Fecal Transplants and You

is an important subject. It's it's always coming up. I mean, it's always coming out, all right, um, but it's it's one of the things that I end up talking about with the child when we talk about poop and when he needs to poop and how we're going to go about it, and then uh, and then when we have conversations about it on like the changing table, when I put his night diaper on him and he starts talking to me about poop and because he knows that the night diaper is there in case of night poops. So

it's fitting. I was on saying that I should uh hand over another portion of my day considerations of poop. It's fertile ground to tread on. Yes, um, we are of course going to be talking about pecal transplants, which we've talked about in a cursory way in the past, but we thought, you know what it really deserves this day out there in the sun. Yeah, like the episode that we talked about it, and like we didn't even have fecal transplant in the in the title and uh

and afterwards, I kept kicking myself. It's like people are going wild about pecal transplants, wild about it. They are, I mean, the headlines everywhere about fecal transplantation and and you know Coldbert Daily Show, everybody's throwing in jokes about it because you just can't resist the scatological implications here. And uh, so we decided, yeah, let's go back, let's

let's discuss it. Let's discuss some new uh um information that's out there about the procedure and about the technology and the idea behind it, and uh and just really own up to it. Because that's another thing about now being the father of a toddler, is that I am far more um open about poop. I'm more likely to make a poop joke, I'm more likely to discuss it, I'm more likely to just be open about about what my my own bowel movements are doing in the course

of the day. It's just really changed my life in that respect. Welcome to the world of schatology. It's a beautiful place. Um. Well, yeah, Feces as a medicine really goes back to the fourth century China, where it was orally given to those suffering from food poisoning or severe diarrhea. And in the sixteenth century in China, a fecal suspension called quote yellow soup was created for the relief of constipation, fever, pain, diarrhea, and vomiting. And fast forward, fecal animals were first used

to treat pseudo membrennous colitis. So it's been around this concept of using this beneficial gut flora. Yeah, to your point, it's uh, it's an idea that existed before modern medicine, and modern medicine has gotten back around to it and seeing the value in it. Yeah. I mean essentially there's gold in them their poo. Yeah. And I love to throw out this quote because I think it's true. Um, this is according to Stanford microbiologists Stanley Falco, the world

is covered in a fine patina of feces. And you and I have discussed this before, Like any time that you're digging into the dirt, you have to know that there are particles of dinosaur poop there, right, Yeah, And there's there's poop in the ground, there's poop, you know, potentially the air around you. I mean, you're every day you're dealing with poop. We in our lives, we often try to to limit ourselves not only from the reality

of poop, but just the the notion of poop. Um. We we don't like to think about it in terms of our our water purification systems or or or anything. It's one of the reasons our toilet systems haven't really evolved out that much because we're we're far more content just to say, all right, it works, it flushes the pool away in clean water. I don't want to think

about it anymore. But all that poop has been really beneficial, right, because if you think about all the dinosaur done, the billions of pounds of it that seated the earth, that helped other creatures to sprout forth, and other sort of

plants and animals to subsist. So there's a definite symbiotic quality to it, although you don't tend to think about that when you're thinking about living with someone and there microbiota, yeah, I mean, the microbiot is key here because we've we've we've devoted whole episodes of this in the past talking about just the the the the microbiota, the the the creatures that that make us up. They live inside us

um and they live in our poop. I mean, our our poop is is mostly bacteria, and in a sense, we are our poop and the senior we own up to that the center, we can we can really get along with a number of the the implications of the studies that we're discussing in this episode. Yes, so it's not really like I am what I eat, It's I

am what I poop. Right, Yeah, I mean we're not just this brain where this whole body, and we're not just this the body as it would exist if if it was taken to a mortuary and flush clean of all its fluids, and because those fluids are essentially us as well, not only our blood but even our our waste products are kind of parts of us on the way out. And as I had mentioned before, we don't tend to think about this like what is what's my gut microbiota doing right now? Is there any crossover with

someone I live with? And this is from a new York article Roller Derby of Microbiome, the author very Nique Greenwood explores the idea of whether or not we colonize each other with our own bacteria, specifically with gut bacteria, and she talked to Balfour Startur, who is a gastroenterologist at the University of from Carolina at Chapple Hill, and he specializes in inflammatory bowel disease like crones, and he says that there is a growing stack of evidence, some published,

