This week, a stomach-turning therapy (no pun intended) has been gracing our social media feeds with unexpected zeal. The idea: That fecal transplants, delivered via tiny little capsules, can cure one of the most difficult bacterial infections that exist. In the U.S., Clostridium difficile causes a quarter million hospitalizations and kills 14,000 people a year. Fecal transplants delivering beneficial bacteria have been previously found to be about 90 percent successful, but they typically require invasive and uncomfortable colonoscopies or, even worse, tubes up the nose.
In the most recent study, which was to ascertain whether treatment could be administered via less invasive methods (ie, pills), Elizabeth Hohmann of MassGeneral Hospital, together with Ilan Youngster from Boston Children’s Hospital and colleagues, enrolled 20 patients, ages 11 to 89, who’ve had at least two to three episodes of C. difficile infection. The overall success rate for the frozen capsules was 90 percent, making them just as safe and effective as traditional transplant techniques.
As the New York Times noted in their coverage of the story, stool can contain thousands of types of bacteria, and scientists do not yet know exactly which ones have the curative powers. So for now, samples must be used pretty much intact. Hence, the undeniable cringe factor. But, here’s where it gets interesting.
As the microbiome—the community of microorganisms that we play host to with a population outnumbering our own cells by a multiple of 10—begins to take center stage as a key player in our health, the potential for more selective bacterial interventions on a whole host of conditions becomes incredibly enticing.
An article in the journal Current Gastroenterology Reports from last year noted other disease states are closely linked to the GI microbiota, namely, obesity, metabolic syndrome, diabetes, and even autism spectrum disorder. Patients with any one of these disorders may, theoretically, see an improvement with microbiome tinkering. Even more fascinating, and hinting at a bright future for microbiota therapy, are the isolated case reports of fecal transplantation responses with multiple sclerosis, Parkinson’s disease, and chronic fatigue syndrome. The power of the microbiome even calls into question free will, as behavior itself can be modified just by altering it. Again, this is a new frontier with massive implications, and these therapies will see accelerating evolution in the coming years in no small part due to the success of these recent trials.
The brain-gut axis is so burgeoning an interest that just recently, a new peer-reviewed journal specifically to explore this scientific border town was announced, called Brain and Gut, edited by neurologist and best selling author Dr. David Perlmutter. It will be dedicated to exploring a vast array of physical interrelationships, including those between the gut bacteria, the microbiome, and various neurological processes.
Imagine being able to take a pill packed with microorganisms, isolated and grown in a lab (no poop required), which could then cross-talk with your own microbiome for positive health outcomes. We would no longer have to treat ourselves, but the universe of bacteria living within us, which, when taken as a whole, is vastly more complex than we are: for every gene in your genome, there are 100 bacterial ones. The implications for our health are just astounding.