12 ms·

Why DIY fecal transplants are a thing

149 points by ca98am79 13y ago

Zigurd 13y ago
FTA: "Fecal matter occupied a gray area..."
- fencepost 13y ago
  Clearly a plumbing misconnection. Gray water is sinks, tubs, etc.
ca98am79 13y ago
My wife has ulcerative colitis and it always surprises/annoys me when I ask the doctor about fecal transplants and they bring up the "ick" factor - how they think it is disgusting. They usually say something like "you really want someone else's poop in you?" At this point our only other option is for my wife to be cut open and have her intestines removed - which I find much more horrifying and risky, but they mention it as if it is just the normal thing to do.
- e40 13y ago
  Were I in your shoes, I'd go the DIY route and try our a FMT from you to your wife. The downside doesn't seem nearly as bad as surgery.
  - babby 13y ago
    Id imagine one would want to analyze the matter to decern that its composition is conducive with the transplantee, though perhaps thats not strictly necessary.
    - ca98am79 13y ago
      The human body carries about 100 trillion microorganisms in its intestines (10x the number of cells in the entire human body), so little is known about it and our complex relationship with it. Further, we are not even sure if or in what way ulcerative colitis is related to our gut bacteria. So there isn't a way to tell if someone's stool is conducive. The best you can do is test it for disease or parasites.
- npsimons 13y ago
  Yeah, I initially had the "ick" reaction, but was then quickly annoyed that the article seems to have the "ick" tone throughout. There are already many things in medicine which have an "ick" factor, and many of them we just take for granted because we're used to it.
- AlisdairO 13y ago
  I know it's relatively early-stage research as yet, but have you come across Helminthic Therapy? I believe that's had some promising initial results for UC patients. Obviously not the sort of thing many people would want to consider before the intestine-removal stage, but at that point it might be worth looking into.
  - btilly 13y ago
    Actually not that early-stage research. Just stalled by the FDA that decided it is a medical treatment and needs approval. The FDA approval process usually costs about $150 million, and there is no way to recoup it for anything not patentable. Hence research in this area died because it is not getting through the FDA process. How many other cheap treatments are not available for the same reason?
  - tocomment 13y ago
    I couldn't find much information about the treatment details. Do you know if anyone has looked into sterilizing the worms? It seems like the only downside is worrying about the worms reproducing. If you could make them sterile before applying them, and then just take new ones every month or so.
    - refurb 13y ago
      They don't need to sterilize the worms, they just use worms that can't reproduce in humans (i.e. pig whipworms) I'm keeping an eye out for the trial results. If it works, it would greatly expand our understanding of immune diseases. http://biotechtranslated.com/2011/07/30/the-hygiene-hypothesis-goes-on-trial/ http://biotechtranslated.com/2011/07/30/the-hygiene-hypothes...
      - tocomment 13y ago
        I didn't realize that. That's pretty smart. Do you know if you still get weight loss with pig whipworms? I've always thought worms would be preferable to surgery for obesity too.
- jpdoctor 13y ago
  > but they mention it as if it is just the normal thing to do. As usual, you need to evaluate your doctors' incentives. Do they make more money from 1. Cutting your wife open, with all the associated hospital care or 2. Fecal transplant, for which their competition is free DIY? As Upton Sinclair said a long time ago: It is difficult to get a man to understand something, when his salary depends upon his not understanding it. Edit: BTW, I wish you luck with your situation. I gained familiarity because my wife had recurrent c-diff. During this episode, I saw such non-scientific quack-like behavior that I pretty much lost faith in most of the modern Medical Industrial Complex. And this was for a bacterial infection, for which the literature is accessible to anyone with a high-degree of education and a decent biology background. The takeaway lessons from our episode was: Take matters into your own hands as much as possible. You have 24 hours a day to work on your problems, the doctor has about 20 minutes. So if you're not an expert on your particular situation, then you're pretty well screwed.
  - ca98am79 13y ago
    Thank you - yes, I agree. Not sure if this is completely relevant, but I found it very interesting: http://www.radiolab.org/blogs/radiolab-blog/2013/jan/15/bitter-end/ http://www.radiolab.org/blogs/radiolab-blog/2013/jan/15/bitt...
  - usefulcat 13y ago
