It's a transpoosion!

*Disclaimer: If you are offended or grossed out by talk of fecal matter, this post may not be the best read for you. If you enjoy telling and hearing poop jokes, please read on. 

 At my work, I see poop on a daily basis. And I do mean human poop. Just to give a bit of background so you don't think we do this for fun (although the other day two employees were fighting over who got to work with the poop that day-it was weird), we are testing a couple of products that my company manufactures. These products are intended to be used for stool screening, so it is appropriate that we use poop of the human variety as a testing matrix for our studies. I never get tired of saying that I had a shitty day or that it was a load of crap when asked how my day at work went. So I thought I would dedicate a post to talk about poop, since I deal with it much more often than I ever thought I would, and gut health is actually a topic I enjoy discussing.

If you read my Furry Friends and Benificial Bugs post, you may recall that I briefly mentioned how much we benefit from the microorganisms that reside in our intestinal tract, and how we actually couldn't live without them. If bacteria make up 60% of the dry mass of feces (no joke), they've got to be doing something important, right? The relationship between humans and their gut microflora is very much a symbiotic one. Microorganisms in the gut ferment unused energy substrates, train the immune system, prevent growth of harmful species that could make you sick, regulate the development of the gut, produce vitamins for the host like biotin and vitamin k, and produce hormones to direct the storage of fat. That's not a completely inclusive list either, just a few of the main points. Drastic modifications or imbalances in the gut microbiota are associated with obesity, and certain species that can be found in the gut are thought to be capable of causing disease or infection or even increasing the risk of cancer. So a healthy gut microbial community is crucial for a healthy you. This means not only is it important that you actually have a gut microflora, but also that the composition of the bacterial community in your gut is one that promotes healthy living.

In college I took a course in medical microbiology and I remember the day we learned about the organism Clostridium difficile. This is a bacterium that causes infectious diarrhea and the resulting infection can cause pseudomembranous colitis (inflammation of the large intestine). Diarrhea, bloating, and abdominal cramps can occur for up to months or even years when infected with this bacterium. Infection is commonly associated with prolonged antibiotic treatment. When antibiotics are taken for long periods of time, the flora in the gut is wiped out and it allows for bullies like C. diff  to take over and cause disease. Sometimes, stopping antibiotic treatment is enough to alleviate symptoms but other times, the bacterium has taken such a strong hold that treatment is difficult and even the last resort antibiotics (like vancomycin) don't help and can actually make the situation worse. So how do you treat such a nasty infection? It was in my medical microbiology class that I first learned about fecal transplants. Yes, that is exactly what it sounds like. Refer to the oversimplified comic above if you are still confused. Most of us in the class were dumbfounded by the idea but I remember one individual saying, "Yeah, I've heard of it. It's a transpoosion!"

In Fecal Microbiota Transplantation (FMT), a fecal microbiota preparation using stool from a healthy donor is transplanted to the patient's colon. The idea is to replenish the community of organisms in the patient's gut so that they can overcome infection. Donors, of course, must be screened just like you would need to be before donating blood. After providing blood and stool samples, and passing the screening, donors make frequent donations (at least 4 times a week) for a minimum of 60 days. Talk about feeling pooped out after all that. Patient's then receive transplants via a nanogastric tube or a fecal enema. The procedure has shown a cure rate of 90%. More recent research is being done on encapsulating fecal microbiota preparations to provide an easy, oral method for receiving treatment. You know, poop pills. You might be wondering who is behind all this crap (last one, I promise) and where is all the poop being kept? Well, stool banks are becoming a real thing. OpenBiome is the

name of the nonprofit organization, launched in 2012, that is working with clinicians to make FMT easier, cheaper, safer, and more widely available. OpenBiome really does give a shit (Ok, seriously that was the last one) about helping those who suffer from C. diff infections. If you would like to learn more about this organization or FMT, I encourage you to read more on www.openbiome.org. I included an informational video from OpenBiome's website at the end of this post for your viewing pleasure. Thanks for reading!

Haha!