SYSK Selects: Fecal Transplants: You Gonna Drink That Poop?

why my real life. Oh I know why because I was watching the Great Tig Nataro show One Mississippi UM, which has a second season that's starting kind of right about now, and on that show, I think she had a fecal transplant, and I think she did in real life, so it made me think of this one. It's just

being a really interesting kind of um. Despite the fact that their poop shakes cutting edge medical uh technology, I guess you would call it, or at least procedures and um and a serious note it it really helps people out who have real problems. So UM. We do make quite a few jokes, but it was pretty cool show, So give it a listen to. I hope you enjoy it. Welcome to you Stuff you Should Know from House Stuff Works dot com. Hey, and welcome to the podcast. I'm

Josh Clark. There's Charles W. Chuck Bryant, and we are so fly by the seat of our pants. We just now decided which of the two episodes we're going to record first. That's never happened. I looked at Josh while he was talking. I pointed to the thing, and he just nodded. That's we're gonna do poop. We're doing poop. Yes. I can't wait to hear intro for this, because I can't imagine what kind of intro you would have for drinking a poop shake exactly zero intro. Okay, now you've

put me on the spot, all right. Um, I had only recently heard of this. You me pointed it out to me about six or so months ago. And then pressto Obama, change Joe, We've got a an article on the site. Finally get this pretty a new article, right, yeah, and it was at least October, and the earliest this has come up a couple of times in our show already. Yeah, we did a little video that's now vanished on fecal transplants.

That's right. Oh yeah, that's right, that's where it came up. Um, and then this but yeah, this article is by a dude named Nicholas Gerbas or Jervis. I don't know who he is. He's a freelancer. But this guy is top notch. Yeah, he wrote some funny sentences, he did. And but it's like every every sentence in this article was underlying and highlighted. Yeah, very good, comprehensive article on poop shakes, good thick stuff.

M Um, so chuck, did you know that if you are infected with something called the neuro virus, which is very frequently contracted in dorms, prisons, cruise ships, aren't they all virtually the same thing? Pretty much? When you put oop, each gram of stool has literally billions of neuro viruses in it. Yeah, and I believe one of the ways you can contract this is by eating sushi from fish that had been swimming in contaminated waters. Right, Oh, is that the same one? The norwalk virus and the neuro

virus are the same one. Oh okay, Yeah that sounds familiar.

That was in the first pilot one point all right, um, but yeah, okay, So the neuro virus um that you can get it from eating sushi, you can also get it if you happen to be friendly with a person who's just filthy and has the neuro virus and doesn't wash their hands after pooping and then shakes your hand or feed you like a gummy bear or something with their poopy fingers, and um, you accept that gummy bear and like maybe their fingers like get inside of your

mouth just a little bit. Then all of a sudden, you have the neurovirus and you're in big, big trouble. For the most part, though, it was always regarded as like this UM kind of just just a terrible thing to have for a few days. Is extremely very virulent, UM, extremely easily passed. It could survive for days weeks on a surface UM. But ultimately you just pooped a lot, you vomited a lot, and then it was done. Not so any longer. Thanks to the rise of misprescribed antibiotics UM,

about fifty of antibiotic prescriptions are considered unnecessary. Yeah, I try to avoid it. It's a it's good and it's nice that you're doing your part. I try to do my part too. And it stinks that, like we have to suffer, right because other people are getting antibiotics at the drop of a hat. But that's the point and one of the one of the reasons why you and

I choose to suffer. People haven't caught on yet. Is because if you expose a virus or bacteria to an antibiotic, something intended to kill it, and it it doesn't kill it, that antibiotic or that that virus or bacteria has just been effectively naturally selected and it goes on to reproduce and reproduce and eventually develops resistance to these antibiotics, and so the medicine we have becomes useless to it. That's happened with Nora virus. It's also happened with another very

nasty virus called Clostridium difficial. Yeah, it is melli difficial. Difficial, but is what French and Spanish for hard and difficult. I think so. And the reason they call it that

