The Magic Poop Potion
February 18, 2015 5:26 AM Subscribe
It's a class thing. "Florida Man". The flyover and southern states get put in a special box.
posted by clvrmnky at 5:48 AM on February 18, 2015 [4 favorites]
posted by clvrmnky at 5:48 AM on February 18, 2015 [4 favorites]
Mod note: Let's call that duly noted now, and not start out with a giant derail?
posted by taz (staff) at 5:51 AM on February 18, 2015 [9 favorites]
posted by taz (staff) at 5:51 AM on February 18, 2015 [9 favorites]
Good for her! And her husband sounds like the kinda guy who really does give a shit! (Also, I had no idea that submarines worked like that.)
posted by valkane at 6:01 AM on February 18, 2015 [5 favorites]
posted by valkane at 6:01 AM on February 18, 2015 [5 favorites]
Previously.
That thread spawned my all time favorite metafilter comment.
It's amazing this procedure has been around so long and not gained traction.
posted by cjorgensen at 6:03 AM on February 18, 2015
That thread spawned my all time favorite metafilter comment.
It's amazing this procedure has been around so long and not gained traction.
posted by cjorgensen at 6:03 AM on February 18, 2015
The efficacy rate of the transplant is ninety-eight percent, Khoruts estimates, and there are several hypotheses why it works. One is that C. diff may be native to the human gut, so replacing the missing flora restores the balance. Another idea, to which Khoruts assigns more credibility, is that there’s an active microbial warfare being waged inside our bellies. Different bacteria produce different compounds that have antibiotic qualities and kill off other species. “There are antibiotics being made by our own bacteria,” Khoruts explains — some of them have been identified and are being studied. “They are not like our compounds that carpet bomb everything; they very narrowly target C. diff.” The third idea is that microbes talk to our immune system, stimulating its response. “When you put animals or people on antibiotics, that microbiota decreases,” Khoruts says. “So the immune system is less active in fighting any infection.”
Good article. It also seems that when the drugs stop working, modern medicine behaves badly.
posted by Brian B. at 6:03 AM on February 18, 2015 [1 favorite]
Good article. It also seems that when the drugs stop working, modern medicine behaves badly.
posted by Brian B. at 6:03 AM on February 18, 2015 [1 favorite]
MetaFilter: Eat More Poop.
posted by Buttons Bellbottom at 6:10 AM on February 18, 2015 [2 favorites]
posted by Buttons Bellbottom at 6:10 AM on February 18, 2015 [2 favorites]
Great article. Follows in the vein of an awesome radiolab on the same topic. I worked with a friend with crohns who was very interested in trying but couldn't get over the skeeve factor. A real shame since he really suffers. Hopefully he can.
Although I love a pun and being a sarcastic dick a lot I sort of hated the punny "flush it down the toilet" jokes. And the Canadian synthetic stool is called repoopulate? Get it? Poop. Of course there will be a flood of "give a shit comments" too. Ugh. This will really help people. And it's a very serious topic. Can't we all just be adults for a second?
posted by chasles at 6:11 AM on February 18, 2015 [2 favorites]
Although I love a pun and being a sarcastic dick a lot I sort of hated the punny "flush it down the toilet" jokes. And the Canadian synthetic stool is called repoopulate? Get it? Poop. Of course there will be a flood of "give a shit comments" too. Ugh. This will really help people. And it's a very serious topic. Can't we all just be adults for a second?
posted by chasles at 6:11 AM on February 18, 2015 [2 favorites]
I worked with a friend with crohns who was very interested in trying but couldn't get over the skeeve factor.
Given all the indignities and discomforts of bowel issues, I'm surprised that someone would be stopped by the ickiness of doing a poop enema. Everyone has their limits, I guess.
posted by Dip Flash at 6:19 AM on February 18, 2015 [2 favorites]
Given all the indignities and discomforts of bowel issues, I'm surprised that someone would be stopped by the ickiness of doing a poop enema. Everyone has their limits, I guess.
posted by Dip Flash at 6:19 AM on February 18, 2015 [2 favorites]
My old favorite response to the "conventional medicine" detractors was to point out that scientists will happily promote medicines derived from willow bark or mold, just as long as they show significant results in randomized blinded tests. I mean, seriously, what could be a better example demonstrating that scientists aren't constrained by any anti-nature, anti-dirty-hippie bias?
Fecal transplants. Fecal transplants are the better example.
posted by roystgnr at 6:20 AM on February 18, 2015 [2 favorites]
Fecal transplants. Fecal transplants are the better example.
posted by roystgnr at 6:20 AM on February 18, 2015 [2 favorites]
Good article. It also seems that when the drugs stop working, modern medicine behaves badly.
Might be more accurate to say "when patentable solutions stop working"
posted by phearlez at 6:21 AM on February 18, 2015 [10 favorites]
Sorry, got it wrong and missed the edit window.
MetaFilter: Eat More Peer-Reviewed Poop.
I really am interested in this for my own gastro issues which are not, for the moment, debilitating, though at one point were life-threatening.
posted by Buttons Bellbottom at 6:32 AM on February 18, 2015 [2 favorites]
MetaFilter: Eat More Peer-Reviewed Poop.
I really am interested in this for my own gastro issues which are not, for the moment, debilitating, though at one point were life-threatening.
posted by Buttons Bellbottom at 6:32 AM on February 18, 2015 [2 favorites]
Ugh. This will really help people. And it's a very serious topic.
I love living in this fabulous future where eating poop is considered a serious topic.
posted by dr_dank at 6:44 AM on February 18, 2015 [7 favorites]
I love living in this fabulous future where eating poop is considered a serious topic.
posted by dr_dank at 6:44 AM on February 18, 2015 [7 favorites]
And it's a very serious topic. Can't we all just be adults for a second?There's definitely some serious questions of safety here. The reason we're instinctively repelled by feces is that any would-have-been ancestors who weren't so repelled tended to die of fecal-oral-transmitted diseases, right?
