I imagine that, right now, the idea of a “fecal transplant” must sound ridiculous in the minds of many readers. The mere fact of imagining a transplant of “poop” from another person does not sound very scientific and, nevertheless, it is one of the methods that is being analyzed with more seriousness for the treatment of various pathologies. Many of you will be thinking that it is some new idea, too scatological, arising from improvisation, but in reality, it goes back centuries under other names. The first time that a similar treatment is described dates back to China in the fourth century AD and was known as “yellow soup”. It was a thick and unpleasant broth, made up of the dried or fermented feces of a healthy person, which the patient drank to treat diarrhea caused by food poisoning. Later, in 1958, an innovative surgeon, Dr. Ben Eiseman, administered fecal enemas to his patients in Denver, USA, to treat serious intestinal infections. That first medical experience obtained very positive results as soon as it had an impact and ended up being forgotten.
For my part, the first time I heard this strange idea of transplanting faeces from a healthy person to another sick person was a little over ten years ago, when we published a scientific article in Naukas that bore the resounding and forceful headline “poop transplant ”. Since then, the studies and trials have continued, the techniques have been improved and the treatment has ceased to be taboo to become a successful therapy, especially for infections caused by the bacteria. Clostridium difficile. In fact, the results obtained during all these years leave no room for doubt: fecal transplantation is more than 90% successful in treating patients with severe digestive infection.
How is a fecal transplant performed? Spoiler: It’s not nice.
I’m afraid it sounds a lot like what you’re thinking. To do this, we need to collect the feces from a healthy donor, who has not recently used antibiotics and who previously undergoes blood and feces tests to rule out infections. Once we have the donor poop, it is mixed with saline water and filtered. Here comes the most unpleasant part… that solution is introduced into the patient through a tube that goes into the stomach through the mouth or through a colonoscope that reaches the digestive tract. In recent years, different capsules and pills made from dried and frozen feces have also been developed.
But before we continue with this perplexing and unappetizing solution, let’s first start by understanding the problem: We are running out of effective antibiotics. A few years ago the World Health Organization itself, in an impressive study, warned that by the year 2050 there will be more deaths related to resistant superbugs than for cancer. In fact, the WHO estimates that, by that not so distant 2050, resistance to antibiotics will be the main cause of death on the planet.
Very successful results in a complicated bacterium
The C.difficile It is a species of bacteria that, under normal conditions, can form part of our intestinal microbiota in small quantities. However, if that balance is upset, for example when we take antibiotics, the bacteria become more numerous, proliferate and release a potent toxin that causes inflammation and bleeding in the lining of the colon. Explained in a simple way, we find ourselves before a curious paradox: How to act against a bacterium that becomes strong, grows and causes problems precisely because of taking antibiotics? We have some specific medications (anti-clostridials) that can help but, generally, the treatment that is usually carried out is to stop the antibiotics, with all that this decision entails.
This is where the fecal transplant solution comes in. Studies carried out show that it restores bile metabolism, that it compensates for intestinal imbalance and that it blocks the germination of C. difficile bacteria, in turn controlling the infectious disease. During the last decade, there have been remarkable success ratesin these cases and now researchers wonder if it could be applied to other pathologies.
Many possibilities to explore
The most recent example is that fecal microbiota transplants appear to be a promising treatment for irritable bowel syndrome with a point in favor that is more than interesting: your benefits extend for years. One study brought together a group of 125 patients with this syndrome who received fecal transplants of 30 and 60 grams of stool from a healthy donor, along with a control group who received transplants of their own stool. The researchers found that fecal transplants not only markedly improved symptoms, but the benefit extended up to three years after transplant.
Antibiotics have been one of the greatest medical advances in history, they have saved millions and millions of lives but they face a serious threat with the proliferation of resistant bacteria. As we work to develop a new generation of more effective antibiotics, we should also look at how other, less flashy treatments can help us. It sounds less elegant, it’s true, but many researchers suggest that you should start stool donor programs, with its mandatory controls and analysis, and explore the possibilities that receiving “poop” from another person can offer when our microbiota is in danger. Studies are becoming more numerous and diverse, which suggests that, once the cultural barriers and taboos of this treatment are overcome, fecal transplants will become more accepted.
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