The brave new world of DIY faecal transplant
bbc.co.uk
bbc.co.uk
An interesting aside - as you may have read, FMT is being investigated as a treatment for autism. The thinking here is as follows. Babies are born with a certain level of Clostridium species (not necessarily C. diff). Clostridium are very good at producing toxins (botulism and the toxins involved in C.diff). Normally the level of clostridium in babies drops on its own. It's believed that in some babies, this drop never happens. These babies are then therefore continually exposed to toxins from these clostridium bugs, some of which may have neurotoxic properties and can result in autism. The goal of FMT is to alter the gut flora enough to get rid of these Clostridium species and stop the toxin from reaching the brain. There has been success in young children. What we need to keep in mind though is that autism is a spectrum of not only symptoms, but also a spectrum of causes as well, so FMT won't necessarily work for everyone.
It's well known that children with autism have frequent GI issues (diarrhea etc). You'll find that many parents have their autistic children on special diets (gluten free, dairy free etc) all of which attempt to alleviate the GI symptoms. They may work, but it's likely because they are changing the gut flora, rather than removing the gluten protein for example.
Babies get their intestinal bacteria during the birthing process from the vagina, their mother, the mother's feces, etc. That's why C-section infants have vastly different gut flora initially. They never made that trip down the vagina to be exposed to vaginal bacteria and are exposed to different types of bacteria during the first few weeks of life. I'm not sure the effect of antibiotics are the same or similar to that of a c-section baby. I'm not sure we know the long term effects of c-section babies and gut flora especially later in life. I would think c-section would be much more disturbing to gut flora than antibiotics.
http://en.wikipedia.org/wiki/Gut_flora#Acquisition_of_gut_fl...
http://www.autismtoday.com/library-back/Autism_More_Likely_i...
(Problems are food intolerances, some cause unusually painful gas, others affect my mind. My doctor has no idea what causes it, and some of them are to really common foods, so staying on my diet is difficult.)
Human feces hasn't been an area with much prestige (and money to be made), so few used to care about it. But, if I remember correctly, the growing interest has partly been caused by geneticists who were initially studying the genome of e.g. humans, but who switched target as the original work was done much quicker than anybody though was possible.
From what I know about the research so far, it seems like our bacterial flora, especially in the gut, is tightly connected to quite a few diseases. However, for many of them, it is still unclear what is cause and effect: Does the altered flora cause the disease, or does the disease cause the altered flora? External factors like stress is known to alter gut flora. On the other hand, bacteria in your gut may affect your mood and personality. Figuring out what is what is tricky, and I suppose there can be feedback loops here as well.
There is much more research to be done. You should be careful with experimenting, as there is risk involved: You may get bacteria that you don't want, and you don't know what the changed flora will do to you. An acquaintance of mine is a researcher in this field, and he does not recommend taking probiotics for e.g. IBS, as he think we still know too little about what types of bacteria to take, dosage, and potential negative long term effects. "Good" strains can do bad things in some contexts, and interaction/symbiosis between different strains (and us) may complicate things. That being said, afaik, probiotics is generally thought to be safe (although I am not sure all manufacturers are trustworthy).
Personally, I think this field has the potential to really change the way we think about health, disease, and medicine. Another field, which I think is related, is diet and fasting: food, and lack of food, alters our gut flora too.
Do you mean geneticist rather than genealogist?
An example of this is the report by Borody that three Parkinson's patients who had C. difficile infections treated using faecal transplant. The transplants cured the C difficile infection, but he noticed that their Parkinson's symptoms were significantly reduced. Changing the bacterial in the guts somehow had an effect on neurotransmitters in the brain.
If I was doing this I would put the faecal matter in a ziploc bag containing saline, expel all the air, close the bag and gently massage it to get the nice "soup". This would stay anaerobic and save my blender too :)
Microbiologist here - the name anaerobe is a pretty broad term. Within the gut there is going to be obligate anaerobes (killed by atmospheric O2) and facultative anaerobes (can survive in both oxygen rich and oxygen deplete environments).
In a blender, the obligates will likely die but the facultative will remain.
In a blender, the obligates will likely die but the facultative will remain.
The problem is that most of the organisms in the gut are obligate (strict) anerobes. Sure the faculatative anaerobes will survive, but this is going to create an imbalance in the populations being transplanted. If the aim is to restore tha balance present in a healthy individual why introduce oxygen when it is easy to avoid.
The other issue is that it would be very hard to get a fecal sample that hasn't been exposed to O2.
Interesting idea though. What happens if it goes wrong?
Actually the risk of getting worms is an interesting potential positive. There is a lot of data suggesting that the lack of intestinal worms in western countries is one of the reason for the rise of autoimmune diseases like Crohns. The theory is that the immune system in the gut is designed up to keep worms under control and in their absence starts attacking things like the gut tissue instead. There are a couple of stage three trial currently running that are giving people pig wipworms (they can infect but not reproduce in the human gut) to treat Crohns. The earlier trials were really encouraging so it will be interesting to see how they turn out.
But the more I discover about medicine and biology, the more I realize how much we still don't know. Hundreds of types of bacteria in a typical stool sample? This is amazing! Whole biomes await study... from internal gut bacteria (very small scale), to microbial colonies (regional or national scale) that we use for fermentation. Exciting!
Stool transplant, also known as a fecal transplant, is a unique therapy. At our hospital, we recommend stool transplants only if all else has failed. Specifically, if a patient has had recurrence of C. diff, even after pulse-tapered Vanco treatment, or multiple bouts of Vanco, Dificid or Flagyl, it’s time to consider a stool transplant.
The idea behind a stool transplant is to “reseed the lawn,” so to speak. After exposure to weeks or months of antibiotics (including Vanco) the normal bowel flora — the organisms in your colon that help prevent infection — is weakened. They simply can’t keep C. diff out. In other words, the normal barrier function of the colonic flora is gone, and C. diff gets right back in. So putting in some normal flora from a healthy donor is like reseeding the lawn — it restores the barrier.
The author was aware of the DIY movement, as well as the rise of holistic medical practitioners who are offering transplant treatments.
He also noted that transplants are still relatively rare. Not many PCPs know much about C diff and recommended treatments; patients usually are referred to specialists in gastrointestinal and infectious disease.
Is anyone making coated capsules to deliver flora further down the gut?
When the scope reaches the top part of the colon, the doctor injects through the scope a feces suspension prepared from a healthy donor, usually a family member or close friend. … The scope is slowly withdrawn. As it is withdrawn, and more fecal suspension is put in from the top to bottom of the colon.
Not sure of the answer to the second question.
But of course, a drop of water on your skin would be over 1E20 molecules of H2O, so it would be dead things:living things > 1E7 (give or take a few orders of magnitude)
http://freakonomics.com/2011/03/04/freakonomics-radio-the-po...