By the time Dr. Christine Lee’s patients learn their cure may be a poop transplant, they’re usually too exhausted to get squeamish.

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They suffer from a range of chronic gut disorders — from Crohn’s disease to C. difficile infections.

“They’ve gone through this for weeks to months, so they’re in a state of desperation. So they’re willing to try,” said Lee, an Island Health doctor. “But because it’s really foreign to them, they can be understandably nervous.”

The idea behind a “fecal microbiota transplant” is to restore the healthy balance of flora in a patient’s colon using stool from a healthy donor.

“The process takes about 15 seconds,” Lee said.

After months of suffering through symptoms such as diarrhea, constipation, loss of appetite and low energy, many patients respond after only two transplants, Lee said, although it depends on the condition.

Fecal transplants are not new, even if the procedure is just gaining steam in Canada.

It takes inspiration from a Chinese remedy dating back to about 50 BCE, in which sufferers would drink feces to re-establish the bacterial balance in their bodies, Lee said.

“They were given what was called a ‘liquid dragon gold’ treatment. And they would drink it,” she said.

“We don’t ask patients to drink it [today].”

Instead, it is delivered via an enema.

Joan Andersen, 78, said she suffered for more than a year with a C. difficile infection before trying the fecal transplant.

She contracted the infection in December 2015 as a side-effect of an antibiotic treatment for a sinus infection.

After five rounds of antibiotic treatments, she was wiped out. She had lost 32 pounds, could not think straight — let alone travel or go to the movies.

After two treatments and an adjustment period to re-introduce a normal diet, she said she feels better.

“I’m cured, absolutely,” Andersen said.

Fecal microbiota transplants are not available in most health-care facilities in Canada, except in clinical trials for patients with inflammatory bowel and, since 2015, those with recurrent C. difficile.

Lee is part of a provincial group working to make the transplants available across the province. She and her team are conducting a three-year, $90,000 study of the effectiveness of freeze-dried stool in the treatment.

The challenge to establishing fecal transplant programs include finding suitable donors and laboratory support, as well as working with the limited shelf-life of fresh and frozen stool.

So far, results have been positive.

Lee has used freeze-dried stool on 60 patients and has seen results similar to those of fresh and frozen samples.

“The major challenge is finding suitable donors. So many centres, even though they may want to offer it, they do not have donors who are willing or adequate to donate,” Lee said.

If freeze-dried samples are found to work, they may be shipped to fill those gaps, she said. “Then we can distribute to any centres across Canada and the world.”

asmart@timescolonist.com