Power of Poo: Fecal Transplants May Treat Crohn's Disease, Multiple Sclerosis

A study published in PLOS Biology reviewed the growing prevalence of fecal transplants, which has increased as a last resort treatment for certain infections found in the human gut.

Fecal transplants have shown success in treating Clostridium difficile colitis, and has shown preliminary evidence of the efficacy of stool transplantation from healthy individuals in order to treat Crohn’s disease and multiple sclerosis.

“This research is just getting started,” said study author Seth Bordenstein. “It is driven by the new paradigm of the microbiome which recognizes that every plant and animal species harbors a collection of microbes that have significant and previously unrecognized effects on their host health, evolution, and behavior.”

There has been accompanying growth in fecal material being used in animal experiments. In one particular study, researchers found that fecal transplants from lean mice turned sterile mice into lean mice, while transplants from obese mice turned sterile mice into obese mice.

The use of fecal transplants to treat Clostridium difficile infections has a 95% cure rate, according to the study.

“There is no doubt that poo can save lives,” Bordenstein said. “Right now fecal transplants are used as the treatment of last resort, but their effectiveness raises an important question: when will doctors start prescribing them, or some derivative, first?”

Healthy human stool contains an average of 100 billion bacteria per gram, but it also contains 100 million viruses and archaea per gram. Furthermore, there are approximately 10 million colonocytes and a million yeasts, and other single-celled fungi per gram.

Although the interest in fecal transplants among Western scientific circles was minimal until 2010, it has a long history in Chinese medicine. The earliest recorded applications in humans occurred in the 4^th century by the Chinese medical doctor Ge Hong. In the 16^th century, it became popular enough to gain the nickname “yellow soup.”

Thus far, most of the research has focused on the role of bacteria in donor stool, with bacteria being the most abundant active agent in the material; however, researchers noted they are not the only functional player in feces.

“Feces is a complex material that contains a variety of biological and chemical entities that may be causing or assisting the effects of these transplants,” Bordenstein said.

The focus on the bacterial component seems to work in some cases, such as Clostridium difficile colitis, but not in other cases, such as multiple sclerosis. In fact, it is possible the effects of fecal transplants may be influenced by, or even caused by, their non-bacterial constituents.

The study authors said that more research designed to separate out the effects and interactions of each of these components needs to be conducted.

“When scientists identify the specific cocktails that produce the positive outcomes, then they can synthesize or grow them and put them in a pill,” Bordenstein said. “That will go a long way to reducing the ‘icky factor’ that could slow public acceptance of this new form of treatment.”