    > As usual, you need to evaluate your doctors' incentives. I would question their background even more. Think about how they were trained, and think about what are likely to be considered "best practices" in the medical field. Doctors tend to err on the side of caution (and usually with good reason). From that viewpoint, it's not surprising that something relatively new and seemingly radical is not likely to be recommended.
  - Osmium 13y ago
    > As Upton Sinclair said a long time ago: It is difficult to get a man to understand something, when his salary depends upon his not understanding it. Incidentally, this is one of the many benefits of services like the NHS. Our doctors aren't thinking about their profit margins!
- DanBC 13y ago
  But with medical fecal transplants there's very little ick factor. Wikipedia has a nice article describing the process. (https://en.wikipedia.org/wiki/Fecal_bacteriotherapy https://en.wikipedia.org/wiki/Fecal_bacteriotherapy) It must be very frustrating for you. Good luck.
  - ca98am79 13y ago
    Thank you. Yes, to me, it seems a lot less "icky" (and more natural) than taking chemotherapy drugs, or biologics via IV, or surgical removal of the large intestine - but these treatments are the norm.
  - jpdoctor 13y ago
    > But with medical fecal transplants there's very little ick factor. I find the ick factor thing absurd. Again, Which is more likely? 1. An MD, who has been through anatomy lab which cuts off every part of the human body (ever cut off someone's face? Turns out that it is fascinating...), working long hours smelling formaldehyde over a dead body, and realizes that it's been a long time since the last meal so would like to step out for a bite to eat, thinks a fecal transplant is icky or 2. S/He won't make money. I'm gonna go with Occam on this one.
    - Fomite 13y ago
      Except since this isn't a standard procedure, they can charge whatever they please for the testing and prep - why do you think a doctor won't make money with fecal transplants? You seem to be asserting this with absolutely no evidence.
      - wtbob 13y ago
        > Except since this isn't a standard procedure, they can charge whatever they please for the testing and prep - why do you think a doctor won't make money with fecal transplants? Is he allowed to, either by law or his malpractice insurance?
        13y ago
- 7952 13y ago
  Its not like you are putting something dirt into a place that was otherwise clean. The contents of my intestine are always icky, but it might as well be functional ick.
- wiggins37 13y ago
  I might chime in as an internal medicine resident that fecal transplantation is relatively new, and most doctors still only think of it being used for recurrent c diff (clostridium difficile) infections (which is a very bad diarrheal infection that is associated with antibiotic use and just being in the hospital). It sounds like you are doing a good job bringing this up and questioning why your doctors are choosing certain therapies for your wife. There's more and more data coming out on using fecal transplants in Ulceratic Colitis (UC) patients and for the most part it seems well tolerated (there is one case report I just saw of someone getting a fecal transplant for c diff and then having a flare of their UC after it was in remission for 30 years). Keep pushing and when they say no ask them why they don't think this is appropriate to try rather than the risks of surgery. It sounds like you've already done research online about this and are well informed. If her doctors aren't open to trying this (or can't because their hospital doesn't have experience doing this) I'm sure they would be able to refer you guys to someplace that would try it. Of course, there's the whole insurance issues of covering this (new and still experimental) which I won't get into but maybe there is a research study you can join.
- cheald 13y ago
  This is tongue-in-cheek, but find a doctor who has kids. Once you become a parent, poop becomes Just Another Thing. :)
  - vidarh 13y ago
    We celebrated the 150th diaper changed when our son was two weeks. We know it was 150, as we got a 150-pack of nappy sacks, and it was empty two weeks in. Bought a cake and everything...
nicholassmith 13y ago
I understand medical regulations are in general a good thing, but if a treatment works why not let people push it as much as possible? If doctors (note, preferably doctors who don't stand to make money from it being a roaring success) are confident that there's an inherent level of safety, and a patient is willing to accept there's an inherent level of risk, why not just let them get on with it? Like the article says, it'll just go underground and there's less to be gleaned through studying.
- roc 13y ago