On the other hand, the FDA and other regulators have some distorted incentives which pose a problem. If they approve a new treatment after insufficient investigation, and people are harmed by the treatment, the public is greatly upset. If they approve a new treatment only after excessive investigation, and people are harmed by the delay (or in marginal cases, harmed by the disincentive for researchers to even begin such investigation), that's a relatively invisible consequence which is less likely to incite public anger. The natural human bias is to avoid visible and active harm even if the invisible and passive option would have worse results.
With non-communicable diseases I'd say that the solution is to allow even the most experimental treatments iff sufficiently-informed consent has been obtained, but in cases where one of the risks is acceleration of a pathogen vector, you can't necessarily identify all the potential victims, much less get informed consent from them.
Okay, that was at least thirty seconds. I'm done.
posted by roystgnr at 6:45 AM on February 18, 2015 [4 favorites]
> My old favorite response to the "conventional medicine" detractors was to point out that scientists will happily promote medicines derived from willow bark or mold, just as long as they show significant results in randomized blinded tests.
A medicine has to show significant results and those results have to be reliably correlated to the medicine itself. In other words, it has to be the acetylsalicylic acid isolated from any other component that was also in the willow bark. And it has to work predictably most of the time with reliable dosages.
Double-blind tests are an important process, but don't fetishize it as the key determinant of valid research. Acetylsalicylic acid (as well as carbolic acid, for sterilizing wounds) were key components of medicine many decades before the double-blind trial was formalized.
posted by at by at 6:47 AM on February 18, 2015 [1 favorite]
A medicine has to show significant results and those results have to be reliably correlated to the medicine itself. In other words, it has to be the acetylsalicylic acid isolated from any other component that was also in the willow bark. And it has to work predictably most of the time with reliable dosages.
Double-blind tests are an important process, but don't fetishize it as the key determinant of valid research. Acetylsalicylic acid (as well as carbolic acid, for sterilizing wounds) were key components of medicine many decades before the double-blind trial was formalized.
posted by at by at 6:47 AM on February 18, 2015 [1 favorite]
Several years ago there was a Frontline episode about alternative medicines, largely an expose about the mainstreaming of homeopathy and the non-regulation of herbal remedies.
However, there was also a really intriguing bit about a controlled experiment on acupuncture, the first of its kind to study its efficacy. Unfortunately the study was being conducted during the Frontline and there were no results.
Has anyone come across the findings of that study?
posted by mcstayinskool at 6:58 AM on February 18, 2015
However, there was also a really intriguing bit about a controlled experiment on acupuncture, the first of its kind to study its efficacy. Unfortunately the study was being conducted during the Frontline and there were no results.
Has anyone come across the findings of that study?
posted by mcstayinskool at 6:58 AM on February 18, 2015
Double blind? Banting and Best were too badass for that.
The team was eager to start testing on humans. But on whom should they test? Banting and Best began by injecting themselves with the extract.They felt weak and dizzy, but they were not harmed.
Self experimentation FTW!
posted by mandolin conspiracy at 7:00 AM on February 18, 2015 [1 favorite]
The team was eager to start testing on humans. But on whom should they test? Banting and Best began by injecting themselves with the extract.They felt weak and dizzy, but they were not harmed.
Self experimentation FTW!
posted by mandolin conspiracy at 7:00 AM on February 18, 2015 [1 favorite]
Women can and should be described and defined outside of their capacity to procreate. What's wrong with woman?
The use of "Indiana grandma" is meant less as a denigration of the the woman, and more of a backhand slap leveled at the medical industry. It's a sort of "HAHAHA...Lookit what this little old grandma did that you "scientists" couldn't. Stoopid science." thing. "Indiana grandma" is meant to evoke a down-home, average-person-next-door response, in the same way politicians like to invoke the "common sense" ploy.
posted by Thorzdad at 7:00 AM on February 18, 2015 [18 favorites]
The use of "Indiana grandma" is meant less as a denigration of the the woman, and more of a backhand slap leveled at the medical industry. It's a sort of "HAHAHA...Lookit what this little old grandma did that you "scientists" couldn't. Stoopid science." thing. "Indiana grandma" is meant to evoke a down-home, average-person-next-door response, in the same way politicians like to invoke the "common sense" ploy.
posted by Thorzdad at 7:00 AM on February 18, 2015 [18 favorites]
While there are genuine issues about the framing, and about experimental procedures, the cynic in me notes that a one-time, cheap treatment isn't typically a popular option in the U.S. medical industry.
posted by idb at 7:05 AM on February 18, 2015 [2 favorites]
posted by idb at 7:05 AM on February 18, 2015 [2 favorites]
Boston-area residents can go through the process to determine if they can get paid to contribute their stools to Open Biome.
posted by Buttons Bellbottom at 7:07 AM on February 18, 2015 [1 favorite]
posted by Buttons Bellbottom at 7:07 AM on February 18, 2015 [1 favorite]
The article raised an interesting point about pursuing a tissue donation approval, like a blood transfusion, instead of a "investigational new drug" approval, which was noted to take a year and ten researchers to complete in one case. However, it doesn't seem to fit in either category, and may be stalled (from health spa approaches) by the coincidence of the patients being so sick at the time of need, and their risk of dying anyway when it fails.
posted by Brian B. at 7:09 AM on February 18, 2015 [1 favorite]
posted by Brian B. at 7:09 AM on February 18, 2015 [1 favorite]
Thorzdad, so what you're saying here is that doctors hate her one weird trick for curing C. diff?
posted by strangely stunted trees at 7:09 AM on February 18, 2015 [28 favorites]
posted by strangely stunted trees at 7:09 AM on February 18, 2015 [28 favorites]
I have a friend who works in a genomics lab that looks into the genetics involved in this area of C. Diff treatment. He gets marketing emails, which he sometimes forwards to me, for things like:
"PowerFecal ® DNA Isolation Kit
Designed for fast and easy purification of DNA from samples high in PCR inhibitors; including stool, gut material, and biosolids."
posted by mandolin conspiracy at 7:16 AM on February 18, 2015
"PowerFecal ® DNA Isolation Kit
Designed for fast and easy purification of DNA from samples high in PCR inhibitors; including stool, gut material, and biosolids."
posted by mandolin conspiracy at 7:16 AM on February 18, 2015
I love living in this fabulous future where eating poop is considered a serious topic.
