Poop transplant for a happy gut?

By: Attabey Rodríguez Benítez
Editor: Lyanne M. Meléndez García
Average Lecture time: 4 minutes
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          Last week I went to a conference for chemists (American Chemical Society ACS) in Boston. On my way to the conference, I saw some intriguing advertisements. For example, I saw one that said: “Give your poop” and I said: “ this has to be a joke”. To my surprise, it wasn’t; if you qualify, you can donate, well, your stool. Then I asked: “Why would someone want my excrement?” I mean, don’t take me wrong, someone paying me for pooping is marvelous. But, why would someone do that? The key is in the gut microbiome. Here in Ciencia en Arroz y Habichuelas we will explain what fecal matter contains and why it is so important that some people even pay for it.  -Yes, I am seeing how many synonyms of  defecation I can find-

             To understand the importance of feces, we need to talk about the microbiome. Micro- comes from microbes and -biome a community of living things. Thus, the gut “microbiome” is a community of microbes composed of (bacteria, viruses, fungi, and others) that inhabit the human gut. In the intestine alone there are around 100 trillion microbes, representing as many as 5,000 species and weighing approximately 4.4 pounds! But don’t worry, most of these bacteria are good for your digestive system. (1

            Fecal matter has a lot of microbes, nothing new, right? Have you ever thought what would happen if our intestine were microbe free? This is what happens when we ingest antibiotics excessively. Antibiotics can exterminate microbes that inhabit your gut or prevent further reproduction, which is not bad in and of itself. The problem is that antibiotics do not differentiate between “good” and “bad” bacteria, creating a cleansing tsunami wiping some bacteria from existence, like Thanos in Marvel. When this happens, it creates an imbalance in the intestine, and when the parents are not guess who is having a party… Since there are more bacteria competing for space, other organisms, not having your health in their best interests, can re-colonize your gut. And we all know how that went with the Native Tainos in Puerto Rico. 

              One of the colonizers is C.difficile or C.diff. This bacteria can cause symptoms from diarrhea to colon irritation. Depending on the gravity of the infection, treatment can range from stronger antibiotic treatment, which sometime just helps the infection enhance, removing infected parts of the colon. (2) Usually, this infection is contracted when people are on antibiotic treatment, particularly in hospitals. Recently, in a desperate attempt, scientists have discovered another way to treat this infection. Yes, you guessed it, here is were the poop transplant comes in.
 
                    What would have happened if Spaniards had had competition when colonizing the Americas? They would have had a hard time conquering all the land and Taino people would have had a chance to avoid the wipe-out. Fecal matter transplants (FMT) bring competition to the infected gut. This transplant brings with it its own microbiome which tries to colonize its new -host- environment. This is a case-by-case treatment, with the successful treatment rate around 87 - 90% (4) Even though, the the FTM is usually used and with great success, scientists do not know the mechanism behind it that makes this a successful procedure. Some of the theories are that the bacteria are competing for resources, thus, C.diff  do not propagate as fast.

            Now, here is the million dollar question: How do patients receive this transplant?  There are multiple methods among them (1) orally. Yes, I know what y’all are thinking this is not a The Help movie situation. A gastric tube is used for this purpose or even pills. Option number (2) is a fecal enema and it has been demonstrated that both options are equally as effective. (5) Not very attractive options, but that is the what is available at the moment towards this infection

        On the other side, the are many research groups interested in designing a drug that can combat “bad” microbes in the gut in a selective manner. Actually, little is know on how the microbiome acts and by which mechanisms. Nonetheless, there are advances still being made in this field.

           On the next article we will talk a little more about 💩 and how close they are in finding the perfect drug. Like always, thank you for reading En Arroz y Habichuelas.  If you have any questions please comment below and if you liked it please share the love all through social media by clicking icons below.