Since stool transplants have turned out to be useful in fighting deadly hospital-borne C. difficile infections, new claims about the healing powers of poop are everywhere.
The slogan on panelist Jonathan Eisen’s black t-shirt, spelled out in pink glitter, captures the current entrepreneurial mood: “Ask Me About Fecal Transplants.”
A wide array of products and innovations are already promising to help us improve our inner flora. Yet reporters and consumers need to be wary.
“Microbiome hype” is rampant, warned Eisen, Ph.D., a professor from the University of California, Davis, School of Medicine and College of Biological Sciences.
He was one of several speakers to weigh in during the panel “Microbiome Research: What to Cover and What to Avoid” at Health Journalism 2015 conference in Santa Clara, Calif.
Scientists are only just beginning to understand how the body’s microbiota might be used to fight infection and chronic health conditions such as obesity.
Headlines that declare “Improving your microbiome will make you sexy,” are premature, noted Eisen. Still, he added, the study of what has come to be known as the human microbiome is full of potential and already helping to save lives.
In the case of C. difficile, the pathogenic bacterium was killing hospital patients at a devastating rate when doctors concluded that antibiotic use was making the patients more vulnerable to the illness. The medicine had wiped out the friendly microbes that might have held the harmful ones at bay. So they reversed course. Instead of fighting the illness with antibiotics they borrowed an old trick from veterinary medicine. They introduced feces from a healthy donor into the sick patient.
The patient recovered. The stool transplant helped restore the healthy ecosystem in the gut, they concluded.
“Historically we are just throwing more antibiotics at these people, noted Neil Stollman, M.D., of the East Bay Center for Digestive Health. “The right answer is to reconstitute their flora.”
The U.S. Food and Drug Administration since opened access to fecal microbiota transplants (FMT) for use by patients with recurring C. difficile disease.
Yet Stollman said he believes better, more focused approaches to delivering specific helpful microbes are on their way.
“I suspect FMT is a temporary solution,” he said. “It’s a shotgun.”
Other researchers are looking at how outer environmental diversity may have helped shape inner environmental diversity over thousands of years. They want to know if the changes that have come with modern life might impact health and disease.
“We have evolved in a microbial soup,” explained Susan Lynch, Ph.D., an associate professor of medicine at the University of California, San Francisco. Her work has led her to suspect that children who grow up in “bacterially impoverished homes” are more vulnerable to allergies.
Justin Sonnenburg, Ph.D., an assistant professor at the Stanford University School of Medicine said he believes maintaining microbial diversity within the gut is a key to health. He is concerned that urbanization, the use of antibiotics and sanitizers and dietary changes have contributed to “microbial diversity loss.” By moving away from the fiber-rich diet that sustained our hunter-gatherer ancestors, we are “starving our microbial self,” Sonnenburg said.
Concerns about the impact that antibiotics can have on the microbiota are increasingly shaping treatment decisions, the panelists said.
Meanwhile, others see stool as the next big thing.
Researchers and entrepreneurs are busy developing stool transplantation devices, new types of poop pills and storage facilities.
“You may bank your stool for future use,” noted Stollman. “It’s the wild west out there.”