is because this is a very intractable bacteria. Yeah, and this is uh, it's become a They call it an emerging epidemic, which is kind of scary to say that, but especially in hospitals, uh, in nursing homes, because it generally affects old folks and they will um, I guess they're so jacked up on antibiotics that their gut that can't kill this thing once it gets in there, well, yes, or if they're on antibiotics for something else, like they

they're in the hospital for something else that they're given antibiotics, the antibiotics going and just wipe their guts clean of good bacteria and bad bacteria. See, normally we have bacteria that fight see difficial. But if it's all gone, then yeah, you're in big trouble. The claustradium comes in and finds root and gives you a lot of problems and maybe kills you. Yeah, it is is a big deal. Um.

Gastro Intestinal infections as a whole are way up these days. Um. The death number doubled from two thousand seven and I think more than seventeen thousand people a year in the US die from uh, gastro intestinal infections. Yeah. U of the gastro intestinal infection fatalities are in patients sixty five and older. Sadly, Um, the next biggest age group is five and under. Yeah, the only young. And it's a

really nasty way to die. And two thirds of those are the C differiceeals specifically, so, which is why they're calling it an epidemic. Um. And the way you die from this is you vomit and diarrhea so much that you become dehydrated. When you become dehydrated, your electrolytes are out of balance. The electrical system that keeps your heart and rhythm malfunctions, so maybe you have a heart attack, or you have a stroke, um or you uh go

into shock and die. Yeah, and even if you're young, it's important to stay hydrated when you're sick like that. Even if you have the stomach flu or something and you're vomiting up stuff, you've got to try to at least keep some water down. And if you can't, then you should probably go to the hospital and have fluids introduced intravenously. Yeah, it's not a bad idea, better safe than sorry. I always keep an IVY in the trunk of my car just in case I start to dehydrate.

So I think we've made the case that see different seal is a big problem, right it is. And the fact that it's they call it intractable, like it's just really hard to get rid of. Even once you get rid of it, Um, there's like a relapse, right Yeah. And um, when you're on antibiotics, you have a seven to ten seven to ten time greater chance of contracting it. And even two months after you finished the course of antibiotics, you're still three times it's likely to contract this normal.

So you really want to stay away from the antibiotics if at all possible. Yeah, of course, if you need them, take them. We're not advising you to not take things to make you better. But if you have the sniffles, if you have like a nasal infection or something like a sinus infection in then what they call them, you kind of need to tough it out for the greater good of humanity. All right, let's talk about bacteria and

what is called the micro biome. Uh, that is an ecosystem in your body of little tiny bacteria, like a hundred trillion bacteria in the human body doing all kinds of good stuff. Yeah, and there's ten times the amount of foreign bacterial cells in your body than your cells, actual human cells, ten times more, and that's a good thing. We've talked about good bacteria and bad bacteria before, and probably the the monsters inside this thing, right, what was

that one? Yeah, probably digestive systems here that too. But anyway to recap quickly, we have lots and lots and lots of helpful bacteria, and there's a burgeoning field in medicine. Some might call it a fringe on the fringe right now, but um, it's called medical ecology, and it's kind of neat. It's basically like, instead of going to war with your body, they're saying you should be more like a gardener and manage your body like a garden of all these live

things inside of you. Flora, bacterial, flora. You don't want to kill these things, no, especially not the good ones. And that's what we've been doing with antibiotics. We just send something in there that kills everything that's right. Uh, there's a really cool thing, have you heard the Human Microbiome Project have. Um. This is based on examinations of two forty two healthy folks that they've tracked for two years, and they're basically sequencing genetic material of bacteria recovered from

sites on the body. And they've recovered more than five million jeans at this point, so they're really like mapping this stuff out for the next wave of medicine coming through down right, Like, that's got to be a pretty

good first step toward tailoring medicine to avoid killing good stuff. Yeah, and this goes along with your hygiene hypothesis that we just talked about when we recorded yesterday and the five second role, yeah, which is that's probably out already, right yeah, okay, Um, but yeah, the hygiene hypothesis is that if you're exposed to bacteria, you learned who your body, your microbiome begins to include um bacteria that can defend against the bad stuff, and so if you're exposed to it early on, you