  I'm guessing because doctors aren't confident that there's an inherent level of safety. [1] Some are optimistic, some less so. But the way they and the FDA generally come to conclusions on these things, is through trials. Trials which have to be properly constructed and conducted to gather meaningful data. Throwing the doors open isn't going to give you very good data. So we wouldn't be gaining anything we could rely on for study. We'd just be enabling DIY-ers to get (for-profit) professional assistance. Which is its own cause for concern. These trials can certainly be better constructed, or made larger or more inclusive in such circumstances (many people facing very major surgeries that might be unnecessary should this approach pan out for their particular affliction; and shockingly-high success rates in early trials). But I don't think there's a better alternative; most of the proposals would just open the doors to all sorts of chicanery that we've spent generations weeding out of the health care industry. [1] It's taken us this long to figure out the importance of gut flora in the first place. And we still have little-to-no idea how it works. So how in the world could someone feel objectively confident they know what is or is not a 'safe' treatment for it? Particularly when you consider the research that this flora impacts brain function as well. A transplant might treat a gut affliction but inflict an equally (or more) serious mood disorder.
- triplesec 13y ago
  Many doctors are as behind the times as the rest of us, as the 'ick' anecdotes here demonstrate
rdl 13y ago
Speaking of DIY and feces, ubiome.com is essentially 23andme for your intestinal flora. It's kind of interesting, although I haven't done it yet (they had a kickstarter that I missed out on).
- ca98am79 13y ago
  yeah - I got this for my wife with the kickstarter. It is supposedly shipping in June (was supposed to be in May)
- gwillen 13y ago
  They are now taking orders through their website.
  - ableal 13y ago
    Clicky: http://ubiome.com/shop/ http://ubiome.com/shop/
- blacksmith_tb 13y ago
  Also American Gut, who did their crowdfunding via Indiegogo. I am waiting for some self-knowledge from them... lead times are months out, though.
swombat 13y ago
I have to do this. It's a once-in-a-lifetime opportunity. ))<>(( (http://www.youtube.com/watch?v=KQoJo81lujk http://www.youtube.com/watch?v=KQoJo81lujk)
strebler 13y ago
What about probiotics for ulcerative colitis? A brief scholar search shows some tentative promise: http://www.nature.com/ajg/journal/v104/n2/abs/ajg2008118a.html http://www.nature.com/ajg/journal/v104/n2/abs/ajg2008118a.ht... http://www.nature.com/ajg/journal/v100/n7/abs/ajg2005272a.html http://www.nature.com/ajg/journal/v100/n7/abs/ajg2005272a.ht... May only help for the more mild cases, but I know a number of people who speak very highly of probiotics for various digestive tract issues.
- ca98am79 13y ago
  Thanks - I've looked into this and my wife has tried it, but it doesn't work for her, at least. I haven't heard much success from others with UC, either.
  - jpmc 13y ago
    As one with UC I can say that this helped me: http://shop.vsl3.com/vsl3-ds-20-pack---prescription-only-p17.aspx http://shop.vsl3.com/vsl3-ds-20-pack---prescription-only-p17... It is magnitudes more powerful than anything else you will find. Taking it stopped my flare and anytime I feel a flare coming on I take it. I had to push my DR into getting the script after fistfulls of Asacol HD and prednisone a day only slowed my flare down.
    - ca98am79 13y ago
      thanks!
  - strebler 13y ago
    That's too bad, I guess the simple things don't always work (especially with autoimmune problems). I hope your wife can find something that works!
    - ca98am79 13y ago
      thank you
marcosscriven 13y ago
This was the process I just went through: 1) Is this actually safe to click on in a public place? 2) What the heck is 'fecal transplant'? 3) Clicked it - oh my goodness, that's gross 4) Read it - wow, this is actually real, and it's amazing 5) Who thought of this, and who tried it first? 6) I'm never going to get a story on the front page of HN, if this is what I have to contend with...
DanBC 13y ago
Intestinal flora are complex. Here's a story about Akkermansia muciniphila (http://www.bbc.co.uk/news/health-22458428 http://www.bbc.co.uk/news/health-22458428) which appears to make it harder for people to become obese. Here's an article from Nature that shows mice can become more easily obese if you infect them with some, er, stuff, and that this is transmissible (http://www.nature.com/nature/journal/v444/n7122/abs/nature05414.html http://www.nature.com/nature/journal/v444/n7122/abs/nature05...) So you could be giving yourself stuff that would make it easier for you to become obese, or you could be giving yourself stuff that would make it easier for you to stay not-obese. And that's just these few bugs. There are a whole range of really quite unpleasant things you could be getting. Regulations are important. They're not to protect well informed people from making calm rational choices, although they do have that unfortunate effect sometimes. Regulations are to prevent cynical, or stupid, people from offering dangerous untested unproven "treatments" at great cost to desperate and ill people. It'd be great if there was a safe way to decouple these, allowing people to gamble with their own health if that's what they want to do, but protecting people from evil con-merchants.
