How to perfome a fecal microbiota transplant (that’s poo donation to you)
WOULD you give a friend or loved one some of your bone marrows. What about a kidney? An eye? what about, erm, donating your poo? Marie Myung-Ok Lee did. In the New York Times, Lee, tells us how her turds and, more vitaly, the beneficial bacteria in them, saved her friend’s life.
How did she do the donating? At home.
We’ve distilled some of the highlights from Lee’s casebook. This is how she helped Gene get over his ulcerative colitis, a colon riddled with bleeding ulcers:
The procedure is called fecal microbiota transplant, or F.M.T.
Transplanting the stool from one person into the digestive tract of another seems, well, repulsive, but it also makes sense. The majority of the matter in stool — roughly 60 percent — is bacteria, dead and alive, but mostly alive. While bacteria can make us sick, they also constitute a large part of who we are; the hundreds of trillions of cells in an individual’s microbiome, as this collective is known, outnumber human cells 10 to 1. The bacteria serve many functions, including in metabolism, hormone regulation and the immune system.
In the 16th century, during the Ming dynasty, fermented fecal concoctions, euphemistically named “yellow soup,” were used for digestive problems. In the 17th century, Christian Franz Paullini, a German physician, compiled a stool recipe book for treating dysentery and other digestive ailments.
The donor question was a tricky one. The donor has to be healthy (and will be screened, via stool and blood, for transmissible diseases like H.I.V., as well as for pathogens and parasites); has to avoid any foods the patient might be allergic to; and has to be nearby, as freshness is an issue: the bacteria mix may begin to change once the stool leaves the body.
Gene’s marching orders were to procure a dedicated blender and sieve, enema tubing and syringe, and lots and lots of newspaper. F.M.T. basically consists of blending stool with saline, straining it, and reintroducing it into the colon via enema.
Gene got better.
What about others?
Some patients have resorted to Craigslist. There is the possibility of creating synthetic stool, but given that there are thousands of unknown species of bacteria in human stool, there’s no way to know if it would be effective. In an ideal future, a universal screening panel will be put in place so that healthy people can donate their microbiota, the way you can with blood.
Maybe they’ll pay for good poo?