have a greater advantage towards um being healthy as an adult, having a fewer allergies, that kind of stuff. Have you ever had a friend that had a kid that was a little cookie with the bure l I've seen it, like before you touch my baby here, scored scored, squored all over you. Yeah, usually when the baby is very young, although I also have friends that like won't touch babies because they think they're just dirty. It's hilarious that we're I was like, are you. I don't hold babies usually

because I'm afraid I'm gonna drop them. Um, And I thought you just saying football, that's probably one of the problems. Well, that's how you carry a baby. The doesn't rhyme go facing the armpit, elbow, over the body, all the real tight in run like hell, I think that is it. I don't think so. I think you cradle and nuzzle. Um. Well, anyway, I thought my friend was afraid of dropping the baby, and he's like, no, I don't touch them because there's

just like bags of germs. All humans are filthy dirty, and babies just don't appear that way because they haven't been around long enough to stink really bad. You know, they smell all downy sweet, and you just from the day you're born, you start smelling worse and worse and worse until the day you die. Have puppy breath to start. I remember going, man, I remember my father's bathroom experience as being a kid and being like, oh my lord, like, am I going to smell that way one day? Yeah?

I remember that too, and then that mixed with like shaving cream smell, and you don't like it now I smell that way. I know you don't. You smell fine. Uh So back to bacteria. Um. If we're talking about millions and millions and millions of these in our body, um our mouth has hundreds of thousands of bacteria species, not just bacteria and they are in our teeth and our gums, on our tongue. There in our lungs, which we didn't think we used to have them in our lungs.

Apparently there's two thousand per square centimeter. And uh, the gut is where you're gonna find some serious action to thirty thousand different species of bacteria. Yeah, and they live in colonies. Were starting to learn colonies, Um, where they they. I guess bacteria kind of likes to stay with their own ilk. And if you put it all together, you've got like a whole neighborhood of bacteria. But um, I

am pretty confident. And once we start to figure out like this colony tends to live in this part of the body, and this colony lives here, I'll bet it helps things function more correctly. And if you move colonies around, I'll bet you you find dysfunction, life balance or not life. Well, I think that's all the reasons why it's still free. G Like you you you you just kind of put your finger on it, like there's balance and all that too, but esoteric, right, But as as you and I know,

homeostasis is the goal of everything that's right. We've talked about it before. So you've got in your mouth, you've got bacteria in your guts, and I mean, I think the fact that bacteria have more cells in our bodies than we do kind of supports this idea that um Nicholas Gerbis Gerbis pointed out is that bacteria probably the most successful life forms on planet Earth. Yeah. What are these guys doing? Oh well, they are breaking down things and too other things. They break down nitrogen into the

in the soil to make it absorbable for plants. They produce vitamins in your gut. Yeah, bacteria do. Yeah, how about that? They produce oxygen that we breathe. There's waste processes. They help maintain your protective qualities of your skin, which is nice. They those plants, they kind of they turn the tables on those plants. They break down nitrogen the soil four plants to take up, and then when we eat the plants, they break the plants down into a

digestible slurry grass. What's it called bolus time? I think time time than bolus time. They also help prevent, prevent and reduced swelling, which is a big deal because swelling can be one of the danger factors if you're sick or injured. A lot of times people die simply because they can't get the swelling down in order to perform procedures they need to perform. So thank you back Terry

for helping with that. Um. And then we were talking about babies to chuck, Um, if you wouldn't hold the baby, then you probably shouldn't like shake hands with the baby's mother, because that's where the baby gets most of his or her initial bacteria's from the mother. There's about six hundred different species found in breast milk. Um. The sugars and breast milk go directly towards motivating bacteria in the baby's gut. Yeah.