So uhhh poop eating would be the assinine joke and not the topic. Sorta a 'hence my point' kinda thing. TFA is about so called sanitary fecal microbe transplant. Which, ya know, doesn't involve the mouth.
Okay, that was at least thirty seconds.
Thank you. I agree about an "informed consent" based system. Unfortunately it alwasy seems like it would likely first be coopted by antivaxxers etc...
posted by chasles at 7:18 AM on February 18, 2015 [1 favorite]
So uhhh poop eating would be the assinine joke and not the topic. Sorta a 'hence my point' kinda thing. TFA is about so called sanitary fecal microbe transplant. Which, ya know, doesn't involve the mouth.
Okay, that was at least thirty seconds.
Thank you. I agree about an "informed consent" based system. Unfortunately it alwasy seems like it would likely first be coopted by antivaxxers etc...
posted by chasles at 7:18 AM on February 18, 2015 [1 favorite]
There was an excellent article about fecal transplants in the New Yorker at the end of last year.
posted by Paul Slade at 7:20 AM on February 18, 2015 [3 favorites]
posted by Paul Slade at 7:20 AM on February 18, 2015 [3 favorites]
And then we will finally catch up with the Chinese doctors’ wisdom of centuries ago: taking the curative crap by mouth, whether powder or juice. Only instead of burying it for ten years, we’ll mass-produce it in regulated factory-size synthetic guts, putting all fecal matters to rest.
All joking aside, as the article mentions, this research is going on, and they're looking at ways to figure out what, from the "transplanted" material actually populates the gut - and remains - by tracking certain genetic markers. My aforementioned buddy is one of the authors in this here study that's linked in the article.
So it's a case of figuring out what it is in that, uh, entire shake is fighting off C. Diff, and figuring out the best way to get it in there.
posted by mandolin conspiracy at 7:29 AM on February 18, 2015 [2 favorites]
All joking aside, as the article mentions, this research is going on, and they're looking at ways to figure out what, from the "transplanted" material actually populates the gut - and remains - by tracking certain genetic markers. My aforementioned buddy is one of the authors in this here study that's linked in the article.
So it's a case of figuring out what it is in that, uh, entire shake is fighting off C. Diff, and figuring out the best way to get it in there.
posted by mandolin conspiracy at 7:29 AM on February 18, 2015 [2 favorites]
The article was going really well until the end when it turned into "If everything goes well, then one day in the magical future, maybe instead of having a family member provide the necessary material, big drug companies can find a way to put a patented version of this in the drug store!"
Though my understanding is that "eating" actually is better. I believe I've read that the preferred way to do this in medical settings is to insert the poop directly in the stomach via nasal tube. It's pretty revolting, but apparently it works better. So yeah, we are talking seriously about eating poop.
posted by If only I had a penguin... at 7:41 AM on February 18, 2015 [1 favorite]
Though my understanding is that "eating" actually is better. I believe I've read that the preferred way to do this in medical settings is to insert the poop directly in the stomach via nasal tube. It's pretty revolting, but apparently it works better. So yeah, we are talking seriously about eating poop.
posted by If only I had a penguin... at 7:41 AM on February 18, 2015 [1 favorite]
Women can and should be described and defined outside of their capacity to procreate. What's wrong with woman?
The use of "Indiana grandma" is meant less as a denigration of the the woman, and more of a backhand slap leveled at the medical industry. It's a sort of "HAHAHA...Lookit what this little old grandma did that you "scientists" couldn't. Stoopid science." thing. "Indiana grandma" is meant to evoke a down-home, average-person-next-door response, in the same way politicians like to invoke the "common sense" ploy.
So yeah, I hate that, too.
posted by leotrotsky at 7:42 AM on February 18, 2015 [8 favorites]
Though my understanding is that "eating" actually is better. I believe I've read that the preferred way to do this in medical settings is to insert the poop directly in the stomach via nasal tube. It's pretty revolting, but apparently it works better. So yeah, we are talking seriously about eating poop.
There are also attempts being made to figure out how to administer it in capsule form. But my understanding is that owing to the amount of material that needs to be ingested, it means 30 or 40 capsules. But I'd take that over the nasal tube, should the choice present itself.
posted by mandolin conspiracy at 7:59 AM on February 18, 2015 [1 favorite]
There are also attempts being made to figure out how to administer it in capsule form. But my understanding is that owing to the amount of material that needs to be ingested, it means 30 or 40 capsules. But I'd take that over the nasal tube, should the choice present itself.
posted by mandolin conspiracy at 7:59 AM on February 18, 2015 [1 favorite]
Thanks, I just sent some of these links to my mother, who told me at Christmas that she apparently picked up C. diff after a hospital stay sometime in the last few years.
posted by dnash at 8:02 AM on February 18, 2015
posted by dnash at 8:02 AM on February 18, 2015
I actually think the puns and bathroom humor about this help, because they offer an easy way to enter into the conversation about a very taboo subject, and if they shift the tone of the conversation from disgusting to silly, more people might be open to receiving the treatment.
posted by Rock Steady at 8:04 AM on February 18, 2015 [16 favorites]
posted by Rock Steady at 8:04 AM on February 18, 2015 [16 favorites]
I actually think the puns and bathroom humor about this help, because they offer an easy way to enter into the conversation about a very taboo subject, and if they shift the tone of the conversation from disgusting to silly, more people might be open to receiving the treatment.