- deleted 13y ago
  [deleted]
- EarthLaunch 13y ago
  If only there were some way that people could make choices for themselves. Perhaps in the future we can invent a political system where individuals have responsibility for their own fate. Then, well-informed people would be rightly be able to do as they thought best, and everyone else would learn to only take action with proper knowledge, making everyone better-informed. Until such a mystical system of rights can be invented, we're just going to have to keep forcing people to die and suffer from disease. Such a conundrum! It seems to be a problem that no HN threads have a solution for.
  - DanBC 13y ago
    > If only there were some way that people could make choices for themselves. People are fucking idiots and need to be protected from themselves. Don't you see the imbalance between a person dying of cancer, who may be easily persuaded to spend all their money on junk, and a multinational multi-billion dollar industry, which has been shown to hide adverse results, to manipulate research, to sell minimally effective medication for huge amounts of money, and to bribe doctors?
chuckcode 13y ago
Your microbiome is essentially another organ in your body. You have 10 times the number of bacteria cells as you do human cells (they are a lot smaller) and they weigh over 2 pounds. Problems with this microbiome have been associated with very important diseases including autism, malnutrition and heart attacks. The economist had a good semi-science summary back in August last year [1]. I would recommend being just as careful getting a fecal transplant as any other organ, it would be terrible to catch something you didn't want like hepatitis. It will likely be a while still until we understand the microbiome as the current sequencing methods only can sequence about ~1000 nucleotides at a time [2]. The strategy is to shred all the DNA into smaller pieces, sequence them and then try to assemble them back into the full genome. This is difficult to do in just single organisms and becomes very difficult when you're dealing with a soup of many different organisms in something like your gut. Hopefully we can make some good progress associating smaller chunks of sequence with phenotypes until we can sequence full chromosome lengths of dna. [1] http://www.economist.com/node/21560523 http://www.economist.com/node/21560523 [2] http://en.wikipedia.org/wiki/DNA_sequencing http://en.wikipedia.org/wiki/DNA_sequencing
crusso 13y ago
I prefer the name "transpoosion".
- marcosscriven 13y ago
  Gave me a puerile giggle, thanks!
- reinhardt 13y ago
  sPOOnfeeding
crohn1 13y ago
Have fecal transplants worked on anybody suffering from Crohn's disease? I have both Crohn's and UC and am running out of options and would really like to explore options for a fecal transplant. My doctor only does FT on patients who have C. Diff but not any others.
zwieback 13y ago
Less gross but also interesting is the earwax transplant anecdote contained in this article: http://www.newyorker.com/reporting/2012/10/22/121022fa_fact_specter?currentPage=all http://www.newyorker.com/reporting/2012/10/22/121022fa_fact_...
j1mmyb0b 13y ago
This is why we need 💩
anonymous 13y ago
If anyone wants to view the site without js, you can just right-click the overlay->inspect element and then right-click the noscript element->delete node.
s_baby 13y ago
Same reason why you should suck your kids pacifier if you have a healthy digestive system.
EvanAnderson 13y ago
The Scientific American podcast Science Talk had a very informative show on fecal transplants: http://www.scientificamerican.com/podcast/episode.cfm?id=fecal-transplants-the-straight-poop-12-01-31 http://www.scientificamerican.com/podcast/episode.cfm?id=fec...
Fomite 13y ago
The "ick factor" - which is pretty much reduced to a minimum if the donor stool is processed appropriately anyway - may not be long for the world. There has been at least one small scale study using synthetically derived donor samples - essentially taking someone's stool, figuring out what the hell is in it, and culturing accordingly. That may also solve one of the big burdens behind using fecal transplant as a common technique - while the procedure itself isn't too expensive (though its not trivial, getting microbes past your stomach acid in quantity is no small thing), testing donor stool is, because of the amount of things we could accidentally give you. Synthetic donor culture would have less of a problem with that.
swah 13y ago
Someone tell me in plain english: is the procedure to take fresh healthy poo and stick it in your anus?
- btilly 13y ago
  Yes, in the hope that the bacteria from that poo will spread and start doing the job that you need done from poo.
lisper 13y ago
Gives new meaning to the phrase, "Are you shittin' me?"
X4 13y ago
Sounds like there is a lot of Pootential in there! Which illnesses does it cure?

