Before we talk about poop transfers, you first need to know a bit about the microbiome. The microbiome is the collection of organisms like viruses and bacteria that live inside the human body (Gilbert et al. 2018). That’s right. Your body is a zoo, full of viruses and bacteria. But they are good for you! Those microbes are known as commensal because they share a relationship with the host that is mutually beneficial. The word comes from Latin, and it means ‘sharing the same table’ (Bogitsh, Carter and Oeltmann, 2012). You can thank viruses that got into our bodies many, many, many years ago because their viral remnants are responsible for placenta formation during pregnancy (Black et al., 2010), and even the process of constructing memories (Pastuzyn et al., 2018)! Bacteria, the focus of this article, are also responsible for many good things in our body. The collection of all bacteria species found in our gut is also known as the microbiota. For starters, our microbiota provides us with our daily dosage of biotin, vitamin B12, folic acid and thiamine – essentially acting as a vitamin supplier. Furthermore, the bacteria of the microbiota can also digest dietary fiber the body is unable to digest (LeBlanc et al., 2013). The reason you feel bloated or fart from eating beans is simply because your friendly neighbourhood bacteria are busy gorging themselves with the beans you’ve given them, expelling smelly methane in the process (Huffpost). Imbalances of the microbiota can be troublesome. They can lead to vitamin deficiencies and even intestinal problems. This is why we typically might have fermented foods such as yogurt or kimchi that contain commensal bacteria to restore our microbiota levels (LeBlanc et al., 2013).
You’ve probably been recommended yogurt after a regiment of antibiotics has been prescribed by your doctor. You see, most antibiotics do not specifically target one single type of bacteria, but might target a common element present in many bacteria (University of Utah). This means that some bacteria in your gut will also be affected, despite being good for you. Sometimes, after using antibiotics, we might get diarrhea (Everyday Health). This can happen sometimes because a bacterial pathogen, also termed as opportunistic, takes advantage of the ‘empty’ gut and begins spreading. Under normal conditions, bacteria use a mechanism called ‘quorum sensing’ that allows them to send out and take in signals from the environment around them to gauge things like appropriate salt concentration, or pH, to adapt in real time to their surroundings (Miller, 2001; McKenney and Kendall, 2016). Sometimes, these signals can be used to tell neighbouring bacteria to not trespass, or to limit the available nutrients to prevent the spread of pathogenic bacteria. When there are not that many bacteria, opportunistic pathogens are not warned off and are free to wreak havoc in the gut. This is what happens to many people that acquire opportunistic Clostridium difficile infections in hospitals. People suffering from C. difficile infection will feel nauseous and experience constant bouts of diarrhea, which can be potentially fatal (Glauser, 2011).
Unfortunately, people who contract C. difficile are typically not responsive to treatment, as this pathogen can quickly become resistant to antibiotics (University of Utah). However, positive outcomes have been reported from studies where patients’ microbiota has been restored through an unusual method known as a fecal transplant or fecal bacteriotherapy (Glauser, 2011). Fecal transplants are not a foreign medical treatment. In fact, as far as the 4th century, diluted feces were used to treat diarrhea in humans. And, during World War II, German soldiers suffering from dysentery learned from the Bedouins that camel feces were a common cure for diarrhea (Robertson, 2015). However, the current opinion is that most studies are anecdotal, meaning results from only one patient and with different conditions, making these studies difficult to compare. In addition, a large study had not been conducted until recently to assess the effects of this procedure. As a result, hospitals do not typically offer the method to patients. In Canada, doctors conduct the procedure at their own discretion. One doctor from Alberta visits patients in their home and delivers the transplant via enemas after carefully testing the donor’s sample for non-commensal microbes. The same doctor has found that the best samples are typically from relatives because patients recover faster than if the donor was not related to them (Glauser, 2011). Research on this procedure would seriously benefit patients that do not respond well to C. difficile treatment. And there you go! A brief history on poop transfers, which might sound unconventional to you, but could save lives.
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