I concur. Poopity poopy poop-poop.
posted by leotrotsky at 8:10 AM on February 18, 2015 [4 favorites]
I concur. Poopity poopy poop-poop.
posted by leotrotsky at 8:10 AM on February 18, 2015 [4 favorites]
poopslol
posted by Rock Steady at 8:19 AM on February 18, 2015 [2 favorites]
posted by Rock Steady at 8:19 AM on February 18, 2015 [2 favorites]
Maybe joking about it does help raise awareness, but there's no need to make crappy ones. There's no need to half-ass it, act like you give a shit, y'all.
posted by Potomac Avenue at 8:48 AM on February 18, 2015 [4 favorites]
posted by Potomac Avenue at 8:48 AM on February 18, 2015 [4 favorites]
Can't we all just be adults for a second?
Not when it comes to poop. POOP! Poop. Poop poop poop.
posted by fiercecupcake at 8:58 AM on February 18, 2015 [3 favorites]
Not when it comes to poop. POOP! Poop. Poop poop poop.
posted by fiercecupcake at 8:58 AM on February 18, 2015 [3 favorites]
I wonder if you could just snort liquefied poop at home and save a doctor's visit?
posted by pracowity at 9:05 AM on February 18, 2015
posted by pracowity at 9:05 AM on February 18, 2015
But then you have stories like this:
Woman's stool transplant lead to "tremendous weight gain."
Which is intriguing, in what we might learn about obesity, but scary, in that we clearly don't really know what we are doing.
posted by emjaybee at 9:13 AM on February 18, 2015 [6 favorites]
Woman's stool transplant lead to "tremendous weight gain."
Which is intriguing, in what we might learn about obesity, but scary, in that we clearly don't really know what we are doing.
posted by emjaybee at 9:13 AM on February 18, 2015 [6 favorites]
I was hospitalized for several weeks with an atypical C. Diff. infection, which only just responded barely to i.v. Flagyl. It was some of the worst pain I've experienced. I wanted to die, especially when they took me off Dilaudid because of concerns about gut motility. I wish people would realize c. diff. is really serious and kills lots of people every year.
posted by werkzeuger at 9:27 AM on February 18, 2015 [1 favorite]
posted by werkzeuger at 9:27 AM on February 18, 2015 [1 favorite]
Which is to say that the pain was severe enough I would have eaten stool with a fork if it would have helped, so all the HURF DURF POOP EATER kind of misses the point.
posted by werkzeuger at 9:29 AM on February 18, 2015 [11 favorites]
posted by werkzeuger at 9:29 AM on February 18, 2015 [11 favorites]
The gut biome is, as they say, "a fertile field for research," which is science-speak for "we have only recently become aware of the vastness of information that we don't have on this topic." Fecal transplants between different strains of mice appeared to cause -- or cure -- anxiety depending on which direction the transplant took place. There's evidence that the gut biomes in people with conditions like rheumatoid arthritis and ankylosing spondylitis may be statistically significantly different than people without these conditions. My mother has a friend who, until recently, had a condition called fructose malabsorption disorder, which my daughter also has; it turned out that my mother's friend had a subclinical case of C. diff that had been misdiagnosed as IBS, and when her C. diff was treated (I think via fecal transplant, actually), her fructose malabsorption disorder went away.
There's a lot we don't know, and a lot to learn, and as an obese woman (oh yeah, gut flora are also possibly linked to obesity) whose daughter has FM and whose husband has an autoimmune condition, I am anxiously awaiting every discovery on the subject.
posted by KathrynT at 9:35 AM on February 18, 2015 [5 favorites]
There's a lot we don't know, and a lot to learn, and as an obese woman (oh yeah, gut flora are also possibly linked to obesity) whose daughter has FM and whose husband has an autoimmune condition, I am anxiously awaiting every discovery on the subject.
posted by KathrynT at 9:35 AM on February 18, 2015 [5 favorites]
I'd guess this procedure -- and the knowledge behind it -- is apt to become threatening to the pharma business model as more gets understood.
Who'd have thought a straightforward transfer would also transfer a strong tendency to obesity? It took one experiment to make a very strong case for that happening.
I'd bet a wide variety of microbes that live around us and inside us -- or did at some point-- had coevolved long enough to be part of what makes us human, and we've left some of them behind one way or another.
Are there ways that primates in their natural ranges are healthier than those in zoos, by being surrounded by a longterm living environment? Yeah there are plenty of reasons we need medicine -- Guinea worm, malaria, et cetera.
But could it be there are other microbes we could get from nature providing something while circulating through us that can't be provided by a prescription pill?
Better get the FDA to shut down this whole notion before it causes economic troubles, eh?
Or else we're going to have to consider that "human being" is a rather arbitrary circle drawn in a rather large complex ecosystem, not limited to what's under the skin or reproduced by sperm and egg alone.
posted by hank at 9:46 AM on February 18, 2015
Who'd have thought a straightforward transfer would also transfer a strong tendency to obesity? It took one experiment to make a very strong case for that happening.
I'd bet a wide variety of microbes that live around us and inside us -- or did at some point-- had coevolved long enough to be part of what makes us human, and we've left some of them behind one way or another.
Are there ways that primates in their natural ranges are healthier than those in zoos, by being surrounded by a longterm living environment? Yeah there are plenty of reasons we need medicine -- Guinea worm, malaria, et cetera.