149 points by ca98am79 13y ago

Zigurd 13y ago

FTA: "Fecal matter occupied a gray area..."

fencepost 13y ago
Clearly a plumbing misconnection. Gray water is sinks, tubs, etc.

ca98am79 13y ago

My wife has ulcerative colitis and it always surprises/annoys me when I ask the doctor about fecal transplants and they bring up the "ick" factor - how they think it is disgusting. They usually say something like "you really want someone else's poop in you?" At this point our only other option is for my wife to be cut open and have her intestines removed - which I find much more horrifying and risky, but they mention it as if it is just the normal thing to do.

e40 13y ago
Were I in your shoes, I'd go the DIY route and try our a FMT from you to your wife. The downside doesn't seem nearly as bad as surgery.
- babby 13y ago
  Id imagine one would want to analyze the matter to decern that its composition is conducive with the transplantee, though perhaps thats not strictly necessary.
  - ca98am79 13y ago
    The human body carries about 100 trillion microorganisms in its intestines (10x the number of cells in the entire human body), so little is known about it and our complex relationship with it. Further, we are not even sure if or in what way ulcerative colitis is related to our gut bacteria. So there isn't a way to tell if someone's stool is conducive. The best you can do is test it for disease or parasites.
npsimons 13y ago
Yeah, I initially had the "ick" reaction, but was then quickly annoyed that the article seems to have the "ick" tone throughout. There are already many things in medicine which have an "ick" factor, and many of them we just take for granted because we're used to it.
AlisdairO 13y ago
I know it's relatively early-stage research as yet, but have you come across Helminthic Therapy? I believe that's had some promising initial results for UC patients. Obviously not the sort of thing many people would want to consider before the intestine-removal stage, but at that point it might be worth looking into.
- btilly 13y ago
  Actually not that early-stage research. Just stalled by the FDA that decided it is a medical treatment and needs approval. The FDA approval process usually costs about $150 million, and there is no way to recoup it for anything not patentable. Hence research in this area died because it is not getting through the FDA process. How many other cheap treatments are not available for the same reason?
- tocomment 13y ago
  I couldn't find much information about the treatment details. Do you know if anyone has looked into sterilizing the worms? It seems like the only downside is worrying about the worms reproducing. If you could make them sterile before applying them, and then just take new ones every month or so.
  - refurb 13y ago
    They don't need to sterilize the worms, they just use worms that can't reproduce in humans (i.e. pig whipworms) I'm keeping an eye out for the trial results. If it works, it would greatly expand our understanding of immune diseases. http://biotechtranslated.com/2011/07/30/the-hygiene-hypothesis-goes-on-trial/ http://biotechtranslated.com/2011/07/30/the-hygiene-hypothes...
    - tocomment 13y ago
      I didn't realize that. That's pretty smart. Do you know if you still get weight loss with pig whipworms? I've always thought worms would be preferable to surgery for obesity too.
jpdoctor 13y ago
> but they mention it as if it is just the normal thing to do. As usual, you need to evaluate your doctors' incentives. Do they make more money from 1. Cutting your wife open, with all the associated hospital care or 2. Fecal transplant, for which their competition is free DIY? As Upton Sinclair said a long time ago: It is difficult to get a man to understand something, when his salary depends upon his not understanding it. Edit: BTW, I wish you luck with your situation. I gained familiarity because my wife had recurrent c-diff. During this episode, I saw such non-scientific quack-like behavior that I pretty much lost faith in most of the modern Medical Industrial Complex. And this was for a bacterial infection, for which the literature is accessible to anyone with a high-degree of education and a decent biology background. The takeaway lessons from our episode was: Take matters into your own hands as much as possible. You have 24 hours a day to work on your problems, the doctor has about 20 minutes. So if you're not an expert on your particular situation, then you're pretty well screwed.