some not that people who have lived with inflammatory bowel disease sufferers for long periods of time had higher rates of it themselves than people in the general population. He also cited a two thousand seven study that was published in the journal Cell in which scientists deliberately transmitted gut bacteria of mice genetically predisposed to develop intestinal inflammation to healthy mice, and this caused the healthy mice in turn

to develop the condition. So here we see essentially the seating of the condition through a fecal transplant, again changing the organism by changing the contents of its bowels. Again, this is just um well, not necessarily in the case of the mice. But when star Toro was talking about more about people just who are living together, uh, who have those trace bits of gut bacteria essentially feces being exchanged here. So that's just the tiny bit that would

be colonizing your own microbiota. Yeah, and again colonization is key here. I mean, just to throw out a few quick stats that we've hit in the past, I mean, the human mouth alone contains five hundred to a thousand different types of bacteria, and of those, only a hundred to two hundred live in a mouth at any given time. And that's just a mouth. When you take into account the entire human body, Um, it really begins to skew the idea of what is an individual and what is

a a collective. Yeah, because we've talked about this before, like we're just host for for bacterial cells when you look at how very colonized we are by them. Now, we want to talk a little bit about a couple of conditions that are very difficult to treat because this

will actually play into fecal transplants. And the first is something called Clostridium deficily or see death if you will, death on the streets, and it's a bacterium that releases toxins that attack the intestinal lining and cause inflammation of the colon, and according to the Centers for Disease Control and Prevention, C DIFF is linked to a quarter of a million hospitalizations in four deaths a year in the US, and deaths from CEDF increased four hundred percent between two

thousand and two thousand and seven due impart to the emergence of a stronger strain. Yeah, this can be especially a huge problem for the elderly. UM in some sort of a care environment, and just to throw some symptoms that you UM, just to know what we're dealing with here.

You can get more severe infections of C. Deaf causing watery diarrhea up to fifteen times per day, severe abdominal pain, loss of appetite, fever, blutter, puss in the stool, weight loss, and then in extreme cases C. Deaf infection can lead to a hole in the intestines, which can be fatal if not treated immediately. So is it is this is the affection spirals out of control. UM. It can cause a lot of major health problems. So this is this

is not a condition to take lightly. Yeah, and it's been associated with hospitals quite a bit because the strain that emerged is one that has become antibiotic resistant. And so not to scare anybody who may or may not

have to visit a hospital. But it turns out that in an October issue of the American Journal of Infection Control, but they reported that the incidents is ce deaf and hospitals nearly doubled between two thousand and one and two thousand and ten, with mortality increasing from six point six percent in two thousand and one to seven two percent in two thousand and ten. And again, as you had mentioned in the other really this can be terrible. This

is this is a big blow to the body. Yeah, and you know, it's it's interesting just to think about antibiotics and their role in this and another condition, another condition they're going to talk about and and think again about the body is this collective of all this bacteria and uh and and and as as well as our

actual cellular structures and so forth. But in dealing with bad bacteria, when you you're using powerful antibiotics, it can all it can almost be like carpet bombing a city to deal with some sort of insurrection or some sort of a crime problem or what have you because you end up just laying waste, and sometimes you're creating an opportunity for quote unquote bad bacteria to rise up and take advantage of the new environment. Yeah, because with those antbiotics,

you have carpet bombed all the good bacteria. And it turns out that in about except for a course of treatment, that of first time patients will suffer again. And up to sixty percent of patients who have experienced two episodes

are doomed for another. So there, up until now, and we will talk about people transplants and a little bit there really wasn't a good course of action to take against this, Yeah, because again it just keeps being a problem, and so you've destabilized the region and then no matter, subsequent carpet bombings don't seem to be helping somehow. Yeah. Now, another bacterium reeks quite a bit of havoc and again very hard to treat. We're talking about k pneumonia or

albusiela um. Pneumonia is a type of Gram negative bacteria that can cause different types of healthcare associated infections. We're talking about pneumonia, bloodstream infections, wound or surgical fight infections, and meningitis, and it too has developed antimicrobial resistance and recently to the class of antibotics known as carbon panems.

