Chris Kresser: Unfortunately, nowhere. Right now fecal transplants are only … Well, let me revise my answer. Fecal transplants are only approved for antibiotic-resistant C. diff, so a patient must have C. diff and they must have taken antibiotics already and failed them in order to qualify for a legal fecal transplant administered by a doctor. Now, there’s nothing preventing them from doing one at home, but we talked about some of the challenges with that at the end of the gut section, when I discussed fecal transplants in more detail.
So if the patient does have antibiotic-resistant C. diff and they’re interested in a fecal transplant, I know of a medical group in Oakland that was doing fecal transplants for those patients. The last time I checked in with them, they had been sort of inundated with requests, and they specifically asked me not to mention that because they just couldn’t take on any more patients that needed fecal transplant. I’ll let you know if that changes.
Then there is the Bright Medicine Clinic, Dr. Mark Davis. He’s a naturopathic physician. That’s in Portland, and if someone needed a fecal transplant and had antibiotic-resistant C. diff, that’s where I would send them. He has been doing this for a long time. I really like his process and appreciate the way he approaches things. It’s not too far from California, it’s a short flight, and so if you have a patient in California that meets that requirement, then I would send them to the Bright Medicine Clinic in Portland.
If, however, they don’t have antibiotic-resistant C. diff, the only two options are traveling to the Taymount Clinic in the UK or their satellite office in the Caribbean or doing a DIY, at-home procedure. I really wouldn’t recommend it unless there is antibiotic-resistant C. diff and for whatever reason they can’t get to a place like the Bright Medicine Clinic or find a doctor locally that will do it. I think in that case where the stakes are really high, meaning they’re facing death, then the benefits are outweighed by the risks, but in other cases, I think we just don’t know enough about donor selection and screening for it to be super-safe for the average person unless they’re really under close supervision by you or someone who has experience with these procedures.