The brave new world of DIY faecal transplant

I was diagnosed with crohn's disease in 2008. Thankfully mine is under control with 2.5mg naltrexone every second night - I have mildy active disease now but am asymptomatic and have no ulceration visible on a 'scope. Before I started LDN, I'd have happily done this, and my symptoms were pretty mild compared to many. Everything that can be done to make this easier, safer and a more wildly offered option should be done ASAP.

I am a fecal donor for FMT (in addition to a microbiologist and epidemiologist) and am willing to answer any questions you might have, an AMA if you will.

There seems to be a growing interest in this field, but there is a lot we don&#x27;t know yet.<p>Human feces hasn&#x27;t been an area with much prestige (and money to be made), so few used to care about it. But, if I remember correctly, the growing interest has partly been caused by geneticists who were initially studying the genome of e.g. humans, but who switched target as the original work was done much quicker than anybody though was possible.<p>From what I know about the research so far, it seems like our bacterial flora, especially in the gut, is tightly connected to quite a few diseases. However, for many of them, it is still unclear what is cause and effect: Does the altered flora cause the disease, or does the disease cause the altered flora? External factors like stress is known to alter gut flora. On the other hand, bacteria in your gut may affect your mood and personality. Figuring out what is what is tricky, and I suppose there can be feedback loops here as well.<p>There is much more research to be done. You should be careful with experimenting, as there is risk involved: You may get bacteria that you don&#x27;t want, and you don&#x27;t know what the changed flora will do to you. An acquaintance of mine is a researcher in this field, and he does not recommend taking probiotics for e.g. IBS, as he think we still know too little about what types of bacteria to take, dosage, and potential negative long term effects. &quot;Good&quot; strains can do bad things in some contexts, and interaction&#x2F;symbiosis between different strains (and us) may complicate things. That being said, afaik, probiotics is generally thought to be safe (although I am not sure all manufacturers are trustworthy).<p>Personally, I think this field has the potential to really change the way we think about health, disease, and medicine. Another field, which I think is related, is diet and fasting: food, and lack of food, alters our gut flora too.

Not for the faint of heart... the picture of the blender was a little too much for my taste!

My company published a guide to C Diff last year. The author, a GI doc and C diff researcher, had this to say about hospital-initiated transplants:<p><i>Stool transplant, also known as a fecal transplant, is a unique therapy. At our hospital, we recommend stool transplants only if all else has failed. Specifically, if a patient has had recurrence of C. diff, even after pulse-tapered Vanco treatment, or multiple bouts of Vanco, Dificid or Flagyl, it’s time to consider a stool transplant.<p>The idea behind a stool transplant is to “reseed the lawn,” so to speak. After exposure to weeks or months of antibiotics (including Vanco) the normal bowel flora — the organisms in your colon that help prevent infection — is weakened. They simply can’t keep C. diff out. In other words, the normal barrier function of the colonic flora is gone, and C. diff gets right back in. So putting in some normal flora from a healthy donor is like reseeding the lawn — it restores the barrier.</i><p>The author was aware of the DIY movement, as well as the rise of holistic medical practitioners who are offering transplant treatments.<p>He also noted that transplants are still relatively rare. Not many PCPs know much about C diff and recommended treatments; patients usually are referred to specialists in gastrointestinal and infectious disease.

As I was glancing down the front page, I read the title as &quot;DIY facial transplant&quot;.

For me, the most interesting part of this article was recognizing that you can actually indirectly die from taking antibiotics. Of course sometimes you need to take it, but it shouldn&#x27;t be the default thing to do when you just have a cold.

&quot;90% of cells in our body are bacteria - organically, our bodies are only 10% human&quot; That would be amazing, but of course those ~3 X 10^12 cells only weigh about a kilo, so yes, &#x27;organically&#x27; (whatever that means in this context) bacterial cells outnumber ours by a large ratio, but in terms of mass or volume, they are only a few percent. Not to say they aren&#x27;t extremely important.

The Freakonomics Podcast has an episode on faecal transplants:<p><a href="http://freakonomics.com/2011/03/04/freakonomics-radio-the-power-of-poop/" rel="nofollow">http:&#x2F;&#x2F;freakonomics.com&#x2F;2011&#x2F;03&#x2F;04&#x2F;freakonomics-radio-the-po...</a>

HN being the one website that I can normally read while having breakfast this left an - for want of a better term - bad taste in my mouth. I misread &#x27;faecal&#x27; for &#x27;facial&#x27; (serves me right for not having my reading glasses on...).

How hard would it be to extract the useful stuff and throw the gross stuff away? I&#x27;m sure that would make the procedure a lot more attractive to patients and doctors.

Followed by the brave new world of DIY hepatitis.

As someone who&#x27;s father died from rapid, late-onset Ulcerative Colitis, this is really fantastic and makes me wonder what could have been.