administered Home Fecal Transplantation for Chronic Clostridium difficile Infection” (Silverman et al)  recommends the following tests. However are they all necessary? I decided that they were not for me.

Blood Tests included

human immunodeficiency virus (HIV), syphilis enzyme immunoassay, Hepatitis A, B and C, Helicobacter pylori antibody (a bacteria that causes stomach ulcers)

Stool test included:

from both donors and recipients were obtained for culture and sensitivity, ova, and parasites, cryptosporidia, microspora and Clostridium difficile (c diff) toxin.

First off, why test the recipient? We already know that their guy is not doing well? Honestly it appears to mostly be academic especially if you have been tested at some point in the past. In the case of c. diff related Colitis it might be worth knowing whether or not the person really does have c. diff bacteria or not. Other parasites might be contributing factors, but can anything be done about them? The fecal transplant is the most effective option at eliminating c diff bacterial infection. It might also help either eliminated or dramatically reduce the effects of other bacteria and parasites by establishing a sufficiently strong colony to suppress the other bacteria.

In my case I have already had stool testing before and it had come back negative. So there were no detectible parasites or bacteria that they have tests for.

Testing the donor. Once again do they have any symptoms of STDs like Syphillis, AIDS or Hepatitis? Have they engaged in behavior that makes it at all likely they would have contracted various STDs? Do they have any symptoms or have ever had any symptoms of bacterial infection or parasites in the intestines? Have they been to countries where certain bacteria and parasites are known to be a problem?

Bottom line, know your donor well and certainly evaluated their medical history. Given accurate information from the donor’s medical history that you can trust, testing may not really be necessary in many cases.

Comments

  1. Thanks for your website and sharing this important information. After reading all of your posts I was wondering how you knew if it was the FT which cured you or the anti depressants you took (since these do work for some people with IBD)? I am interested in trying this on a child who can not take those meds. Do you think it could still work? What did you notice in your body while doing the FMTs? If you don’t mind emailing me directly, I would really appreciate it. Like you, we are facing surgery.

    • Hi, thank you for visiting my site and commenting. I honestly can’t say how much the anti-depressants Bupropion and a very low dose of Doxepin (6 mg) helped cured me in addition to the Fecal Transplants. Since I also started taking Apriso and using mesalamine suppositories and dramatically dropping the Prednisone at the same time, those could also have helped. However I think the anti-spasmodic effect of Doxepin (Silenor) and the mood elevating effects of Bupropion and possible anti-inflammatory TNFa inhibiting effects of Bupropion helped a great deal. I think can be used in conjunction with the FTs.

  2. I was wondering in my case, if the donor is asthmatic, will he still be the best candidate? He is having normal movement everyday and otherwise is fit and fine

    • As far as I have read, asthma should not cause a problem as long as the donor is otherwise healthy and free of diseases that can be transmitted through blood or stool or they are taking or have recently taken any anti-biotics.

  3. Martha Partridge says:

    I am 62 years old and my donor would be my daughter who is 25. She has been to India and South America so I thought that I should have her stool tested. she also has herpes. Since this is an STD, does it preclude her from being my donor?

    I also have considered putting her feces in capsules and swallowing them so that I get some of the upper GI as well as fecal enemas. What do you think?

    • Yes, you should definitely have her stool tested since she has gone to those places, however if she has not had active traveler’s diarrhea hopefully she is ok. If she did make it without any health complications it might be further evidence that she has a robust bacterial colony in her colon. As for herpes I have not seen that illness listed as one to be tested for in any published studies. I have seen HIV, Syphilis and Hepatitis A,B and C listed but not Herpes. Capsules might be effective in that case. My only concern would be that the capsules rupture before getting into the digestive tract which could make you sick or render them ineffective. A better way to get feces higher in the colon is by using a higher volume enema or colonoscope. However even if feces aren’t directly piped up to that area the bacteria should eventually work their way all the way up the colon even if it takes a few extra days.
      In my case I had pan Colitis and am now completely healthy even though I used low volume enemas using just a rectal syringe. This leads me to believe that the bacteria effectively colonized the colon.

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