- ca98am79 13y ago
  Thank you - yes, I agree. Not sure if this is completely relevant, but I found it very interesting: http://www.radiolab.org/blogs/radiolab-blog/2013/jan/15/bitter-end/ http://www.radiolab.org/blogs/radiolab-blog/2013/jan/15/bitt...
- usefulcat 13y ago
  > As usual, you need to evaluate your doctors' incentives. I would question their background even more. Think about how they were trained, and think about what are likely to be considered "best practices" in the medical field. Doctors tend to err on the side of caution (and usually with good reason). From that viewpoint, it's not surprising that something relatively new and seemingly radical is not likely to be recommended.
- Osmium 13y ago
  > As Upton Sinclair said a long time ago: It is difficult to get a man to understand something, when his salary depends upon his not understanding it. Incidentally, this is one of the many benefits of services like the NHS. Our doctors aren't thinking about their profit margins!
DanBC 13y ago
But with medical fecal transplants there's very little ick factor. Wikipedia has a nice article describing the process. (https://en.wikipedia.org/wiki/Fecal_bacteriotherapy https://en.wikipedia.org/wiki/Fecal_bacteriotherapy) It must be very frustrating for you. Good luck.
- ca98am79 13y ago
  Thank you. Yes, to me, it seems a lot less "icky" (and more natural) than taking chemotherapy drugs, or biologics via IV, or surgical removal of the large intestine - but these treatments are the norm.
- jpdoctor 13y ago
  > But with medical fecal transplants there's very little ick factor. I find the ick factor thing absurd. Again, Which is more likely? 1. An MD, who has been through anatomy lab which cuts off every part of the human body (ever cut off someone's face? Turns out that it is fascinating...), working long hours smelling formaldehyde over a dead body, and realizes that it's been a long time since the last meal so would like to step out for a bite to eat, thinks a fecal transplant is icky or 2. S/He won't make money. I'm gonna go with Occam on this one.
  - Fomite 13y ago
    Except since this isn't a standard procedure, they can charge whatever they please for the testing and prep - why do you think a doctor won't make money with fecal transplants? You seem to be asserting this with absolutely no evidence.
    - wtbob 13y ago
      > Except since this isn't a standard procedure, they can charge whatever they please for the testing and prep - why do you think a doctor won't make money with fecal transplants? Is he allowed to, either by law or his malpractice insurance?
      - 13y ago
7952 13y ago
Its not like you are putting something dirt into a place that was otherwise clean. The contents of my intestine are always icky, but it might as well be functional ick.
wiggins37 13y ago
I might chime in as an internal medicine resident that fecal transplantation is relatively new, and most doctors still only think of it being used for recurrent c diff (clostridium difficile) infections (which is a very bad diarrheal infection that is associated with antibiotic use and just being in the hospital). It sounds like you are doing a good job bringing this up and questioning why your doctors are choosing certain therapies for your wife. There's more and more data coming out on using fecal transplants in Ulceratic Colitis (UC) patients and for the most part it seems well tolerated (there is one case report I just saw of someone getting a fecal transplant for c diff and then having a flare of their UC after it was in remission for 30 years). Keep pushing and when they say no ask them why they don't think this is appropriate to try rather than the risks of surgery. It sounds like you've already done research online about this and are well informed. If her doctors aren't open to trying this (or can't because their hospital doesn't have experience doing this) I'm sure they would be able to refer you guys to someplace that would try it. Of course, there's the whole insurance issues of covering this (new and still experimental) which I won't get into but maybe there is a research study you can join.
cheald 13y ago
This is tongue-in-cheek, but find a doctor who has kids. Once you become a parent, poop becomes Just Another Thing. :)
- vidarh 13y ago
  We celebrated the 150th diaper changed when our son was two weeks. We know it was 150, as we got a 150-pack of nappy sacks, and it was empty two weeks in. Bought a cake and everything...

