Could a Poo Transplant Cure You?

We spend a lot of time making sure we're clean - scrubbing ourselves with harsh soaps, sanitizing our hands and environment with chemicals, and eliminating any trace of dirt from our homes and lives - but could our squeaky clean lifestyles be causing more harm than good?
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You might be recoiling in horror at the idea of a poo transplant, but this all-natural way of treating certain illnesses may well become a common medical procedure in the next few years...

We spend a lot of time making sure we're clean - scrubbing ourselves with harsh soaps, sanitizing our hands and environment with chemicals, and eliminating any trace of dirt from our homes and lives - but could our squeaky clean lifestyles be causing more harm than good?

In the last century, a new breed of illness has emerged in western countries: autoimmune diseases, caused by the immune system waging war against the body's own healthy tissues. Diabetes, rheumatoid arthritis, Crohn's disease, ulcerative colitis, eczema, and multiple sclerosis (MS) are all examples of autoimmune diseases, and together, they affect millions of people in the UK.

Many doctors, myself included, are convinced that these diseases are caused by damage to the microbiome - the thousands of bacteria that live in our digestive system - from overuse of antibiotics and chemicals which kill all bacteria, not just the harmful ones.

In some cases, this damage can be reversed by 'rewilding' ourselves - getting down and dirty with nature - and eating right, but sometimes our gut microbiome is already so depleted that we need to take drastic action. That's where the poo transplant - or fecal microbiota transplant, to give it its proper name - comes in.

Once you get over the yuck factor, it's clear that when it comes to gut bacteria, going straight to the source makes perfect sense. Fecal microbiota transplant has already proven to be the most effective therapy for certain types of intestinal infections, like Clostridium difficile colitis, and there's growing evidence that it's a useful treatment for autoimmune diseases like Crohn's and ulcerative colitis.

Farmers have long known that feeding a sick cow the intestinal contents that have been sucked out of a healthy cow's stomach can successfully treat illnesses in cattle. Coprophagia, or eating stool, is common in the animal kingdom: baby elephants, pandas, koalas, and hippos eat the feces of their mother or other adults in their herd in order to acquire vital gut bacteria required for digestion. Consumption of fresh camel feces has been observed among certain tribes, including the Bedouin, as a highly effective treatment for infectious diarrhea, and in medieval times it was not uncommon for physicians to taste their patient's stool to aid in diagnosis--a practice I'm in no hurry to resurrect!

We've come a long way - from being disgusted by our own poo to contemplating consuming other people's. Fecal microbiota transplant represents a fascinating and logical way to tackle severe microbial discord by increasing rather than decreasing our bacterial load. There's still a lot we don't know about it - including which conditions benefit the most; who makes an ideal donor; what the long-term risks are; how many transplants we need to do; whether ingestible capsules work as well as fecal enemas - but the answers are coming at breakneck speed as clinicians, scientists, and patients embrace and explore the concept of the poo transplant.