‘Microbiomes’ are communities of bacteria, fungi, and viruses that flourish all over our bodies and throughout the environment, on land and at sea. You can think of your microbiome like a cellular finger print, we all have a unique composition of microbes flourishing in our gut, on our skin, in our nasal cavity, basically any region that is hospitable to their growth. In fact, you have ten times as many microbial cells on your body than human cells.
An abundance of academic research has been published in the last few years linking microbiome composition to a range of diseases including obesity, cancer, allergies, depression and ageing. But a lot of it is bad science, lacking control groups or even clinical trials in humans. Biologist Jonathen Eisen at the University of California coins the pre-emptive hype, “microbiomania”.
Of particular worry is the rise of the DIY Fecal Matter Transplant (FMT), seen as a last-resort for those suffering from untreatable gastrointestinal pain. An FMT involves inserting faeces from a healthy donor into the patient’s rectum, and has proven to be 90% effective in curing C. difficile infections. There are very strict regulations in the U.S. limiting the procedure to C. difficile patients. On the other hand, in the UK, physicians are free to administer FMT at their own discretion and as a result clinics have opened up claiming to treat autism, obesity, cancer, and other diseases, all of which are scientifically unproven. FMT treatment for other conditions is only available through clinical trials in the US, and as a result it is becoming more common for people to take the DIY approach.
Whether the treatment has any positive affect or not, the biggest risk with the DIY FMT is that the donor faeces are not necessarily screened for pathogens and viruses. The non-profit OpenBiome provide hospitals with freeze-dried capsules of stool that have undergone a rigorous screening process where less than 3% of donors are approved.
Is DIY healthcare more empowering or detrimental to the general public? It’s hard to say, on one hand it has cured some people’s symptoms where they couldn’t find relief elsewhere. On the other hand, DIY FMTs have reportedly also led to significant weight gain and new bowel disease.
Then there is the ethical question of how people chose their donors and whether full consent is given. If clinical trials don’t move quickly enough, could healthy stool become a highly valued asset? Might this lead to faecal theft?
Image credit: Caroline Davis2010 / Flickr