There's a change in um, the vaginal microbiome, Yeah, where they think that possibly the baby is basically coated in this upon entry into the world. Yeah. That's called Lactobacillus john sony. And that is present when you're pregnant and you're vaginal micro biome, right, and they think that you get coated on the way out. Yeah, And then all of a sudden you're like, Okay, I've got some defenses here, and these guys are going to be my friends for

the rest of my life. Well, the lacto basilus actually helps them digest the milk. So um, little little babies that come out. That's why they say, if you're born in a cesarean fashion, then you might not have what you need to digest the milk. You might have problems there, you might have uh fewer defenses against IBD, inflammatory bowe disease and um what else Merca staph infection. Well, yeah, that skin. They think that there's studies that suggest that

you're more prone to Merca infections on the skin. UM. This is still very much under debate, huge debate between cesarean and natural birth stuff. It's like a hornet's nest man. But they think that you know, there there is a definite link they imagine between amritable bowel syndrome or inflammatory bowel disorder sorry UM, which includes like Crohn's disease and all sort of colitis um. And it's a big deal. You can lose parts of your intestines, you can die,

you can become malnourished UM. And there's like a one point seven billion dollar expense in healthcare just from inflammatory bowel disorder alone in the US. UM. And they believe that that's linked to some sort of problem with bacteria in the guts. So all of this small talk about bacteria has been leading to the setup of this podcast, which is drinking the poop shake. Yeah, the fecal transplant, and they call it a transplant, and it makes it sound a little more like a medical procedure than I

thought it was. Uh. There's no cutting, there's no laser ing, there's nothing like that. Um, this has been practiced. Something like this has been around since fourth century China. I was looking. I couldn't find anything on that. Could you really now, I couldn't. We should email the author here. Um. But it has been around in earnest since n Dr Ben Eisenman UH from Denver General Hospital pioneered this. Uh.

I guess it's a procedure. I was gonna say technique. Um, And it really didn't come around in earnest until about two thousand. So here's how it works. You're donor gets screened for hepatide us in HIV and other disease causing germs that you don't want. They take the stool of the donor poop poop, they blend it um with saline or this is so gross. Four percent milk in a

medical blender. Yeah, sure, it's not that Queason art. I bet it is a Queason art sense that you would use milk if you want to propagate moss on something. A little bit of buttermilk, a little bit of um sugar in a and just take some moss and throw it in a blender altogether, press, blend, take it and painted on whatever you want. It's right and it will grow.

See our moss podcast for that one. Yeah. Uh. So basically, you have the stool sample of the poop four percent milk and in milkshake machine and you mix it up and you feed it to the patient through Uh, you don't have to drink it. No, there's different ways to introduce it, but one of them it does end up in your stomach, and I don't understand how you don't just in immediately throw it right back up. All right. So the two methods um that Josh will explain are

nassa gastric and nasso duodenal. Yeah, we never figured that one out in our Digestive episode the remember they duodenum duodenum um. Yeah, Well that's a tube that goes through your nose and if it's naso gastric it ends in your stomach, which means you have poop going directly into your stomach. And don't think that four percent milk makes it any easier to take through your nose, through your

throat into your stomach. Or the nasal duodenum goes through your nose into your stomach and then into your intestine, so it bypasses your stomach and it goes directly to where you want it. The intestines. Wow when that. You can also do a a an enema that's designed to stay in rather than flush back out. Um enema. Yeah, what do you think? I say, I don't know. I just they should call the other ones out of us,

I guess. Or a kolonoscope, not a kaleidoscope, although that would work if you turned it around and I guess broke all the glass out ahead of time. Is there just be like a funnel. Then that's true. Um. But the point is that you have someone else's poop, a healthier person's poop, in your stomach, and they expect that about of the living bacteria found in that poop is going to stick around and you're intestines, what you're doing.

The whole point of a fecal transplant is to repopulate your gut flora so that your immune system can get back in order. The best way they thought about to do it. Yeah, they have. They have another cocktail that they're working on, which is just a bunch of like bacteria that I guess you could take as a pill. But man, this works. Yeah, it seems to UM. One of the stats we have here is that people who have undergone this and it's still well, we'll get to help.

