Human Feces as Medicine?
During my childhood, medicine always tasted disgusting and I suspected that adults made it so deliberately to spite children. They could have made it delicious had they wanted to.
Disgusting ingredients have been used in supposedly therapeutic concoctions down the ages. They had three qualities: vileness, rarity, and expense. These strongly promoted the placebo effect, for who would not claim to feel better if continuing to swallow camel’s goat’s bile were the alternative? A little bit of what revolts you does you good, that is the theory.
Now at least when we resort to disgusting means, they are scientifically reasonable. I worked for a time for a surgeon in a country where antibiotics were not easily available, who wanted to test honey as an antiseptic dressing for open wounds (bacteria do not grow in honey). I cannot remember the results from the bacteriological point of view, but I recall that the aesthetic results were not pleasing.
I have also seen the use of maggots for wound cleaning. The therapy is effective, but it is difficult not to be repelled by it, especially if (as I have) you have actually suffered a parasitic skin infection by maggots.
However, my disgust at honey and maggots paled by comparison with what I felt upon reading the title of a paper in a recent edition of the New England Journal of Medicine, “Duodenal Infusion of Donor Feces for Recurrent Clostridium difficile.” The excrement of various creatures was long an ingredient of supposed remedies in the days when nothing really worked, but I had fondly supposed that medicine had passes what Freud, in another context, would have called the anal stage.
Clostridium difficile is a life-threatening bowel infection that old people in particular are liable to contract when in hospital (indeed, the rate of such hospital-acquired infection is one indication of the general state of hygiene of hospitals). The infection gives rise to dangerous diarrhea and can be very difficult to treat. The usual method is therapy with an antibiotic, vancomycin, together (sometimes) with bowel washout; but in a sixth to a quarter of cases there is a recurrence. In addition, vancomycin is a drug with serious side-effects.
The authors, from Holland, divided patients with recurrent Clostridia into three groups: those who received vancomycin for fourteen days, those who received it for fourteen days plus bowel washout, and those who received vancomycin for four days and then a duodenal infusion of a solution of donor feces, the donors of the latter having first been screened for various communicable diseases of course.
Originally the authors had expected to enroll 40 patients in each group to show a difference between them, but as the trial progressed the results were so clear-cut (as is rarely the case in such trials) that it became unethical to continue. The cure rate of those given the infusion of feces 81 percent, or 94 percent on repeat treatment; in the other groups it was 31 percent in the vancomycin alone group and 23 percent with vancomycin plus bowel washout. Furthermore, 83 percent of the patients who did not respond to antibiotics were cured by infusion of feces.
Recolonization of the bowel by normal bacteria, then, is better than antibiotic therapy alone. Here is a case in which rationality must overcome revulsion. My admiration is great for the person who first thought of such a therapy: imagination leapt over prejudice. If it had been up to me, I should have waited passively until the pharmaceutical industry developed a more effective antibiotic than vancomycin. With this method, however, the raw material is abundant and cheap and not, I presume, under patent.
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Image courtesy shutterstock / Julien Tromeur / Sebastian Kaulitzki
More from Dr. Dalrymple at PJ Lifestyle:
I think this has been around for quite a while… I worked for a time in the early 1980s in a medical Library where I had few duties to perform. Most of my time was spent reading all the obscure literature, the stranger the better… Anyway, I believe I read about the re-introduction of gut flora – possibly in Russia(?) …
BTW – some of the most shocking things I came across in my stint at this Library were from obscure local journals dating from the early 20th century… Various doctors were busy in the SF Bay Area lobotomizing people for petty crimes like shoplifting, “hysteria”, and various “female disorders” which they were too dainty to elucidate… It seems it was quite efficacious as a remedy for a wide range of “maladies”. I think this was part of a pattern of huge crimes committed by some in the medical community – effectively covered up by the fraternity of doctors ever since. Someone should investigate!
When I first heard of the poo transplant it made immediate horse sense to me. Of course I had come from a background stuffed with probiotics and live-culture yoghurt so I knew of the importance of colonic flora. I guess the argument here is that really probiotics don’t work cause all of that good bacteria is destroyed in the stomach acid. You gotta go in by the back door.
There is a form of pro-biotic that is enterically coated so it makes it’s way into the bowels without getting destroyed by stomach acid. It’s called BIO-K. Both of us take it regularly here following my wife’s 3 bouts of C.Diff, the first having been provided courtesy of a local hospital who by the way has recently decided to save money by cutting down on the infectious disease cleaning specialty staff. Smart eh?
Compared to other pro-biotics this stuff is expensive…around 35$ for 15 caps only
but cheap compared to the Vancomycin that goes for 8 to 10$ a cap making a script for 14 days worth around $500 +
No, the problem is that typical probiotics contain only at most two or three different strains of good bacteria–whereas feces contain about 200.
There are actually 10 times more bacteria living in your gut, than there are cells in your entire body. It’s true symbiosis. We feed those friendly bacteria, and in return they keep the pathogenic bad bacteria away: “Hey, this is our spot, you move on!”
