I know a few places in Europe where they are already doing fecal microbiome transplants on a daily basis. For example, Quadram Institute & NHS Norwich. They have had some adverse events, so it's not totally safe, but I think the benefits already outweigh the risks if it's having a significant impact on your quality of life.
New research avenues include, for example, doing a phage-only transplant. And obvious things like matching donors by HLA haplotypes. Both should improve safety.
Still, I understand progress is too slow for patients. Most research institutions are pretty bad at polishing, industrializing and translating basic theories into clinical benefits. They just like to churn out small papers. I have sometimes considered to spin off as a non-profit maybe to speed things up.
Theories are beginning to be understood quite well. It's mostly about cross-reactive bacterial epitopes and self antigens [1]. Plus metabolites. A very complex network, but some epitopes are central. For example, Ro60 in Lupus or insulin in T1D and their corresponding bacterial mimics. With sufficient data, we could easily throw in a personalized cocktail of phages that could halt many autoimmune disorders and tumors with high probability. That's the vision for the next 10 years, I think.
I spent thousands of dollars on trying out medications, tests, visiting a number of highly trained doctors etc, nothing came up in tests and at the end almost all doctors threw their hands up and categorized my gut issues as IBS which is just a catchAll term for which there is no specific treatment other than trying out a number of things.
There isn't any magic pill yet but until someone invents it I can tell you I've found great comfort following the FODMAP diet.
I've wasted ten horrible years until I discovered that Monash University diet.
Ten years of pain and expending.
Hoping it can help you as well https://www.monashfodmap.com/
Which is basically Cereals (what make beer) onions, garlic, and beans; Lactose; Fructose; and at least two of the "Sugar Alcohols".
As someone who had their gut biome wrecked by aggressive antibiotics, i was told i will probably have to take probiotics for the rest of my life, but i managed to track down two things that will 100% all the time cause pain - Garlic and Onions. I'm not entirely sure which is worse, but i'd wager garlic. For a long time i assumed it was certain types of oils, too.
Basically if you're adhering to this "Low FODMAP" diet, you're meandering between "slow carb", "atkins", and several other dietary restrictions.
That "fructose" one though, that's a doozy. There are tons of health ramifications to avoiding all of the stuff on the list, so if you suffer from intestinal stuff, it'd probably be best to experiment with each thing on the list (on the site) and see if it causes discomfort, how much, how long, etc.
To anyone wanting to learn about FODMAPs, Monash University blog (1) helps to understand this very complex topic.
Turns out every wheat product with the exception of sourdough wheat bread is high fodmap! I tried low fodmap and nearly instantly got a lot better. And I can now eat some fodmaps by reintroducing in lower amounts.
Highly recommend anyone with ibs try this. It is complicated but you can get free or cheap apps that let you search ingredients fast to figure out what to remove.
And the great part is the intolerance is quantity based. So, celery in a recipe? No problem. Just don’t eat a massive amount of it. Very much unlike any kind of hard avoidance plan.
This won’t solve all issues but give it an honest shot. Mine has moved from seriously debilitating to minor inconvenience.
Identifying the triggers, and keeping an eye on quantity are the keys for me. It isn't an easy process but it makes a world of difference as you say.
I have also slowly been introducing foods I have been avoiding back and so far I have been able to tolerate them well
About gluten, in my case I found out that it wasn't the problem but fructans.
You might be a well-meaning person, but you're hard to distinguish from a bot pushing a fad diet with online courses, a for-pay app, a shop, "find a dietician" services, certifications, etc. Preying on offering hope to the sick and desperate is common and people are cynical and wary of it, and even genuine well-meaning people are prone to sharing dubious alternative medicine suggestions which they honestly believe help but aren't proven to do anything more than the placebo effect. If you were a long-standing HN commentor, you'd probably get more benefit of the doubt; signing up as "fodmap" to link to an apparently for-profit fodmap service with an emotional message makes it easy to assume bad faith astroturfing at a glance - focused username, commercial link, fringe/alternative/woo treatment, claims of health cure for incurable condition, SEO style message ("As a fellow sufferer, believe me, I know, I've been there, trust me, just one easy credit card payment").
[I wrote this for your deleted comment;]
Obviously you should talk to your doctor before adopting the diet. It may not provide all of the nutrients that your body needs and its normally only recommended for 3 to ~6 months. Its may also not work well for some variants of IBS / IBD / other gut issues and may even be a detriment - so talk to your doctor.
Personally its been helpful for me. A lot of people also may not need to do fodmap and instead just do a elimination diet. For example you may not know it but may be suffering from lactose intolerance or gluten intolerance and so on. Probably easier to try that first as well.
Thank you for answering anyway. Your comment helps me to see why my post could be seen as not well intentioned.
Its a fairly new thing - from about 15 years back. Nowadays one of the treatments that a gastroenterologist could recommend if they have exhausted everything else is low dose anti-depressant.
Key is to identify what is causing stress and treat that
Also I’ve heard promising things about fecal transplants for biome restoration.