Fecal transplants no joke

| 24 Comments

Before writing this article, I confess I went to the Web and Googled “fecal transplant joke” but, alas, all I could find were sentences like, “Fecal transplants are no joke.” No, they are not, but could we not expect at least a modicum of childish humor?

An article, The promise of poop, in Friday’s Science magazine discusses the medical possibilities of fecal transplants. As far as I know, these were first considered as a last-ditch treatment for Clostridium difficile infections, which are very severe intestinal infections and come about when antibiotics kill the great majority of the other floras in the large intestine. A hospitalist in a long-term care facility told me a couple of years ago that he thought fecal transplants would become the treatment of choice for “C-diff.”

Sure enough, fecal transplantation - the inoculation of someone else’s, um, manure into the patient’s intestine - has now become a hot topic and so successful in treating C-diff that even I would not hold out for a series of double-blind tests. The technique shows promise for treating Crohn’s disease and possibly other autoimmune diseases. See Carl Zimmer’s article in the Times for an indication of how we must have coevolved with thousands and thousands of species of microbes.

Fecal transplants are a little icky and conceivably could be dangerous. Nevertheless, I was pleased to note that the FDA retreated from its intention to treat fecal transplants as unapproved drugs and therefore regulate them.

Watch out, though - I read somewhere (but cannot recover the reference) that different people may have markedly different floras, and after a fecal transplant you may find that your exhaust gases smell different.

Note added Sept 1. There is no truth to the rumor that I painted this sign:

IMG_0284_PoopSign_600.JPG

24 Comments

“Watch out, though - I read somewhere (but cannot recover the reference) that different people may have markedly different floras, and after a fecal transplant you may find that your exhaust gases smell different.”

Is it likely that someone living in close contact – in the same household – with the recipient would have very similar intestinal flora (before the antibiotics), so that a transplant be more likely to restore things to normal?

Wonder what the fundie fringe has to say about this. Is it an abomination before the Lord, or just one more medical treatment that was never envisioned in “Bible times”? Once their pastor tells them what to think about it, then they’ll know what they think about it.

I sense an entrepreneurial opportunity here. Someone is going to establish the equivalent of a blood bank to serve the needs of this new technology.

The technique shows promise for treating Crohn’s disease and possibly other autoimmune diseases.

The link with autoimmune diseases is fascinating. Autoimmune and hypersensitivity diseases are common, poorly understood, can be devastating, and are currently treated mainly with broadly active suppressors of the inflammatory and immune system. The drugs used have abundant undesirable side effects.

(At this point I might as deal in advance with some obviously predictable things. Conceding the limitations of contemporary medicine always draws people, most self-serving but some genuinely suffering, who claim that, if scientific medicine is imperfect, their own claims should be uncritically accepted as perfect. It’s an error we see creationists make too. Assumption of an arbitrary preference as default. If science is imperfect and scientists admit it, their someone else’s biased claims must be accepted as perfect with no further investigation. I’m willing to listen to anyone who has sufficient background knowledge, a credible, coherent, and consistent hypothesis, and either objective evidence or a decent plan for gathering objective evidence. But the fact that scientific medicine does not have, nor claim to have, the answer for everything, does not mean that every other approach is perfect. Defend your ideas on their own merits.)

Autoimmune disorders are already associated with post-infectious states, in some cases. Obviously, there seems to be some kind of relationship between the way the immune system normally learns to recognize self, and some kinds of interactions with microbes or other triggers, and individual genetics, that can predispose to autoimmune disease. Background environmental factors could also play a role. The more we can learn about such mechanisms, the better we may become able to treat autoimmune diseases.

Just Bob said:

“Watch out, though - I read somewhere (but cannot recover the reference) that different people may have markedly different floras, and after a fecal transplant you may find that your exhaust gases smell different.”

Is it likely that someone living in close contact – in the same household – with the recipient would have very similar intestinal flora (before the antibiotics), so that a transplant be more likely to restore things to normal?

Wonder what the fundie fringe has to say about this. Is it an abomination before the Lord, or just one more medical treatment that was never envisioned in “Bible times”? Once their pastor tells them what to think about it, then they’ll know what they think about it.

If the pastor is reading from the King James bible, Philemon ch 1 vs 7, vs 12, vs 20, there is a possibility that it should be OK.

Just Bob said:

“Watch out, though - I read somewhere (but cannot recover the reference) that different people may have markedly different floras, and after a fecal transplant you may find that your exhaust gases smell different.”

When I was a child, one of our family members had some abdominal surgery which required her to take very powerful antibiotics for weeks, essentially killing off all the flora in her intestines.