Gut bacteria also provide certain vitamins that we humans can’t synthesize ourselves.
I first read about this therapy in an article documenting feces donation from one spouse to another, also with remarkable success. I wonder if that counts as a living related donor?
I’m sure the squeamishness of physician and patient resolves pretty quickly when confronted with someone dying of resistant c diff infection. Anyway, God bless those GI docs, I wouldn’t want their job. Except for the hours, of course!
This treatment will be wide spread in Obama care.
And remember, spread wide. Will probably appear in the next year’s school nutrition guidelines.
Soylent Green is people. Soylent Brown is…
It IS Obamacare.
Today, one can get honey infused bandages via amazon.com. I guess the results worked out pretty well in that case.
It seems that this is old news.
http://en.wikipedia.org/wiki/Probiotic
Probiotics are also delivered in fecal transplants, in which stool from a healthy donor is delivered like a suppository to an infected patient.
http://en.wikipedia.org/wiki/Fecal_bacteriotherapy
Yep I have seen this done. I worked over 40 years as an RN in the hospital and C diff is very nasty. I have also seen maggots used but not deliberately. It was in the days before air conditioning, a patient with a compound fracture and a cast. When the cast came off the wound was full of maggots. Oh the stories I could tell.
Snicker. Yes, my admiration also great who thought of the therapy, but that pales in comparison to the admiration of the first volunteer to receive it. You’re going to do what?
There is no shortage of donors amongst the media, the political class and Hollywood. They can start a public service campaign with the motto. “Don’t Just Sit. Give a Sh*t.
honey works as an antiseptic because the water content of honey (normally) is too low to allow bacterial life. bacterial die from having their fluids sucked out into the honey.
I just read an article yesterday in the Daily Mail about a nurse from some far off land that started a program in GB of using sugar to dress serious infected wounds and it worked almost all the time. It was a remedy used in his homeland and I believe it worked a lot like the honey you described, but I don’t remember the details.
A mix of sugar and Betadine (sugardine) is an old military medic “trick”.
So it just occurred to me there’s a new version of that old curse
“eat s_ _ t and die” It’s now ” Eat s_ _ t and live”
I suspect that the success of the fecal transplant had something to do with the mix of the bacteria rather than any one species. And the fact that the transplant was between marital partners probably means that the bacteria were well suited to handle their common diet. We need to know a lot more before we can tell what would happen if feces was transplanted from a vegetarian Indian to a meat-eating Texan.
We have a lot to learn about the microbiome and how it interacts with us.
The reason spouses are typically the donor is because it is assumed that both parties would have been exposed to each other’s germs/pathogens from living together for many years. Still, basic screening is warranted. So this is a unique situation unlike donors for other kinds of medical needs where extensive blood anaysis is performed for typing and matching. I suppose if one didn’t have a spouse, a long-time room mate would likely be the first best option.
I suspect our head honcho in DC has been the recipient of many a donation over the years, however it appears that it settled between the ears, not in the rears…
Actually, I don’t think it qualifies as a transplant, nor even a transfusion, more like sharing shit. I wonder if it’s approved and covered under HHS treatment mandates for sharing the wealth?
Bacterphages, viruses that live in diarrhea, were discovered at about the same time as antibiotics. Antibiotics took over, as did the power of the pharmaceutical industry. Bacterophages are still a viable alternative to antibiotics, and are actually part of treatment regimens in some Russian hospitals. Once we have exhausted all working antibiotics, this is still going to be an option.
Of course this has little to do with this article. Just a “disgusting” bit of poop trivia.
In my understanding, any dose of bacteriophages administered to cure disease is considered a drug under the US’s Food and Drug Administration (FDA) rules. And live viruses as medicine were never contemplated when FDA regulations were established. That’s why bacteriophage treatment has not gotten much research in the US.
Another odd treatment that is now receiving a lot of attention is the use of parasitic worms to give an overactive immune system something real to work on.
With autoimmune diseases, the body’s immune system goes into overdrive, attacking itself as if one’s own tissues are an invader. Many suffer from Crohn’s disease, an inflammatory disease. Allergies are another example of how the body’s immune system overreacts to the wrong things.
There is a theory, called the Hygiene Hypothesis, that suggests that the reason why these autoimmune and allergy diseases are so prevalent in our developed Western society is that we’re just too clean. Our immune system–which constantly looks for invaders to attack–can’t find any, because sanitation and home cleanliness has rid us of most parasites. So instead, it eventually locks in on harmless pollen or (even worse) on the body’s own tissues.
I personally know one mom who is such a fanatic about cleanliness that she follows her own 5 year old son around the house, constantly cleaning everything he touches and spraying disinfectant around anything he tracks in from the outdoors.
