Originally published at: https://boingboing.net/2019/06/14/fecal-transplant-blamed-in-dea.html
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Unholy shit!
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Well, (un)shit!
Darn FDA, has to (un)shit on everything.
Guess I won’t be having a shitty day after all? 
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“The agency would not explain why [the patients] were immuno-compromised, why they were given the transplants, who performed the procedures or when or where the cases occurred.”
Went to the article for the details. Turns out there aren’t any
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Business idea: Fecal transplants from people whose shit doesn’t stink.
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Back in my day, we just transplanted fecal matter right onto the neighbor’s porch.
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Usually the best delivery system was a flaming paper bag.
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Ooooh, look who grew up on the side of the tracks that could afford paper bags and matches!
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Obligatory response from 4 Yorkshiremen
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Sadly, that was almost guaranteed to happen eventually, as fecal transplants are actually really poorly understood. Although FWIW, an immunocompromised patient is at high risk in this procedure anyway, and so there absolutely need to be screening procedures in place. That said (and the squeamish may want to turn away now) to be effective, the “donor” must be administered within just a brief period of time from being, umm, procured. Basically, it needs to be fresh and warm. There is really no way to screen that sample quickly enough without impacting the effectiveness. The usual practice would be to preapprove a donor and essentially trust they will not have acquired a resistant organism s8nce their last screening.
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“I just can’t take this shit anymore”
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start with yoghurt
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Not necessarily. There are different ways of doing the “transplants.” A common way is to take the donor material and heavily process it, dry it, and put it in pills. I assume the pills would have a similar shelf life to the probiotic pills that you can buy today, since the important part of the fecal transplant is the bacteria from the host’s intestines.
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The phrase “Eat shit and die” exists for a reason.
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As Gniob states, there are multiple ways to handle FMT. Even freezing the material is a valid method. That gives plenty of opportunities for testing and even the ability of long-term storage, blood bank style.
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And @HomeBoy E. coli dies if you look at it funny. You might be able to transfer some viable bacteria after freezing or dehydration, but certainly not the majority. The less of the (easily-killed) beneficial bacteria successfully makes the transfer, the more likely harmful bacteria, especially spore-formers like C. diff, will thrive after the transfer.
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Rob,
I’m glad to see that your perspective on this treatment seems to be evolving, but why are you so against DIY, as you put it?
I ask in all seriousness, as for thousands of people, this is the only viable course to follow. Currently, unless something like C. Diff. has been diagnosed multiple times, doctors can’t / won’t prescribe FMT. That leaves the DIY option as the only avenue to follow.
Like much in life, DIY is not for everyone. However, in this case, it is a very well documented procedure (see Sky Curtis’s The Fecal Transplant Guidebook) and something that anyone with the willpower to do it can do properly.
It doesn’t matter if the majority of particular bacteria survive freezing, etc. Bacteria multiply. The point is not to replace the biomass of bacteria in the recipient’s intestines, it’s to seed the intestines with the correct bacteria. A typical human gut biome weighs around 4 pounds. Obviously you’re not going to eat 4 pounds of poop pills to completely replace it.
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That’s not my point. The microorganisms in your gut compete for resources. In a healthy gut biome, bacteria like E. coli dominate and outcompete dangerous newcomers. That’s a big reason why a healthy gut biome is important. Part of the whole point of fecal transplant is to restore a healthy gut biome, when it’s been ravaged by antibiotics.
Freezing and dehydration give the competitive edge to bacteria that are more hardy but at lower prevalence in the gut biome, especially spore formers. They react to the first signs of environmental stress by sporing out extremely resistant spores. They include some of the most dangerous enteric microorganisms. That’s the opposite of what you’re trying to encourage with fecal transplant.
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