In 2021, a couple approached me with a request to perform stool transplant for their young child. I refused because our unit was only performing it for severe alchohol-related liver disease under strict research protocol.

But the mother was adamant. Also exhausted. She had not slept for years. She understood that stool transplantation for her child would not lead to miracles. The child was autistic and they had done everything from trying Homeopathy to energy healing to crazy fad diets to get the child’s quality of life better.

She had only two concerns in her child that required some kind of relief. His sleep, and appetite & bloating. He would be wide awake at night and be extremely active. The parents could not sleep at all. Office work the next day would suffer so much that the mother stopped working. She would sleep in the mornings with the child. The child would not eat well at all. The stomach looked bloated most times and, could not tolerate a diverse number of food items.

We were the only ones doing stool transplant consistently at the time. No other unit would encourage her and none wanted to hear her out or hear from her again. She was full of hope when she came to us, because we were mavericks.

Stool transplantation was generally safe. But it was the first time we were doing it in a child. An autistic child was even more challenging. I wanted to sent them away to follow what others were doing for autistic children – you know, the standard approach. But I had never seen a family so distraught. I could not imagine the hardship.

In 2021, we did the first stool transplant in our unit for an autistic child. We did one session each week, as a retention enema, after sedating the child. Every week, the mother would hold on, until the child slept and we would process the donor stool in the meantime and push it in ever so gently high up into the rectum and position the child so that the fresh stool suspension would graviate all the way into the upper parts of the large intestine. Every week, the child slept for an hour, under the watchful eyes of our anesthesia team as large amount of microbes from a healthy stranger flooded the child’s bowels.

2024. Three years since we did that.

The child has been sleeping every night for at least 5 hours since the 4th session. For three years straight. Complains less about his abdomen pain and bloating and has been eating a diverse range of foods. Yes, the autism gives his family good and bad days, but there has been so much difference since we decided to be mavericks for the child.

I did not know how to explain this. I still dont, because it is anecdotal and I do not believe in anecdotes.
But then found this study that claimed that sleep worsened when a bacteria called Eggerthella increased and when stool transplant reduced it and increased levels of the “good guys” such as Lactobacillus, Bifidobacterium and others.
pubmed.ncbi.nlm.nih.gov/38088972/
Maybe this is what happened in the child too, we do not know yet.

Even though stool transplant has not shown conclusive evidence for benefits in sleep modulation… academic.oup.com/nutritionrevie…
…we await better trials…and may even start a protocol for autistic children at our center. I think it is worht it. I do not think anyone in India is looking at this or performing this consistently for autistic children. After all, it was only mavericks who have ever unlocked the power of science.