But could it be there are other microbes we could get from nature providing something while circulating through us that can't be provided by a prescription pill?
Better get the FDA to shut down this whole notion before it causes economic troubles, eh?
Or else we're going to have to consider that "human being" is a rather arbitrary circle drawn in a rather large complex ecosystem, not limited to what's under the skin or reproduced by sperm and egg alone.
posted by hank at 9:46 AM on February 18, 2015
Punk Rock Medicine!
posted by Emor at 9:52 AM on February 18, 2015 [1 favorite]
posted by Emor at 9:52 AM on February 18, 2015 [1 favorite]
For anyone who is going to take a run of antibiotics, also take a one month course of probiotics, they sell generics at places like Walgreens and Rite Aid. Keep it up another thirty days if you can afford it.
http://en.m.wikipedia.org/wiki/Adenovirus_serotype_36
I did read about the potential link to viral acquired obesity from common Adenovirus. For most people it means a brief cold, for some other percent it means permanent weight gain.
posted by Oyéah at 10:00 AM on February 18, 2015 [1 favorite]
http://en.m.wikipedia.org/wiki/Adenovirus_serotype_36
I did read about the potential link to viral acquired obesity from common Adenovirus. For most people it means a brief cold, for some other percent it means permanent weight gain.
posted by Oyéah at 10:00 AM on February 18, 2015 [1 favorite]
http://news.rediff.com/special/2010/sep/23/special-indian-scientist-finds-virus-link-to-obesity.htm
Here is a link to that history. The woman with huge weight gain may have been emaciated, and undernourished from gut malfunction, or maybe picked this virus up. Otherwise, y'all be careful, fat is catching, don't y'all kiss no fat folks, and especially avoid lifesaving fecal transplants from objectionable sorts.
Gut bacteria is the big buzz these days.
posted by Oyéah at 10:13 AM on February 18, 2015
Here is a link to that history. The woman with huge weight gain may have been emaciated, and undernourished from gut malfunction, or maybe picked this virus up. Otherwise, y'all be careful, fat is catching, don't y'all kiss no fat folks, and especially avoid lifesaving fecal transplants from objectionable sorts.
Gut bacteria is the big buzz these days.
posted by Oyéah at 10:13 AM on February 18, 2015
(And I have enough health problems that C. diff is something I fear I'll have to deal with at some point in my life, so making fun of the POOP! aspect of it is as much to deal with that fear as it is that poop is inherently funny. I've thought a lot about this issue since I read about it years ago, and I think it's brilliant and amazing that it's made a lot of people better. I know I would try it were I in that position, and I hope if that happens to me that we've made some progress on how the medical/pharma industry deals with poop transplants.)
posted by fiercecupcake at 10:13 AM on February 18, 2015
posted by fiercecupcake at 10:13 AM on February 18, 2015
I saw a lovely talk on treating C. diff this way last summer, wonderful approach. There is hope for treating many other conditions too, but not sure anyone really has a target list yet.
posted by jeffburdges at 10:15 AM on February 18, 2015
posted by jeffburdges at 10:15 AM on February 18, 2015
Which is intriguing, in what we might learn about obesity
If it is discovered that you could get skinny through a shit donation from a skinny person, I suspect a lot of squeamish people would suddenly have a change of heart. What's a little shit through the nose compared to obesity and all the negative things obesity often entails?
posted by pracowity at 10:16 AM on February 18, 2015 [2 favorites]
If it is discovered that you could get skinny through a shit donation from a skinny person, I suspect a lot of squeamish people would suddenly have a change of heart. What's a little shit through the nose compared to obesity and all the negative things obesity often entails?
posted by pracowity at 10:16 AM on February 18, 2015 [2 favorites]
Please, guys - let's skip both the "flyover states" and the "poop poop poop" derails? This is a really interesting topic, especially since a few years from now we're all going to be dealing with multi-drug-resistant C Diff strains.
posted by RedOrGreen at 10:47 AM on February 18, 2015 [3 favorites]
posted by RedOrGreen at 10:47 AM on February 18, 2015 [3 favorites]
This woman got it all wrong. Doesn't she know you're supposed to eat shit and die, not eat shit to live?
posted by onlyconnect at 10:55 AM on February 18, 2015 [5 favorites]
posted by onlyconnect at 10:55 AM on February 18, 2015 [5 favorites]
You know how some people donate their own blood prior to surgery that might require a transfusion?
How about setting aside some of your own feces for a possible transplant before beginning a course of antibiotics?
Or just setting some aside as a general precaution the way some people are saving cord blood?
Expect businesses which store your own poop for you cryogenically within the year.
posted by jamjam at 11:40 AM on February 18, 2015 [2 favorites]
How about setting aside some of your own feces for a possible transplant before beginning a course of antibiotics?
Or just setting some aside as a general precaution the way some people are saving cord blood?
Expect businesses which store your own poop for you cryogenically within the year.
posted by jamjam at 11:40 AM on February 18, 2015 [2 favorites]
You know how some people donate their own blood prior to surgery that might require a transfusion?
Or family/friends who are compatible if you can't donate for yourself.
How about setting aside side some of your own feces for a possible transplant before beginning a course of antibiotics?
Probably not - there's a reason you'd be taking the antibiotics usually ... and wouldn't want that back. Similar to after a course you're supposed to change your toothbrush, IIRC.
Sometimes I wonder if that's why long term severe elimination diets help some folks - get rid of whatever is feeding some bad bacteria (do a search on "yeast overgrowth" for some foo and some fact, can't tell apart).
posted by Buttons Bellbottom at 11:45 AM on February 18, 2015
Or family/friends who are compatible if you can't donate for yourself.
How about setting aside side some of your own feces for a possible transplant before beginning a course of antibiotics?
