Imagine the following. A tube is placed down a nostril, snaked into and through your stomach, right to the start of your intestines. Then someone else’s stool is pumped in to the tube and down your throat.

And if you’re suffering from a “C-diff” infection, trust me, the day has come when you’ll be begging for it. You can ask someone who has experienced it, or just ask an experienced nurse, about what it is like to suffer through the severe diarrhea that comes from an infection by the bacteria Clostridium difficile. It is severe, non-stop, and often life-threatening. It generally only happens when the gut has been robbed of its normal flora, the bacteria that is supposed to be there to compete with bad guys like C-diff (and a good reason to run whenever you hear anyone talk about a “colon cleanse,” a clean colon is an unhealthy colon!).

A C-diff infection is notoriously hard to treat, sometimes requiring months of a potentially toxic IV antibiotic (Vancomycin). But a new study seems to verify an old treatment. We can treat the infection by doing a fecal transplant, essentially replacing the normal flora that should be there. I have to say, when I first read about this treatment, my immediate response was “No Shit!” It makes sense though.

Donor stool  is screened for parasites and other serious infections, diluted and strained, and is then introduced in to the patient. (Now, to be fair, in Europe studies have been performed with the nasogastric tube as described above, but in the US, studies have been done via colonscopy.) The study linked to above was stopped early because it was so successful as to mean it would be unethical to continue the control arm. The treatment was 94% effective. Of 16 transplant patients, 13 were cured on their first infusion, and two more on a repeat round. In the two drug arms, the rates were 31 percent in the vancomycin-only group (4 of 13) and 23 percent (3 of 13) in the group receiving vancomycin plus lavage. That’s amazing.

In science, everything always needs to be repeated, and every endorsement is always hedged — but really, this was a rousing success. As an accompanying editorial says:

The study is an important confirmation of the efficacy of (fecal microbiota transplantation) for recurrent C. difficile infection… The results … represent a clear precedent in which planned therapeutic manipulation of the human intestinal microbiota can lead to demonstrable, clinically important benefits, thereby bringing FMT to the mainstream of modern, evidence-based medical practice. (It) will encourage and facilitate the design of similar trials of intestinal microbiota therapy for other indications, such as inflammatory bowel disease, irritable bowel syndrome, prevention of colorectal carcinoma, and metabolic disorders, to name just a few.

Given the Yuck factor, once we can meet the demand for the procedure as is, the next goal will be to create a synthetic stool, grow in cultures the bacteria needed and suspend them in some sort of benign slushy. NPR’s Shots health blog has a great interview with the Canadian team who came up with the synthetic substitute, amusingly dubbed “RePOOPulate.”