nicholassmith 13y ago

I understand medical regulations are in general a good thing, but if a treatment works why not let people push it as much as possible? If doctors (note, preferably doctors who don't stand to make money from it being a roaring success) are confident that there's an inherent level of safety, and a patient is willing to accept there's an inherent level of risk, why not just let them get on with it? Like the article says, it'll just go underground and there's less to be gleaned through studying.

roc 13y ago
I'm guessing because doctors aren't confident that there's an inherent level of safety. [1] Some are optimistic, some less so. But the way they and the FDA generally come to conclusions on these things, is through trials. Trials which have to be properly constructed and conducted to gather meaningful data. Throwing the doors open isn't going to give you very good data. So we wouldn't be gaining anything we could rely on for study. We'd just be enabling DIY-ers to get (for-profit) professional assistance. Which is its own cause for concern. These trials can certainly be better constructed, or made larger or more inclusive in such circumstances (many people facing very major surgeries that might be unnecessary should this approach pan out for their particular affliction; and shockingly-high success rates in early trials). But I don't think there's a better alternative; most of the proposals would just open the doors to all sorts of chicanery that we've spent generations weeding out of the health care industry. [1] It's taken us this long to figure out the importance of gut flora in the first place. And we still have little-to-no idea how it works. So how in the world could someone feel objectively confident they know what is or is not a 'safe' treatment for it? Particularly when you consider the research that this flora impacts brain function as well. A transplant might treat a gut affliction but inflict an equally (or more) serious mood disorder.
triplesec 13y ago
Many doctors are as behind the times as the rest of us, as the 'ick' anecdotes here demonstrate

rdl 13y ago

Speaking of DIY and feces, ubiome.com is essentially 23andme for your intestinal flora. It's kind of interesting, although I haven't done it yet (they had a kickstarter that I missed out on).

ca98am79 13y ago
yeah - I got this for my wife with the kickstarter. It is supposedly shipping in June (was supposed to be in May)
gwillen 13y ago
They are now taking orders through their website.
- ableal 13y ago
  Clicky: http://ubiome.com/shop/ http://ubiome.com/shop/
blacksmith_tb 13y ago
Also American Gut, who did their crowdfunding via Indiegogo. I am waiting for some self-knowledge from them... lead times are months out, though.

swombat 13y ago

I have to do this. It's a once-in-a-lifetime opportunity. ))<>(( (http://www.youtube.com/watch?v=KQoJo81lujk http://www.youtube.com/watch?v=KQoJo81lujk)

strebler 13y ago

What about probiotics for ulcerative colitis? A brief scholar search shows some tentative promise: http://www.nature.com/ajg/journal/v104/n2/abs/ajg2008118a.html http://www.nature.com/ajg/journal/v104/n2/abs/ajg2008118a.ht... http://www.nature.com/ajg/journal/v100/n7/abs/ajg2005272a.html http://www.nature.com/ajg/journal/v100/n7/abs/ajg2005272a.ht... May only help for the more mild cases, but I know a number of people who speak very highly of probiotics for various digestive tract issues.

ca98am79 13y ago
Thanks - I've looked into this and my wife has tried it, but it doesn't work for her, at least. I haven't heard much success from others with UC, either.
- jpmc 13y ago
  As one with UC I can say that this helped me: http://shop.vsl3.com/vsl3-ds-20-pack---prescription-only-p17.aspx http://shop.vsl3.com/vsl3-ds-20-pack---prescription-only-p17... It is magnitudes more powerful than anything else you will find. Taking it stopped my flare and anytime I feel a flare coming on I take it. I had to push my DR into getting the script after fistfulls of Asacol HD and prednisone a day only slowed my flare down.
  - ca98am79 13y ago
    thanks!
- strebler 13y ago
  That's too bad, I guess the simple things don't always work (especially with autoimmune problems). I hope your wife can find something that works!
  - ca98am79 13y ago
    thank you

marcosscriven 13y ago

This was the process I just went through: 1) Is this actually safe to click on in a public place? 2) What the heck is 'fecal transplant'? 3) Clicked it - oh my goodness, that's gross 4) Read it - wow, this is actually real, and it's amazing 5) Who thought of this, and who tried it first? 6) I'm never going to get a story on the front page of HN, if this is what I have to contend with...

DanBC 13y ago

Intestinal flora are complex. Here's a story about Akkermansia muciniphila (http://www.bbc.co.uk/news/health-22458428 http://www.bbc.co.uk/news/health-22458428) which appears to make it harder for people to become obese. Here's an article from Nature that shows mice can become more easily obese if you infect them with some, er, stuff, and that this is transmissible (http://www.nature.com/nature/journal/v444/n7122/abs/nature05414.html http://www.nature.com/nature/journal/v444/n7122/abs/nature05...) So you could be giving yourself stuff that would make it easier for you to become obese, or you could be giving yourself stuff that would make it easier for you to stay not-obese. And that's just these few bugs. There are a whole range of really quite unpleasant things you could be getting. Regulations are important. They're not to protect well informed people from making calm rational choices, although they do have that unfortunate effect sometimes. Regulations are to prevent cynical, or stupid, people from offering dangerous untested unproven "treatments" at great cost to desperate and ill people. It'd be great if there was a safe way to decouple these, allowing people to gamble with their own health if that's what they want to do, but protecting people from evil con-merchants.