Probably not - there's a reason you'd be taking the antibiotics usually ... and wouldn't want that back. Similar to after a course you're supposed to change your toothbrush, IIRC.
Sometimes I wonder if that's why long term severe elimination diets help some folks - get rid of whatever is feeding some bad bacteria (do a search on "yeast overgrowth" for some foo and some fact, can't tell apart).
posted by Buttons Bellbottom at 11:45 AM on February 18, 2015
She has a lot of guts fortitude. Thanks for posting.
posted by theora55 at 11:50 AM on February 18, 2015
posted by theora55 at 11:50 AM on February 18, 2015
Of course you wouldn't do it if you had an intestinal infection, Bellbottom -- do I really have to spell that out for you?
posted by jamjam at 11:52 AM on February 18, 2015
posted by jamjam at 11:52 AM on February 18, 2015
That's why I didn't get what you were saying, jamjam; it wasn't clear in my reading.
Setting aside your own samples to culture/save/store long before you need a course of antibiotics, maybe, but the work storing all that safely and correctly on a regular schedule on the off chance you might later catch something to require a transplant ... just seems rather problematic.
But looking at this like ancient cheese and beer making, this might just be the first steps in the process of having bottled human-sourced probiotics (or custom mixes after a scoop and scope or something).
posted by Buttons Bellbottom at 11:57 AM on February 18, 2015
Setting aside your own samples to culture/save/store long before you need a course of antibiotics, maybe, but the work storing all that safely and correctly on a regular schedule on the off chance you might later catch something to require a transplant ... just seems rather problematic.
But looking at this like ancient cheese and beer making, this might just be the first steps in the process of having bottled human-sourced probiotics (or custom mixes after a scoop and scope or something).
posted by Buttons Bellbottom at 11:57 AM on February 18, 2015
One of my friends from undergrad co-founded a company called OpenBiome that makes these capsules from donors. Of course, reporters love the angle of "healthy people get paid thousands of dollars to poop!" (The screening process is extremely selective.) She's got some good lines in the VICE article. I'm just hoping they get to help a lot of people.
posted by ilana at 12:33 PM on February 18, 2015 [6 favorites]
posted by ilana at 12:33 PM on February 18, 2015 [6 favorites]
roystgnr: " the FDA and other regulators have some distorted incentives which pose a problem. If they approve a new treatment after insufficient investigation, and people are harmed by the treatment, the public is greatly upset."
Ya, no one wants thalidomide babies on their watch.
posted by Mitheral at 3:47 PM on February 18, 2015 [1 favorite]
Ya, no one wants thalidomide babies on their watch.
posted by Mitheral at 3:47 PM on February 18, 2015 [1 favorite]
She has a lot of guts fortitude. Thanks for posting.
Also her husband.
That is two people who are in it together.
posted by A Terrible Llama at 6:42 PM on February 18, 2015
Also her husband.
That is two people who are in it together.
posted by A Terrible Llama at 6:42 PM on February 18, 2015
The FDA is in a bind here. In order to classify feces as a pharmaceutical, you need to demonstrate current good manufacturing practices (cGMP) criteria such as composition and potency.
There are a lot of uncultivable but viable bacteria and it would be incredibly difficult to consistently produce the same constellation of bacteria from batch to batch.
As such, there's no way that feces (and I suspect "artificial feces" may be less effective) can be classified and regulated as a pharmaceutical, and doctors are disinclined to offer an unregulated treatment.
However, classifying feces as "tissue" might be able to get around some of these regulatory concerns, but you run into a whole other slew of issues (which can largely be addressed - but testing at such a strict level would massively increase the cost of treatment).
A major problem with regulating feces as tissue is that it is so heterogeneous. An individual's commensal microflora can change from day to day, sometimes dramatically. To conduct a successful clinical trial, they would have to do fecal transplants in massive numbers for very well defined disorders and back-correlate that to particular microbiome compositions.
The patient's current microbiome composition will likely have massive effects on the treatment outcome even if the donor composition was somehow held invariant.
There should still be money in regulated fecal transplants - be one of the companies that do the testing and typing of the feces to be transplanted. Much less money than owning a patent on a chronic drug, but services still pays and the cost of qPCR/NGS testing continues to fall. Accreditation to do tests like this are extremely costly and time consuming, but if you're already accredited for other testing, validating the testing and typing service shouldn't be too bad.
Lots of commercial NGS downtime out there and sequencing gets cheaper every year.
posted by porpoise at 6:46 PM on February 18, 2015 [1 favorite]
There are a lot of uncultivable but viable bacteria and it would be incredibly difficult to consistently produce the same constellation of bacteria from batch to batch.
As such, there's no way that feces (and I suspect "artificial feces" may be less effective) can be classified and regulated as a pharmaceutical, and doctors are disinclined to offer an unregulated treatment.
However, classifying feces as "tissue" might be able to get around some of these regulatory concerns, but you run into a whole other slew of issues (which can largely be addressed - but testing at such a strict level would massively increase the cost of treatment).
A major problem with regulating feces as tissue is that it is so heterogeneous. An individual's commensal microflora can change from day to day, sometimes dramatically. To conduct a successful clinical trial, they would have to do fecal transplants in massive numbers for very well defined disorders and back-correlate that to particular microbiome compositions.
The patient's current microbiome composition will likely have massive effects on the treatment outcome even if the donor composition was somehow held invariant.
There should still be money in regulated fecal transplants - be one of the companies that do the testing and typing of the feces to be transplanted. Much less money than owning a patent on a chronic drug, but services still pays and the cost of qPCR/NGS testing continues to fall. Accreditation to do tests like this are extremely costly and time consuming, but if you're already accredited for other testing, validating the testing and typing service shouldn't be too bad.
