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Is Our Waste Really Just Waste?

          It’s 2:00pm on a Wednesday afternoon and you are on your sixth trip to the bathroom since waking up at 8:00am. You have had enough, as this has been happening day and night the entire week, and decide to make a visit to your doctor’s office for a checkup. While there, you explain that you have had excessive diarrhea for the past four days. Your doctor takes a stool sample and tells you to avoid any trigger foods you may have for the time being. Later in the week you hear that your stool was found to contain a bacteria known as Clostridium difficile.

          C. difficile, or C. diff, as it is commonly known, is a bacterial species that attacks the large intestine, causing inflammation known as colitis. It is most commonly acquired in a healthcare setting, where many patients have an already weakened immune system. This germ is highly infectious, with close to half a million infections in the United States in 2011. That year, 29,000 people that were infected died within 30 days of being diagnosed. That being said, cases vary in their severity. Common signs and symptoms of mild cases include frequent diarrhea and abdominal cramping. More severe cases can see rapid heart rate, fever, and nausea, with kidney failure occurring in extreme situations.

Clostridium difficile (CDC, 2015)
          Your physician tells you that your case is a more serious infection, but is treatable and that one relatively new method has been giving patients promising results. The treatment suggested is called a fecal microbial transplant (FMT). The doctor explains that this treatment will see you take “poop in a pill”, which contains the gut bacteria of a healthy person. At the word “fecal”, you immediately become uneasy about this treatment plan. Do they really expect you to put another person’s poop in your body? Why are you being given bacteria, when they’re the cause of this problem in the first place?

          FMT is a treatment method that has been around since the fourth century, but the first modern example was in 1958, when four people were given transplant by enema for Pseudomonas colitis, another gut infection. What ultimately occurs is that a patient receives an entire community of bacteria from the gut or waste of a healthy person. These newly introduced bacteria grow and multiply, which restores the health and function of your intestines. With your digestive tract back in full swing, your body is able to fight the harmful C. difficile and stop the infection. While historically given rectally or by a tube from your nose into your stomach, new methods of FMT include taking capsules of stool. While it may seem unorthodox, this method is less invasive and clinical trials at the University of Alberta showed a 90% success rate for reducing symptoms of C. diff. Similar results were observed in a study at Boston Children's Hospital, prompting further research of FMT in peanut allergies.

Frozen FMT capsules (EndoMune, 2014)


          Returning to the idea of “healthy bacteria”, there is a common misconception in our society that all bacteria are bad and cause disease. At this very moment, you have an almost equal amount of bacterial cells in and on your body as you have human cells. Current estimates are that for every 1 human cell, you have 1.3 bacterial cells. For a 20-30 year old man of 5'7" and 154 pounds, there are roughly 30 trillion human cells, with 39 trillion bacterial cells living among them. This may seem pretty unsettling, but many of these bacteria actually make our lives easier. There are countless bacteria on the surface of your skin that act as a protective barrier from disease by killing other harmful and infectious germs. In your digestive tract, bacteria assist in breaking down food. E. coli, which is also in your intestines, is known to produce vitamin K, which helps strengthen our bones and form scabs over broken skin. Probiotics, a category of nutritional supplement, are actually a pill form of healthy bacteria that help your digestive system and other areas. There are plenty of bacteria out there that are harmful to humans if they are given the chance to infect us, but many others help us to stay healthy.

          After having some time to think it over (and another bathroom trip), you decide to go ahead and receive the transplant. You are given 40 capsules to take over the next hour and are sent home, with instructions to come back if symptoms are not reduced in the next couple of weeks. Four months later, you find yourself healthy as ever and your stomach is back in check. You think back to how squeamish you were when you were first asked if you would consider an FMT. Had you turned it down, who knows how intensely C. diff would have infected you. As foreign an idea as it was to you, FMT was the treatment that restored you to good health.

To learn more about clinical trials being conducted for FMT and other cutting-edge treatments, visit clinicaltrials.gov

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