So this is something that's really hard to treat right now. Yeah, Now, it's worth noting that the of the cell of bacteria, they're normally found in the human intestines, where they don't cause any disease. Where it becomes a problem is when they enter the respiratory tract to cause this pneumonia or

the or the blood to cause a bloodstream infection. The thing about this is that as debilitating as they are, it is known that fecal transplants can vanquish these And we're gonna take a quick print when we get back. We're going to talk about how all this goes down. All right, we're back, and yes, we're talking about vecal transplants, or to use the more official term, fecal microbiotic transplantation or f e m T. That's right, And uh, you know,

we kind of touched on this. We tend to think of our do is just purely waste material, but by weight, sixty of our stool is bacteria. And we're talking about rich, beneficial stew of bacteria in a healthy individual. All, yes, that that turd is is alive there. Um, when when my son personifies the his waist and calls it a mama or a daddy pooh or something often baby poos, So they tend to come late in the movement. Um,

he's he's really not too far off the off the chart. Um. And so the idea here, I think this is one of those ideas just to to to rond a little bit. You know, when when you when you get past the shock headlines and the jokes, it really makes a tremendous amount of sense, Like there's nothing really that wild or

crazy or horrific about it. Um. You know, we've thrown articles about people transplants up on our Facebook page before, and we have a number of Facebook followers, and we have some some very bright bulbs out there, and some people who are just you know, getting their their hands around some science and as well, I mean people of all ages and greeds and and some people you know, react very viscerally to that. They're like, oh god, I

would never do that. That's that's horrible, that's disgusting sounding. But but that's just the surface. Let when you actually get into the science of it when you when you look at yourself not as this singular individual, but as this this colony of bacteria. It makes perfect sense that you would deal with this imbalance by by by bringing balance in with a healthy um stool sample and implant

that or somehow get that to the bowels. Well, but first you have to get over the idea of pumping into your colon someone else's poop, right, right, So if you think about it more like this, Hey, it's a treatment that's done by a colonoscopy. A lot of people have colonoscopies, right to's scary about that? I mean you shouldn't be. I mean, it's just it's an orifice. It's an orifice. There's a way and there's a way out, and sometimes you're gonna let professionals go in there. It's

just how it works. It involves anesthesia or at least adation. There's a full bowel clean out previous to a f MT in a limited diet prior to the procedure out. How this all goes down is you get a healthy stool sample. That's key. They're not just grabbing anybody. Yeah, like you you know, in the past, I think it was done more like, hey, maybe my brother or uncle give me a little sample, and you know that they're healthy. And then of course the stool gets sampled later to

make sure that it's healthy. Yeah, it gets betted anyway, stool samples mixed with sailing and then pumped into the colon and then, as you say, the end result, uh, is a rebalance of gut flora that can eradicate the seed diff because on its own, your gut flora has been demolished. It cannot it just can't stand up to the sea diff. But someone else's, which is quite hardy, can really do a lot of damage to c DIFF. Now, I also want to add that the mixture can also

be fed via a naso gastric tube. So this is the one that that goes in through the nasal passage and down the throat and down into the stomach. But again, rather different than poop. Just thing, don't it's it's hard not to hear that and not think they're gonna put poop in my nose. I know it's impossible to to get past the revulsion of that and the comedic value of that, but uh, you know, again, it's just an orifice. It's a way into the inner workings of your body.

It's actually a bit trickier than a colonoscopy, like doing it through through your bum um. So even though some people might be put off by the idea of a colonoscopy,

it's probably the better way to go. Now. Just to give you an example of of what sort of effect it has and how quickly it takes effect, the Mayo Clinic in Arizona that their fm T team first performed a fecal transplant in two thousand and eleven for a patient with severe c diff And of course this stool was from the brother and according to Robert Ornstein of the Mayo Clinic, he says, unbelievably, the patient left the hospital twenty four hours after the procedure after having them

bedridden for weeks. That is how effective this treatment is. D there and there are plenty of examples of success stories. This is not one of those things where you know, they say, well, one person used this crazy technique and it happened to work in this one instance, but it hasn't really been vetted. We've seen we've seen account after account of of f m T s producing results restoring the balance to two bows. That are plagued by by

these conditions that we've discussed. In fact, just to to go back to the K pneumonia, just last month here in UM at the Jefferson University Hospital in Philadelphia, they treated a thirteen year old girl who who had this condition with a feel microbiotic transplant and they used it to successfully clear the infection. Yeah, and we will not go through the litany of things that happened to her because of K pneumonia, but it was I mean, she

was suffering greatly because it was just one thing after another. Now, I think another good marker of this being a success is the fact that someone is monetizing it. And when I say someone, I'm talking about a company called open Biome. It was that's biom bio Emy. It was launched in two twelve and it is the only independent nonprofit school bank in the country in the US. It is the brainchild of m I T post doc associate Mark Smith.

