September 18, 2018

The Doctors show “warning about DIY Fecal Transplant” a response

Recently “The Doctors” TV show aired a piece about (do-it-yourself) DIY fecal transplants which included some b-roll from my DIY fecal transplants YouTube video. I gave the show permission to use my footage before knowing how the show was going to approach this issue. However, I was disappointed by the way in which DIY fecal transplants were portrayed in the show.

I was disappointed with the lack of information and balance in the reporting. The show failed to clearly identify the actual risk from DIY, a donor with a potentially transmittable disease. It also did not address the primary reason behind DIY fecal transplants: FDA restrictions against doctors performing FMT. I was also disappointed that the guest “expert” doctor was a Proctologist and Colorectal surgeon who has not performed FMT. Whereas there are many Gastroenterologists who have performed FMTs and have significant experience talking to the media. Another way to balance the story would have been to include the perspective of a research scientist or even a patient who has done the fecal transplant for themselves.

What is the actual risk?

So why does the show warn about doing fecal transplants yourself? The primary risk mentioned was not the patient administering an enema. The risk is from contracting an illness that can be transmitted through stool and/or blood. This risk can be mitigated by a donor questionnaire and stool or blood testing. Donor questionnaires are available in published medical journals and one is included in my fecal transplant guidebook. Also, doctors can support those doing FMTs safely at home by providing information and by prescribing tests for donors.

The likelihood of a donor having a transmittable illness can largely be determined through a questionnaire which reviews a person’s lifestyle, medical and travel history. The possible transmittable illnesses can generally be categorized as being gastrointestinal illness such as a tropical parasite/traveler’s diarrhea or an STD. For example, a longtime spouse in a faithful marriage who has generally been healthy has a healthy body weight and has not traveled to certain countries recently is very likely to be a safe donor. Tests of the donor’s stool and blood can further confirm this.

Why do people do DIY Fecal Transplants?

The show also failed to mention why people do fecal transplants themselves.  Having a debilitating illness that has defied treatment while doctors are prevented from treating them by the FDA. Trust me it’s not because all do-it-yourselfers are reckless or ignorant (as the show implied). For myself and many others, FMT has been the last resort for untreatable illness after medically prescribed treatments have failed. At the same time, doctors in the United States are currently limited by the FDA to treat just Clostridium difficile (c. diff) infection. Other illnesses can only be treated in approved research studies. This has taken the decision out of the hands of doctors and their patients which has been widely criticized by doctors and patient advocates.

What is the choice for people who can’t afford to suffer for another 10 or 20 years until the FDA allows doctors to perform FMT for their illness?  Do you continue to suffer from debilitating illness indefinitely even if you know there is an alternative or do whatever it takes to make yourself healthy?  In addition to numerous case studies of successful treatment that have been published in medical journals, FMT is the being widely studied. A recent search revealed 228 results of studies involving fecal transplant. These studies cover a wide range of medical conditions including autoimmune disease such as Ulcerative Colitis as well as obesity.

The potential impact of FMT as a medical treatment

When performed properly using stool from a healthy donor, FMT is a safe procedure. This is especially true when compared to the potentially life-threatening side-effects including cancer of many immuno-suppressant drugs. Possibly hundreds of thousands or millions of people in the U.S. alone might be safely and successfully treated and even cured using FMT. Each year thousands of people can potentially avoid irreversible and life-altering surgery to remove (amputate) their large intestine. For a person with a life-threatening or debilitating illness, the benefits may outweigh the risks of treatment involving FMTs.

I believe patients and their families have a right to know about all medically available choices. Well-informed patients should have the right to have a qualified medical professional perform FMTs. Even now doctors can support DIY fecal transplant patients by providing guidance, prescriptions and other diagnostic and supportive care. For more information about my experience check out this website, my videos and consider getting a copy of my fecal transplant guide, an ebook that includes a donor questionnaire and step-by-step instructions based on those I got from doctors.