Often it's practice here in a second but UM one study found that long term follow up, seventy seven fecal transplant patients reported a CURATE after just one of these and percent uh if you married that with additional probiotics and antibotics and or an additional poop jake right for c deficial. Yeah, that's percent. That's awesome. I don't think that there's anything that has that kind of success rate. Maybe aspirin maybe so. But yeah, it's definitely been shown

to work. And you know it is fringe, but you can still get it done in hospitals. That's where you want to do it. Yeah, you don't want to do this at home. This is not UM. In fact, a couple of the best sentences in this article or in this section. First of all, the preparation you prepare like

you would for a colonoscopy. But as our who's who who wrote this again, Nicholas gerbis Gurbus Gerbas put it this way, Nikki G. Nikki G says, the patient prepares for the procedure via the traditional taking no prisoners date with the thunderbucket ritual used by colonoscopy patients. Yeah. He went from like science writer, science writer, science writer, Mad magazine. Yeah.

And then he also says, uh, this is not a great dy project because stool is a level to bio hazard number two, if you don't test the samples for disease, you could end up in pain. And then third, remind us never to drink a frozen margharita at your house. He just went like funny for one paragraph and then

right back to the business. Right. Well, Um, he says that you want to screen the stool that you're putting into the patient, and um insurance doesn't cover this, not yet, no, but they think it will as early as this year, earlier this year, soon early, um. But even still it's not very cost prohibitive. It's about a thousand dollars. I saw there's a hospital in Madison, Wisconsin that does it. That's pretty it's not bad. And most of that cost

is for screening the stool for disease. I thought it had been the milk or yeah, or pressing them blend buttons right, or holding your breath all the nose clips. Um.

So uh. One of the interesting things you're moving forward is how this is going to be, like you said, affect insurance, and how it's going to be classified if it if and when it becomes like super legit because um, what is on the horizon is that the f d A has declared feces a drug in this case because it's being used as a drug in a way, it's already a class to biohazard right. So now it's a class to biohazard drug according to the FDA, which means which is good because that means it's on the way

to becoming um investigational status. Right. Do you remember with the Dog Show episode where we were talking about how there's the um other bre I can't remember what it was called, but it was like a breed that didn't fit in anything else. Miscellaneous maybe and um, that's how the a k C begins to recognize a breed like at first places it in this miscellaneous. I get the impression that this is the same process the FDA is saying, like that's a drug, and by doing so, we're halting

all of this stuff. You can't just do it any longer, really nearly, like now there's a law attached to it. But we're also classifying is something that we officially recognize that you can now apply for funding to study and say, the FDA recognizes this is a drug. We want to understand it better, so give us some money. So interesting, though, how are they going to regulate like this is a drug that is poop? How are they going to regulate that?

As far as I mean, because we should point out that most of the time the donor is a family member, family or um. But it doesn't have to be or even a blood match. But I think because you share the same environment, you're probably likelier to have a similar gut for I think it's probably has to do with it just being so east dude, don't you think maybe because you don't want to just take some random person's

poop and drink it. See. The thing is is I'd almost rather have a stranger's poop because like what if you know, what if I were doing this and like the donors like just staring at you, like my poop is going in your stomach right now? Is a random stranger you can't do that. Talk about surgical theater. Um. So yeah, it's gonna be really interesting how they move forward with this. UM. But like we said, huge results, um. And according to the cdc C difficial kills fourteen thousand

people annually. So, um, it's a big problem. And they second help with metabolic syndrome maybe. Yeah. So metabolic syndrome is a collection of risk factors like UM insulin resistance, having a lot of weight around the middle UM, and basically it adds up to a higher risk for UM type two diabetes UM, coronary artery disease stroke yeah, stroke. UM. And they've found that uh poop transplant can actually can actually reverse the course of this disorder. They found this

in mice, right. Yeah. They think that um, what it's going on is that them it would it improves your insulin sensitivity, reduces triglycerat levels, and they think that it has to do with the way that you metabolize sugars. Wow. And they also found in rats that if you take the poop from a lean rat and transfer it to an obese rat, the obese rat loses weight, no other

interventions whatsoever, all just from a poop transplant. And again they think it has to do with the way that um, the bacterial colonies, um, help us digest flute food, help us absorb nutrients. UM. So who knows, like poop transplants could be the weight loss wave of the future. Well, they definitely know that the bacteria in a uh, skinny person's gut is different than an obese person's cut and humans,

so there could be something that um. And we're like, we're just now beginning to wrap our heads around the idea that like the gut, there's something there. Um. There's this thing called the enteric nervous system uh. And it's basically your lower brain and it's located in your intestines.