And what they do is they collect, test and provide becal samples too hospitals and thirty three states for these f m T s. Yeah, I was looking around and it looks like the prices currently you're looking at two fifty per sample of the poop. And again that's vetted poop. This is good stuff, this is premot poop, and this is what the hospital would pay for it. Yeah. Yeah, you can't really go to the website in order or or certainly don't binding off Amazon if it looks like

someone's selling it. Um. Yes, So that's a two fifty million lead sample of a fecal microbota prepared for lower transplant delivery, which we already talked about, or a thirty million leader sample for the upper trans planned delivery again through the nasal passage and down in the stomach. The person who donates the poop, well, they're paid forty for each deposit. Now, if you want to become a paid donor to open biome, you have to undergo really thorough screenings.

Of course, we're talking about question health history with a physician to a travel history analysis, and of course recent use of antibotics, because if you've used antibotics, and you're probably not a contender, right right, because you've carpet bombed the civilization that's producing the poop that they're interested in. I like how this could be a real game changer in um UM College dudes making a little extra money, like, no longer do they have to I would not restrict

it to the dudes. Oh well, that's true, that's right. I mean I was just thinking about it in terms of sperm donation. Of course, the other side of that being egg donation. But but the poop donation easier than both. Well, I mean it's great. It's like again, it's kind of again like a blood bank donation, although you're getting paid for this now one waste material anyway, right, what are you gonna deal with it? It's gonna flush it um. Once a donor sample is reviewed by a lab for

any infectious agents in the health of the bacteria. The donor's blood is then tested for standard blood borne diseases we're talking about hepatis, ABC, syphilis, HIV, AIDS, and then finally you can progress to the actual physical donation part of it all. Yeah. Again, so you can think about it in terms of any kind of blood or tissue, uh sample that is that is taken and then reused

and sort of transplant environment. Is it's going to be vetted, it's gonna they're gonna look for all these various diseases before it ever takes that it's the saline blended form. Now, one of the one of the things about this it leads you to the question of like how good is that poop sample? You know, Like then you begin to really sort of great. And I'm sure, right, I'm sure that lab is like, this is great. It's got so

much beneficial gut flora in it. But there's one researcher who really took this to the extreme, and I'm talking about hunting down artisanal hunter gatherer poop. Now, this is from the first paragraph of a Popular Science article by Emily Gertz, writing about the scientists who traveled around the world to give himself an f MT essentially, and it

goes a little like this. This is him writing, quote, as the sunset over a lake aase in Tanzania, nearly thirty minutes had passed since I hadn't served at a turkey baster into my bum and injected the feces of the heads a man, a member of one of the last remaining hunter gatherer tribes in the world, into the

nether regions of my distal colon. Indeed, those are the words of Jeff Leach Lee, and he at this point It's important to know that he'd been living with the hasda uh, these hunter gathers for for over a year. He was he was immersed in their culture, and he was His prime motivation, he claims, was to study quote microbial extinction, uh, something I believe we suffer from in the Western world and maybe at the root of what's

making a six. So the idea here is he's interested in these people's um microbiota in their stool because they perhaps they have things that we no longer have because we've been carpet bombing our our stool for so long with antibiotics that we don't even have a natural sample to turn to in the world around us. That's his his curiosity, his his argument. Yeah, Now the heads are um wandering foragers and they eat a diet of roots,

berries and game. Okay, this is one of the reasons why he was interested, because they don't have the influences of the Western world. Now. According to the study, which compared stool samples from sixteen Italian urban nights and twenty seven heads of foragers of both genders, the heads of guts are home to a microbial community unlike anything that's

been seen before. In a modern human population. And the idea is that perhaps the gut floor is what the human gut microbiome looked like before our ancestors figured out to farm about twelve thousand years ago. So again, he's very interested in seeing what the sort of set point is before all these other influences began to change our diets.

