Dr Yaron Langman performs the first fecal transplant in Rockland County.

FDA recently relaxed rules allowing an innovative form of therapy for a type of colon infection known as Clostridium difficile (C. difficile).

The colon contains hundreds of distinct strains of bacteria which help maintain healthy digestion (at least 500 have been identified and there are likely hundreds more). One of those, C. difficile, can grow out of control when the others are killed. This most often occurs after the use of antibiotics and can become life threatening. Ironically, C difficile infection has been treated with a range of antibiotics, but the infection often recurs and/or does not respond. New research based on experiments in the 1950’s has suggested that returning the colon to its normal balance of microbiome (hundreds of different types of bacteria) can suppress the C. difficile and allow the colon to quickly heal. This has been attempted using probiotic supplements. Unfortunately, that treatment has only a limited effect because not enough new types of bacteria are being reintroduced through supplementation.

A more promising approach is fecal biotherapy. Simply stated, with this treatment, a healthy donor provides a stool sample that is administered to the patient. Data suggest that up to 90% of people respond and can be cured of their C. difficile infection. There are various ways to administer the stool, but the most common is during a colonoscopy. Although mainly performed at large medical research centers, the method has slowly become more widely accepted in other health facilities. Dr. Langman has performed several “stool transplants” with great success. He was the first provider to perform such transplant at Nyack Hospital and has pioneered the current standardized protocol in Rockland County.

Although still in its experimental stage, fecal therapy is available to those patients for whom traditional treatment has failed. It is important to note that fecal biotherapy also shows promise in other diseases such as ulcerative colitis.


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