James Kidwell lies in a bed at Indiana University Hospital. He's there to try and beat an invasion in his colon of Clostridium difficile, also called C. diff, a bacteria that's often resistant to antibiotics and hard to treat.
"It causes really bad diarrhea and it's really painful when you have to go the restroom and such, and it causes a lot of pain on the insides," Kidwell says. "With me it generated down my legs and it made it hard to walk and stand on my legs."
In February, the Centers for Disease Control released an alarming statistic about C. diff: 29,000 people are dying from it each year.
Kidwell has had five C. diff infections in the last few months. With every flare-up, his doctors put him on antibiotics, and each time, it came back worse than before. The infection forces him to go to the bathroom 30 to 40 times a day, and it's hard to do even basic tasks.
"You have to be aware of where all the restrooms are, and at times it's difficult to make it there on time so you have to go back home and clean yourself up before you can do anything else," he says.
So Kidwell drove to Indianapolis from his home in Kokomo in an attempt to put a stop to the recurrent infection.
Once Kidwell is under anesthesia in the operating room, gastroenterologist Dr. Monika Fischer uses a colonoscope to navigate through his bowel.
"And we are now in the middle portion of the large bowel, which is called the transverse colon," she says.
Fischer is winding her way through Kidwell's colon because, instead of trying another round of antibiotics, she's giving him a fecal microbiota transplant.
As strange as it may seem, putting someone else's feces into the colon of a patient suffering with C. diff is an extremely effective way to treat the infection. Depending on how the procedure is performed, the success rate can be higher than 90 percent.
Sitting behind Fischer, connected to a pump, is a plastic bottle, full of brown goo - the donor stool. On the display is the end of Kidwell's colon.
"We're gonna go ahead and infuse the stool here," Fischer says.
The pump is switched on and the bottle steadily empties. It's been processed a little, but that liquefied poo is still full of helpful bacteria, the kind Kidwell needs to repopulate his colon and crowd out the harmful C. diff.
"So we are done; the stool is in," she says. "By the time the patient wakes up, the stool hopefully covers the entire colon and allows these bacteria to repopulate the intestine.
Fischer may have just saved James Kidwells life. Left unchecked, a C. diff infection can lead to severe inflammation and even organ failure.
Cases like his are often thought of as too far gone for fecal transplant, so the current standard treatment for a severe C. diff infection is colectomy, a surgery to remove part or all of someone's infected colon. But even if the patient is well enough to undergo that surgery, the 30-day survival rate is only around 50 percent.
So Fischer thought, in these severe cases, why not start with a fecal transplant?
She decided to do a study. Fischer gave 29 patients with severe C. diff infections a fecal transplant, or sometimes more than one, and 27 of them pulled through.
"We devised a protocol that is working beautifully, and helps people avoid colectomy and walk out of the hospital," she says.
Ideally, Fischer says, patients would get the transplant sooner, so that the disease doesn't progress too far. But even if it does, Fischer's study suggests that it might not be too late to intervene with some poop.
For now, the procedure isn't available everywhere, and it could take some convincing to get doctors to try fecal transplants for these extremely sick patients. It might just seem too dangerous, but Fischer says it's not.
"We are offering a procedure that has minimal risk, so it is very safe, even in this critically ill population," she says. "I don't see a reason - why not try why not giving them a chance, even if it's not gonna work?"
If the idea catches on in hospitals across the U.S., Fischer says many lives could be saved.
As for James Kidwell, he's now out of the hospital and shopping for RVs, which is quite a change for a guy who not long ago was afraid to go too far from a bathroom.