Primordial pop if you will, poop Alyssa curtaindon she's a nutritional anthropologist from the University of Nevada Las Vegas, says quote, many of the bacteria are species that the researchers had never seen before, and even familiar microbes were present in unusual levels and the hads of belly. So I start to think about this, like if you began to extrapolate this or normalize it, then you can see how stool samples might be divided into different price points, as I

had said, depending on the donor's dietary profile. It's kind of like you might be able to flip through a book, right, just like a donor book and um, and then if you especially if it continues to bear out that gut flora can influence anything from like Parkinson's dissay ease to obesity you may see this normalized to such a degree

that people are willingly undergoing f m T suh. Not because they're in pain and they have something like c DIFF, but because maybe they just want to try to lose weight, or maybe they even feel like it would rebalance there their emotional states. Yeah, because as we discussed before, I mean, the mind does not exist in its own little bubble out here in the ether. H. It's not piped into

us from some external soul. That the way that we think every day, the way we interact with their environment, it's all depending on what's going on in the body as a whole. So yeah, it would make I could, I could easily see that that reality coming about. Yeah, and we we even have an episode I think it's called as the gut, the second brain, that goes more into this idea of our guts regulating our moods. But of course all of this um, this idea of taking of just willingly doing a f m T is dependent

on that normalization factor. And what is more normal than taking a pill? Yeah, I mean it's here in the modern Western world espectially, we love taking pills. We don't even care what what's in it. We'll take it. Just give it to us. You say we can treat something

with a pill, great, give me four of them. So so, yes, some scientists have been looking into ways to take f MT and get it away from the UH, the Turkey based nasal UH to being um conoscopy route and getting more into something that is UH that is more medicinal UH in form and so a study published in October this year to fourteen in the Journal of the American Medical Association showed that the ingestion of frozen fecal matter contained in capsules resulted in a success rate among subjects

suffering from recurring seed death infections. So it's the idea, you freeze it, put in the capsule and then send it on its way. I mean, it's taken the same route as those those nasal upper transplant to delivery system. So why not. Yeah, And again we're talking about fecal matter that was you know, surveyed, and it was sampled and made to be sure that it was healthy, and once it was capsulized, it was that was given to the subject. They were giving fifteen capsules on two consecutive

days and then observed for up to six months. And now This gets really granular here. It says their daily number of bowel movements dropped from a median of five a day prior to the first capsule to two on day three and one at week eight, And it says subjects experienced no serious side effects. So it's kind of a no brainer, right, because you're talking about capsules taken, you know, a couple of minutes a day, as opposed to a colonoscopy, which is an actual medical procedure. Okay,

all right, so we get into a pill form. Um, we we get past the jokes and the shock headlines. We get a better understanding of how our bodies work and the importance of our microbiota. UM. Maybe we were even rebranded at some point, the cause you still have vecal in the title. Yeah, what do you want to rebrand it? Um? You know, I feel like if we were to rebrand it from vecal microbiotic transplantation to uh,

something like intestinal microbiotic transplantation. I don't know if if that would work, but like that would be I think that would soften the blow a little bit. I M T I MT maybe a b MT. Yeah, we could just get bowl in there. I think we could do.

But I feel like bowel has really entered into the vernacular or just in a positive off there and just call it a microbiot a transplantation, an empty Okay, I think we've got our thing, you know, the whole like you know, get rich quick team that we've been looking for. I think this is we apply for that small loan and then we start just marketing these I m T s out of the house stuff works office. I think there's only one additional thing standing in our way. What's that?

That's the Federal Drug Administration. Yeah, because the FDA is still has yet to really get behind this as of this recording. As you're listening to this in two thousand fourteen, past this point, I mean, hopefully that the reality will change somewhat, but you know, they have a number of concerns because we're talking about a waste product being reutilized for use as a medicine, and they have a number

of concerns about that. Yeah. In two thousand and eleven, when we first covered this topic, there there are a lot of naysayers out there saying it's not going to come to market because it's actually the cheaper version of trying to treat something, even though it's the more effective one and it's not going to get monetized. But here we are in two thousand and fourteen and we see, you know, now there's a pill form and it seems to be moving forward. So I feel like it's just

a matter of time. Robert Ornstein's I'm just gonna read this little bit from him. He says that the microbiome of the gut is not inactive. It's diverse and plays many roles in health and well being that are just now being explored with molecular biology and the sequencing of these species. This can only get bigger. It's like the beginning of the space program. And I say, here here to that. Indeed, and you know, and we're gonna We're gonn continue to have studies are gonna come out about this.