Your intestines have a sheath of neurons, but a hundred million neurons, which is as many neurons as in the heads of a hundred and five bees, by the way, but that's more than like your your parasympathetic nervous system has and the vagus nerve. Do you remember we were talking about orgasms, UM, and women can still women who are paralyzed can still have orgasms because the vegas nerve goes around the spinal column directly from the from like

the pubic area the gut to the brain. Well, they found that nine of transmissions in the vegas nerve go from the gut to the brain rather than vice versa. They're also figuring out that neurotransmitters, a lot of them are produced in the gut. All of our serotonin is found in our gut UM, so there's definitely something going on. They're like, well, yeah, it's this second brain developed to carry out digestion and all this stuff independent of the

brains of the brain can do other stuff. But scientists are also saying, like, what we're looking at is way too complex to just be dealing with digestion, UM, So what else is there? Now they're starting to figure out like, oh, there's neurotransmitters, there's a lot of smarts in this gut brain, and they're linking it to things like Parkinson's has been

linked to autism spectrum disorder UM. They're starting to figure out, like we need to pay more attention to what's going on with these microbes in this gut because there's definitely something here and I feel like this medical ecology thing, it would be a big revolution in science. I think they're onto something for sure. So I'm sure it'll get more prop or funding as it gets more legit, and at d A I'll have a lot to do with that. I have a feeling this is going to become too

legit to quit in very short order. Boop shakes all around. M Ah, you got anything else, sir? Do you want to say fecal transplant one more time? Fecal transplant? If you want to learn more about fecal transplants, you can type those words into the search part how stuffork dot com. And it's time now. If for you're listening, Mai, Josh, I'm gonna call this uh condoms in the River. Oh man, I know who this one? This one's mind blowing. Did you read this one? Yeah? Um, guy's been an avid

listener for some time. I came aboard around Afprodisiacs, got booked and listened to the entire catalog. Josh, you requested any info to make sense about the ubiquity of condoms on New York City streets. While I can't shed light on how they got there, I can share with you some first MD experience what happens to them from that point.

I'm a sailboat captain for the sail uh for a sail training and charter company on the Hudson River, and I learned very quickly after starting to work here that you don't touch the river water right after it rains. This is because the New York City sewage system is so old that the rain water from storm drains and raw sewage are mixed together and treated by one system. When we get a lot of rain, that system is overwhelmed and the overflow is released untreated into the surrounding

bodies of water, including the Hudson River. Now, after a long rain, you'd expect to find what I suppose you'd call a representative sample of condoms among the floating garbage. But I'm still trying to figure out why condoms represent a grossly disproportionate percentage of the overall floating trash. It should be Dorrito's bag, condom, McDonald straw, Yo play light, and fit cup condom is actually condom condom condom Spiderman

action figure underneath the condom condom condom dead rat. The situation is disturbing enough on its own, but I teach a kid's sailing camp during the summer as well, and the younger kids inevitably asked me what all those white things are, and I just say, those are Coney Island whitefish. And we had someone else right in that called Coney Island whitefish, so I guess this is what they're called. Okay, not in what if He's like, those are French letters.

Uh so those are cony and whitefish, and then I walk away without further explanation. It's best. That's the best way I can think of to avoid further questions from the kids and potential lawsuits from parents. Other things I've seen come up from the Hudson River, in case you're curious, include mating crabs, a sunburned pig, an entire telephone pole in three Dead Bodies. That's disturbing, and as Jonathan actor, singer, sailor and speed dating host, I know this guy is

quite a renaissance dude. Yeah, thank you, Jonathan. Uh if you have any awesome incredible stories. We want to hear them um, whether they pertain to the podcast or not. For more on this and thousands of other topics, is It, How Stuff Works dot com