Lots of commercial NGS downtime out there and sequencing gets cheaper every year.
posted by porpoise at 6:46 PM on February 18, 2015 [1 favorite]
...and the cost of qPCR/NGS testing continues to fall.
Yeah, this is the type of sequencing and testing my friend does.
As I understand it, this is what the PowerFecal testing dealy is for, no?
posted by mandolin conspiracy at 7:17 PM on February 18, 2015
Yeah, this is the type of sequencing and testing my friend does.
As I understand it, this is what the PowerFecal testing dealy is for, no?
posted by mandolin conspiracy at 7:17 PM on February 18, 2015
testing dealy is for, no?
Yes/No.
Mo-Bio is one of those "Good, Fast, Cheap: Pick 2" and they pick "Cheap and Cheap" kind of companies. From my research about a year ago, most of the "stool DNA extraction" kits are knockoffs of the Qiagen reagent (I can't remember the chemical name right now, I have several references on an offline HD somewhere) or don't actually work all that well.
Stool DNA extraction is a legitimate thing, aside from fecal transplants. Think ecology and figuring out what different animal populations eat and stuff like that.
Qiagen, for good and bad, has the market cornered on regulations compliancy friendly products of this class*. They're tiered, too. "Not for in vivo or diagnostic uses" and "blahblahblah produced certified to blahblahblah."
The tests that I were thinking about were for pathogenic bacteria and viruses. So, detection of very specific DNA sequences in a very sensitive manner. The FDA must have some The Big Lists of No-No Bugs lists of stuff that has to be tested for.
My gut feeling is that there's as much to to bacterial microbiome as there is to the phage microbiome, though.
The additional is NGS for 16s ribosomal RNA, which is somewhat accepted, but by no means a complete picture. Someone'll have to spend a lot of money and time to really characterize human gut microbiome species before fecal transplants gain clinical traction. I wouldn't be surprised if it ended up happening, though. I doubt it will be by an established player in pharma, but smaller startups with government grants might get bought up. There's some academic work, and if they can get grant monies, it might happen before a for-profit entity manages to do it.
Introducing "good" bacteria is great; but what if they're out-competed by the resident population? That's the problem with "probiotics" - sure, you eat them but how many of them colonize and persist? Personally, I consume inulin to try to create a gut environment more welcoming of "beneficial" bacterial colonization.
*if you're going to create "lab-developed"/"homebrew" clinical tests, just using Qiagen's nucleic acid purification/concentration products - instead of someone else's - eliminates a bunch of headaches during the validation/accreditation process. Roche also makes a bunch of stuff that regulators tolerate without getting in your face too much.
posted by porpoise at 8:18 PM on February 18, 2015 [3 favorites]
Yes/No.
Mo-Bio is one of those "Good, Fast, Cheap: Pick 2" and they pick "Cheap and Cheap" kind of companies. From my research about a year ago, most of the "stool DNA extraction" kits are knockoffs of the Qiagen reagent (I can't remember the chemical name right now, I have several references on an offline HD somewhere) or don't actually work all that well.
Stool DNA extraction is a legitimate thing, aside from fecal transplants. Think ecology and figuring out what different animal populations eat and stuff like that.
Qiagen, for good and bad, has the market cornered on regulations compliancy friendly products of this class*. They're tiered, too. "Not for in vivo or diagnostic uses" and "blahblahblah produced certified to blahblahblah."
The tests that I were thinking about were for pathogenic bacteria and viruses. So, detection of very specific DNA sequences in a very sensitive manner. The FDA must have some The Big Lists of No-No Bugs lists of stuff that has to be tested for.
My gut feeling is that there's as much to to bacterial microbiome as there is to the phage microbiome, though.
The additional is NGS for 16s ribosomal RNA, which is somewhat accepted, but by no means a complete picture. Someone'll have to spend a lot of money and time to really characterize human gut microbiome species before fecal transplants gain clinical traction. I wouldn't be surprised if it ended up happening, though. I doubt it will be by an established player in pharma, but smaller startups with government grants might get bought up. There's some academic work, and if they can get grant monies, it might happen before a for-profit entity manages to do it.
Introducing "good" bacteria is great; but what if they're out-competed by the resident population? That's the problem with "probiotics" - sure, you eat them but how many of them colonize and persist? Personally, I consume inulin to try to create a gut environment more welcoming of "beneficial" bacterial colonization.
*if you're going to create "lab-developed"/"homebrew" clinical tests, just using Qiagen's nucleic acid purification/concentration products - instead of someone else's - eliminates a bunch of headaches during the validation/accreditation process. Roche also makes a bunch of stuff that regulators tolerate without getting in your face too much.
posted by porpoise at 8:18 PM on February 18, 2015 [3 favorites]
NOT that there's anything wrong with "cheap and cheap." I've bought a lot of Mo-Bio recently when I only need "good enough," in other applications, and needed to pinch the dimes. It's just that its not suitable as part of a medical treatment.
As for self-treatment, the information out there is at best incomplete.
Medicine, for what its worth is a regulated industry and has to follow rules that it has prescribed itself. In many ways it sucks but it's far better than the days of snakeoil and patent medicines.
posted by porpoise at 8:47 PM on February 18, 2015 [1 favorite]
As for self-treatment, the information out there is at best incomplete.
Medicine, for what its worth is a regulated industry and has to follow rules that it has prescribed itself. In many ways it sucks but it's far better than the days of snakeoil and patent medicines.
posted by porpoise at 8:47 PM on February 18, 2015 [1 favorite]
Thanks for the detailed response. The thing I was referring to is just from the marketing material my friend receives (as exchanged in emails where it's "har-har this is the type of target market I am, apparently, and I deal in shit sequencing").