She initially got re-colonized by some very undesirable organism and had a truly miserable time in the bathroom for months until her internal poo-pulation was re-balanced, and by miserable, I mean that by mutual consent we eventually dedicated one bathroom just for her use (which, in retrospect, probably made it harder for her to re-populate, but regardless, we weren’t going to go in there after she was done).

Marilyn said:

If the pastor is reading from the King James bible, Philemon ch 1 vs 7, vs 12, vs 20, there is a possibility that it should be OK.

Thanks, Marilyn. Verse 20 is my favorite.

20 Yea, brother, let me have joy of thee in the Lord: refresh my bowels in the Lord.

I suspect, however, that Paul wasn’t writing about what it seems in today’s English. One thing (among many) that has always amused me about the Perfectly True, Historically and Scientifically Accurate Bible is that none of the writers, up through the last books committed to writing, ever recognized that the human mind and emotions are located in, and products of, the BRAIN. Thus we have numerous verses with people feeling love and other emotions in their bowels. And of course there’s the ubiquitous knowing, feeling, thinking, etc. in the heart, none of which actually occurs there.

My snarky answer is that the human mind has apparently migrated from the bowels, to the heart, and eventually to the brain. No doubt a delayed reaction to the Fall.

My serious answer is that I’m not sure if anyone in “Bible times” recognized the function of the brain, but NONE of the Bible authors did. They really, literally, believed that human thought and emotions took place in the literal heart (or bowels). That’s not their fault. They had no way to learn the truth. But if GOD wrote or inspired or whatever the Bible, then you’d think he would have avoided such absolutely wrong “facts”, ones which he knew would be definitively proven wrong in time.

Only a peripheral joke for this subject: “Doctor, I’ve had problems with silent gas emissions. At home, work, or at church I get lots of silent gas emissions. As a matter of fact I’ve had three sitting here talking to you. What are we going to do?”

“The first thing we’re going to do is check your hearing”

and after a fecal transplant you may find that your exhaust gases smell different.

There’s a new refinement of the basic technique to address that: Fecal Aroma Recalibration Therapy.

I’m sure I’ve heard that coprophagia where the young consume the waste of adults, typically the mother, is observed in many species, typically herbivores. Unfortunately, interest in the current topic appears to have drowned out google on the matter.

So Dr. Heiter was on to something.

I’m sure I’ve heard that coprophagia where the young consume the waste of adults, typically the mother, is observed in many species, typically herbivores. Unfortunately, interest in the current topic appears to have drowned out google on the matter.

Yes, my dogs are all crapivorous

Given the similarity of the microbiota of organisms living in close proximity (Me, my husband, my daughter and… our dog), I wonder if cross-species transplants might ever be considered: http://www.the-scientist.com/?artic[…]-Microbiota/ ;)

My wife is responsible for this limerick, but I share some of the blame.

There was a young man of our species

Who evolved remarkable fecies.

   He contracted C-diff

   And wondered what if

They gave him the fecies in piecies.

I thought that was a command: Fecal transplants – no joke!

Yes, people have different fecal phenotypes and some people make better fecal transplant donors than others, but research still needs to be done. Here’s what we know so far:

Bacterial Ecosystems Divide People Into 3 Groups, Scientists Say http://www.nytimes.com/2011/04/21/s[…]tml?_r=3&;

Fecal transplants are funny only to those who don’t need them. If you need or someone you care about is in need of a fecal transplant visit thepowerofpoop.com

MaskedQuoll said:

and after a fecal transplant you may find that your exhaust gases smell different.

There’s a new refinement of the basic technique to address that: Fecal Aroma Recalibration Therapy.

I am a little ashamed to say I lol’d at that one. Please don’t not think less of me :)

Oh crap, proofreading is on my list of things to do…

I read that when one enters the hospital for the transplant, they require you to bring your own blender to homogenize the donor material, and then won’t let you take the blender home.

I read that when one enters the hospital for the transplant, they require you to bring your own blender to homogenize the donor material, and then won’t let you take the blender home.

Just think of what sort of sterilization procedures that would be needed to make the thing safe to take home after that…

Henry

Shelldigger said:

Oh crap…

Heh!

Oh crap

Not on the carpet!

I think one’s attitude about fecal transplants depends on whether you think of yourself as the donor or the donee.

There’s an article in the Guardian today about another potential use for fecal transplants: fighting obesity.

Link

What I’m wondering, however, is why it has to involve “icky” transplants? Why not just extract and culture the microbes you want and implant them directly, and reduce the risk of transferring detrimental ones? Is it simply cost or convenience, or are there other benefits that outweigh the risks and the revulsion factor?

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This page contains a single entry by Matt Young published on August 31, 2013 5:10 PM.

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