So they’ve learned how to distract the immune system by giving it something real to work on. Patients ingest the ova of parasitic worms. The worms hatch inside the patient’s digestive system. These are species that don’t reproduce in humans, so once the worms die naturally, the patient is rid of them.
http://en.wikipedia.org/wiki/Helminthic_therapy
And in the meantime, LET your kids get dirty when they play! It won’t kill them.
Forgot to add the most important fact about bacterophages; they are viruses that kill specific bacteria, like Pseudomonas or MRSA.
Excellent article . Also check out urine therapy. I daughter a teacher get ringworm from one of her students and in my research I read how your own urine can cure ringworm. Romans use their urine to make their teeth white.
from the poet Catullus born 84 BC
“Egnatius, because he has snow-white teeth, smiles all the time. If you’re a defendant in court, when the counsel draws tears, he smiles: if you’re in grief at the pyre of pious sons, the lone lorn mother weeping, he smiles. Whatever it is, wherever it is, whatever he’s doing, he smiles: he’s got a disease, neither polite, I would say, nor charming. So a reminder to you, from me, good Egnatius. If you were a Sabine or Tiburtine or a fat Umbrian, or plump Etruscan, or dark toothy Lanuvian, or from north of the Po, and I’ll mention my own Veronese too, or whoever else clean their teeth religiously, I’d still not want you to smile all the time: there’s nothing more foolish than foolishly smiling. Now you’re Spanish: in the country of Spain what each man pisses, he’s used to brushing his teeth and red gums with, every morning, so the fact that your teeth are so polished just shows you’re the more full of piss.”
he only lived for 30 years so I wait for the results from others before I test this myself
All that talk of smiling and white teeth reminds me of Joe Biden. I wonder…
I found that article hilarious as well as informative.
Well, with a lot of garlic and black pepper, it might go down.
With a little research I don’t doubt you could culture the bacteria in something like an agar base and use that for implants.
The other point is the nearly complete failure of hygiene in most hospital settings, and that conventional medicine is still very nearly blind to anything like second-order effects of even the most basic medicines.
Though in most hospital settings the basic challenge of getting the right pills to the right patient at the right time, is almost more than they can handle.
Medicine has advanced a LOT in the last forty years, and even more than that if you go back a second forty years, but the *next* forty years should really put it all in the shade, for the first time we have at least a view of the molecular basis of the human body, pathogens, and symbiotes.
As someone who has been involved with infection control in hospitals, I can attest to the dangers of c-diff and how antibiotic resistant strains of this bacteria are mutating rapidly. There is now a strain of c-diff that is lethal.
Bravo to the doctors who developed fecal infusions. The stats are impressive, with cure rates exceeding 90%. It beats taking vancomycin for months if not years on end. And, by the way, long-term use of vanco carries its own risks, including VRE – a very nasty bacteria (enterococci) that is resistant to vanco – as well as the unknown factor of what it means for a person to be on antibiotics long-term.
Yes, the idea of having someone else’s fecal matter infused into your gut is gross. But so is having poison dripped into one’s veins as our best way to fight many types of cancer.
I hope the medical community and the public will get past the “gross” factor and realize this therapy is a God send for so many people. You can imagine how desperate a person would have to be to sign up for it. Hopefully, in the future, it will be an established form of therapy that won’t require desperation. Because none of us should hold our breath for new and improved antibiotics to fight antibiotic resistant bacteria. Research and development of antibiotics is not a hot area because antibiotics are typically used short-term. There’s much more money to be made in meds for chronic illness.
Some of the doctors who have pioneered fecal infusions have also done some excellent research into probiotics. Most probiotics, by the way, are not worth the money since we don’t yet understand which bacteria and how much is needed in the human GI tract (something that may be highly variable from person to person). In addition, random testing of probiotics shows many if not most don’t contain the number of bacteria they claim. Plus, if you’re on antibiotics, it’s a waste of money to take probiotics since the antibiotic will kill the presumably good bacteria you’re taking. In sum, there’s more hype than anything real behind most probiotics on the market, whether in capsule form or via yogurt.
The one probiotic that has very solid science behind it is saccharomyces bouladrii (brand name Florastor) which is not a bacteria, but rather a yeast. There are excellent studies that show this to be helpful for those battling c-diff, not as a cure in itself by any means, but as a supplement to take while on treatment and for several months after treatment.
In closing and worth nothing, c-diff is no longer a superbug that only elderly people in hospitals or nursing homes get (though they are surely at increased risk). “Community acquired” c-diff is becoming increasingly common. So count your blessings if you have not had the bad fortune to contract it and be thankful there are doctors out there working tirelessly to help those who have fallen victim. (And if you think using alcohol-based gels to clean your hands will protect you, think again. It won’t. C-diff is a spore-forming bacteria that is resistant to alcohol. Thorough hand-washing is the way to go.)
Do psychs know how ECT works yet?
Just curious.
per my education (nearly done with MA Clinical Psych) – nope.
just that it does have some use in certain situations…
I misread the title. I thought it said “Human Feces as Policy”.