You gave some awesome context for this layperson about how this stuff is marketed vs. what it's really good for.
The sequencing and testing he does is of the variety that looks for markers where they can attempt to verify that the introduced bacteria can successfully colonize and remain and at the same time has a good clinical outcome vis-a-vis drug resistant C. Diff.
At least, that's what I take away from this:
This proof-of-principle study demonstrates that a stool substitute mixture comprising a multi-species community of bacteria is capable of curing antibiotic-resistant C. difficile colitis. This benefit correlates with major changes in stool microbial profile and these changes reflect isolates from the synthetic mixture.
And that it's some kind of advance in terms of getting to a standardized synthetic mixture that might work vs. the blender full of poop.
He's visiting us this weekend, so we'll likely talk at length about such matters over dinner.
posted by mandolin conspiracy at 8:53 PM on February 18, 2015 [1 favorite]
You gave some awesome context for this layperson about how this stuff is marketed vs. what it's really good for.
The sequencing and testing he does is of the variety that looks for markers where they can attempt to verify that the introduced bacteria can successfully colonize and remain and at the same time has a good clinical outcome vis-a-vis drug resistant C. Diff.
At least, that's what I take away from this:
This proof-of-principle study demonstrates that a stool substitute mixture comprising a multi-species community of bacteria is capable of curing antibiotic-resistant C. difficile colitis. This benefit correlates with major changes in stool microbial profile and these changes reflect isolates from the synthetic mixture.
And that it's some kind of advance in terms of getting to a standardized synthetic mixture that might work vs. the blender full of poop.
He's visiting us this weekend, so we'll likely talk at length about such matters over dinner.
posted by mandolin conspiracy at 8:53 PM on February 18, 2015 [1 favorite]
!! Yep, that's the kind of work that has to keep happening before fecal transplants go mainstream. But like I said earlier, I think that playing with the environment may be more fruitful than introducing new inmates.
Hey, these are the exciting early times. The stuff people'll be learning in the next few years will help design high powered, well controlled, long term studies. I wouldn't be surprised if microbiomics becomes a burgeoning microbiology subdiscipline. I daresay it will compete with neuroscience in complexity.
posted by porpoise at 9:09 PM on February 18, 2015 [1 favorite]
Hey, these are the exciting early times. The stuff people'll be learning in the next few years will help design high powered, well controlled, long term studies. I wouldn't be surprised if microbiomics becomes a burgeoning microbiology subdiscipline. I daresay it will compete with neuroscience in complexity.
posted by porpoise at 9:09 PM on February 18, 2015 [1 favorite]
He's visiting us this weekend, so we'll likely talk at length about such matters over dinner.
<Venkman>I want to party with you</Venkman>
In many ways it sucks but it's far better than the days of snakeoil and patent medicines.
I am assuming you either mean the day when there were only those things and not that you haven't been in certain aisles of the drugstore.
posted by phearlez at 7:27 AM on February 19, 2015 [2 favorites]
<Venkman>I want to party with you</Venkman>
In many ways it sucks but it's far better than the days of snakeoil and patent medicines.
I am assuming you either mean the day when there were only those things and not that you haven't been in certain aisles of the drugstore.
posted by phearlez at 7:27 AM on February 19, 2015 [2 favorites]
Dr. Stephanie Seneff at MIT has found a link between autism and the impact of Roundup on gut bacteria. If she's right, and it's not completely developmental, then fecal transplants might help treat autism.
There are various interesting talks and articles on Stephanie Seneff's faculty webpage but I haven't really looked into them yet.
posted by jeffburdges at 11:53 AM on February 22, 2015
There are various interesting talks and articles on Stephanie Seneff's faculty webpage but I haven't really looked into them yet.
posted by jeffburdges at 11:53 AM on February 22, 2015
Dr. Stephanie Seneff at MIT has found a link between autism and the impact of Roundup on gut bacteria.
If there has to be a bad guy, it might as well be Monsanto and Roundup, and we would be very lucky if drastically reducing suffering turned out to be so easy, but does anyone in the scientific community other than Seneff think that glyphosate causes autism, gluten sensitivity, etc.? posted by pracowity at 12:08 AM on February 23, 2015
If there has to be a bad guy, it might as well be Monsanto and Roundup, and we would be very lucky if drastically reducing suffering turned out to be so easy, but does anyone in the scientific community other than Seneff think that glyphosate causes autism, gluten sensitivity, etc.? posted by pracowity at 12:08 AM on February 23, 2015
I haven't read her papers yet so I cannot really comment. And the article I linked sucks actually.
posted by jeffburdges at 12:18 AM on February 23, 2015
posted by jeffburdges at 12:18 AM on February 23, 2015
Seneff, it turns out, is an MIT scientist, but she is not a scientist with any expertise in autism, epidemiology, or, for that matter, any relevant scientific discipline that would give her the background knowledge and skill set to take on analyzing the epidemiological literature regarding autism.
posted by porpoise at 7:46 PM on February 23, 2015
posted by porpoise at 7:46 PM on February 23, 2015
Yup, I just came here to post that very link, porpoise, but that quote does not really doom her. Epidemiology is not a difficult field mathematically speaking. A.I. researchers do play fast and loose with statistics, but an MIT A.I. researcher possessing the required background is perfectly believable.
A better quote : "if you look at two different variables that have shown an increase with time, you can almost always make it look as though there’s a correlation."
posted by jeffburdges at 12:07 AM on February 24, 2015 [1 favorite]
A better quote : "if you look at two different variables that have shown an increase with time, you can almost always make it look as though there’s a correlation."
posted by jeffburdges at 12:07 AM on February 24, 2015 [1 favorite]
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You never hear male news-makers described as "Chicago Dad".
posted by leotrotsky at 5:46 AM on February 18, 2015 [87 favorites]