idea It might sound unpleasant to have someone else’s poo transplanted into your colon, but it’s understandable. Feces are a smelly mixture of water, undigested food, dead and live bacteria, and other cells and substances. However, the live bacteria in feces have demonstrated their value in the treatment of digestive tract disorders and diseases. That’s why doctors have been transferring stool from healthy donors to patients for years—usually through colonoscopies, enemas, or pills—to restore gut health.
The concept is relatively simple: If the recipient’s microbiome is out of balance, beneficial bacteria from donated stool will colonize the patient’s gut and outcompete any trouble-causing bacteria.For example, healthy fecal bacteria can be used to treat infections Clostridium difficile Bacteria that can infect the human colon and cause mild to life-threatening diarrhea. In clinical trials, fecal microbiota transplantation was estimated to be more than 90% efficient in clearing C. difficile infections.Just last month, researchers in Norway wrote in the journal Gastroenterology People with irritable bowel syndrome (IBS) have fewer symptoms of bloating, stomach cramps, and constipation after receiving a fecal transplant—even three years after receiving a fecal transplant.
David Ong, a gastroenterologist at Mount Elizabeth Hospital in Singapore, sees greater potential for these treatments because gut microbes interact with our brains and other organs. Ong, who became the first doctor in Singapore to perform fecal transplants on patients infected with C. difficile in 2014, said recent research suggests the intervention could also help people with inflammatory bowel disease or obesity, or those with Problems associated with picky eating in people with gut autism. There are currently more than 100 clinical trials investigating the effects of fecal transplants on conditions ranging from depression to epilepsy and Covid-19 to cancer.
“Genes are what you’re born with, that’s what it is,” Ong said. “But the gut microbiome is something you can manipulate. It would be great if you could get a good result in terms of disease.”
Finding the right poop is a small matter, though. In addition to working as a gastroenterologist, Ong co-founded the startup Amili, which has collected more than 1,000 stool samples for transplants over the past three years. However, most voluntary donors were excluded after filling out questionnaires and having stool, blood and saliva tests performed in the laboratory.
Lifestyle, diet, medical history — including the use of antibiotics that can kill gut bacteria — and how a person was born can all rule out people. (Newborns delivered vaginally acquired their first gut bacteria from their mothers when they passed through the vaginal tube and showed greater microbial diversity than those delivered by caesarean section.) In the Norwegian trial, used to treat Stool samples for 87 patients with IBS from a donor: a 36-year-old male who gave birth naturally; breastfeeding; not smoking; receiving only a few antibiotic treatments; exercising regularly; and consuming high amounts of protein, fiber, minerals, and vitamins . Generally, once the donor is deemed healthy enough, a laboratory technician will examine their stool sample. Technicians are looking for different microbiomes, especially bacteria known to compete with harmful bacteria.