deleted 13y ago
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EarthLaunch 13y ago
If only there were some way that people could make choices for themselves. Perhaps in the future we can invent a political system where individuals have responsibility for their own fate. Then, well-informed people would be rightly be able to do as they thought best, and everyone else would learn to only take action with proper knowledge, making everyone better-informed. Until such a mystical system of rights can be invented, we're just going to have to keep forcing people to die and suffer from disease. Such a conundrum! It seems to be a problem that no HN threads have a solution for.
- DanBC 13y ago
  > If only there were some way that people could make choices for themselves. People are fucking idiots and need to be protected from themselves. Don't you see the imbalance between a person dying of cancer, who may be easily persuaded to spend all their money on junk, and a multinational multi-billion dollar industry, which has been shown to hide adverse results, to manipulate research, to sell minimally effective medication for huge amounts of money, and to bribe doctors?

chuckcode 13y ago

Your microbiome is essentially another organ in your body. You have 10 times the number of bacteria cells as you do human cells (they are a lot smaller) and they weigh over 2 pounds. Problems with this microbiome have been associated with very important diseases including autism, malnutrition and heart attacks. The economist had a good semi-science summary back in August last year [1]. I would recommend being just as careful getting a fecal transplant as any other organ, it would be terrible to catch something you didn't want like hepatitis. It will likely be a while still until we understand the microbiome as the current sequencing methods only can sequence about ~1000 nucleotides at a time [2]. The strategy is to shred all the DNA into smaller pieces, sequence them and then try to assemble them back into the full genome. This is difficult to do in just single organisms and becomes very difficult when you're dealing with a soup of many different organisms in something like your gut. Hopefully we can make some good progress associating smaller chunks of sequence with phenotypes until we can sequence full chromosome lengths of dna. [1] http://www.economist.com/node/21560523 http://www.economist.com/node/21560523 [2] http://en.wikipedia.org/wiki/DNA_sequencing http://en.wikipedia.org/wiki/DNA_sequencing

crusso 13y ago

I prefer the name "transpoosion".

marcosscriven 13y ago
Gave me a puerile giggle, thanks!
reinhardt 13y ago
sPOOnfeeding

crohn1 13y ago

Have fecal transplants worked on anybody suffering from Crohn's disease? I have both Crohn's and UC and am running out of options and would really like to explore options for a fecal transplant. My doctor only does FT on patients who have C. Diff but not any others.

zwieback 13y ago

Less gross but also interesting is the earwax transplant anecdote contained in this article: http://www.newyorker.com/reporting/2012/10/22/121022fa_fact_specter?currentPage=all http://www.newyorker.com/reporting/2012/10/22/121022fa_fact_...

j1mmyb0b 13y ago

This is why we need 💩

anonymous 13y ago

If anyone wants to view the site without js, you can just right-click the overlay->inspect element and then right-click the noscript element->delete node.

s_baby 13y ago

Same reason why you should suck your kids pacifier if you have a healthy digestive system.

EvanAnderson 13y ago

The Scientific American podcast Science Talk had a very informative show on fecal transplants: http://www.scientificamerican.com/podcast/episode.cfm?id=fecal-transplants-the-straight-poop-12-01-31 http://www.scientificamerican.com/podcast/episode.cfm?id=fec...

Fomite 13y ago

The "ick factor" - which is pretty much reduced to a minimum if the donor stool is processed appropriately anyway - may not be long for the world. There has been at least one small scale study using synthetically derived donor samples - essentially taking someone's stool, figuring out what the hell is in it, and culturing accordingly. That may also solve one of the big burdens behind using fecal transplant as a common technique - while the procedure itself isn't too expensive (though its not trivial, getting microbes past your stomach acid in quantity is no small thing), testing donor stool is, because of the amount of things we could accidentally give you. Synthetic donor culture would have less of a problem with that.

swah 13y ago

Someone tell me in plain english: is the procedure to take fresh healthy poo and stick it in your anus?

btilly 13y ago
Yes, in the hope that the bacteria from that poo will spread and start doing the job that you need done from poo.

lisper 13y ago

Gives new meaning to the phrase, "Are you shittin' me?"

X4 13y ago

Sounds like there is a lot of Pootential in there! Which illnesses does it cure?