They're going to be more long term studies about that. That's one of the the reasons that has often been cited, UH concerning the FDA's concerns is that we don't have long term studies and potential side effects of of stool transplantation. UM. But but we'll see, like I say, is it's I think it's all going to come out in the end. Well, I didn't even mean to do that. Yeah, it was beautiful. Of course. One of the most exciting things I think it's come out of this is a little product called

pooper RONI whoa are you talking about poop sausage? Yeah? I am all right, Well, um, when is this coming to market? Never? Well, you know, there's weirdly, there doesn't seem to be any companies buying for this process, this this bacterial fermenting of sausage using fecal matter. Yeah, despite the fact that probiotics are a big deal, right, A probiotics yogurt is a big deal. Want why not poop

sausage exactly? And that's what a bunch of scientists in Spain reasons when they were trying to say, hey, maybe we could introduce this probiotic profile to fermented sausage because we use bacterial fermentation. We've did a whole episode on fermenting and uh and and what's involved there? So we use these these in the preparation of our food. That's

no big mystery, that's no revelation. And they said, yeah, there's two kinds of bacteria used most often in probiotics, and they're far more abundant and infant poop than an adult poop. And hey, they thought scratch head a lot easier to get. You can just get it out of the diaper, right, Yeah, and lo and behold these food microbiologists at Calonia's Institute of Food and Agriculture Research in Spain. They absconded with the poop. I say, I'm just counted.

Uh probably they okated with the parents. They took the poop of forty three infants and they used it in the production of something called fhuet. I think I'm saying that right sauce. Yeah, and uh no. It is important to note that there was no actual poop in this sausage. We may say poop sausage, but the only bacteria cultured from the poop was used to create the poop sausage. And yet there's the association, right right, But you know, baby poop is kind of its own holy thing. I

feel like we're a lot better about that. You have the baby showers where people actually engage in the game. Still where they have the candy bar in the diaper. I've heard about this, actually seen it, but it exists supposedly, So I feel like that's a sign that people are they're more okay with eating consuming baby poop or something made with baby poop than they are with this run of the mill adult human poop. No, especially if you

consider that you know, newborn mostly is subsisting on mother's milk. Right, So there's not a lot of crazy. I mean, presumably there's no like Kraft macaroni and cheese in there. Right. They are wholly blameless creatures, and the same can be said of the the bacteria live in their excrement. There's purity and innocence in their poop, is what we're saying. Yeah, alright, So there you have it, fecal transplantation, poop, sausage. Anything you could want out of a podcast, we just pumped

it into you. But do you want more, Well, head on over to stuff to Blow your Mind dot com. If you were streaming this episode off of Stuff to Blow your Mind dot com, Uh, do check out the landing page. In addition to you know, artwork, we always make sure that we have links to related content, So I'll include links to that microbiome article that we sourced as well as our podcast episode, uh and any other related We've done a number of episodes that deal with

human waste and uh and digestion. We did a whole series on how food travels from one end of our body to the other end. So check those out. Yeah, there's the pooping duck episode two. I don't want to spoil that. Oh the colt uh? All right, Um, maybe you guys have some thoughts on f m T s. My question to you is, would you undergo an fm T if you found out it was like the beneficial sort of vitamin D. Although some people are on the fence about vitamin D, but it was like super beneficial

to you. Yeah. Not just a life threatening situation where hey, this is your only way out of it. This is reinfection. We treat it, but just in terms of a near future situation where someone says, hey, you're feeling a bit blue, how about a little brown? How about it? Yeah? Alright, Like I'm telling you, you can really do this. I am keeping all right, send us your thoughts and you can do that by emailing us at Below the Mind. It has to work dot com for more on this

and thousands of other topics. Does it have stuff works dot com