The invisible world
Everybody poos. While the brown stuff may be revolting, it's also home to a vast invisible world. About fifty per cent of poo consists of gut microbes. These bacteria can be highly useful; for example, in a faecal transplant – otherwise known as a 'poo transplant'. But what exactly is it, and why is it regarded as one of the most promising treatments for several chronic gut diseases?
Your body contains a huge number of microbes – enough to make up 1.5 kg of your body weight. Gut microbes make up 99% of these bacteria, digesting food, creating hormones and vitamins, and strengthening your immune system. However, factors such as an intensive course of treatment with antibiotics can disrupt this bacterial society, leading to long-term health issues. During a poo transplant, people who suffer from particular gut diseases receive an infusion of poo from a donor with healthy gut microbes. The aim is to restore a healthy balance in the gut. Such therapies are all in a day’s work at the first Dutch Donor Faeces Bank (NDFB) at the Leiden University Medical Center.
The poo transplant is far from a recent development. As early as the fourth century, the Chinese doctor Ge Hong treated patients with severe diarrhoea by giving them ‘yellow soup’, a potion containing fresh or fermented human poo. By contrast, Western medicine focused entirely on antibiotics as a cure for infections – including gut infections – after the discovery of penicillin. Although antibiotics save many lives, most patients come down with diarrhoea after prolonged use, which can pose a serious health risk. The reason is that antibiotics target not only the bacteria which caused the disease, but also many useful microbes which occur in the body naturally. Their absence clears the way for other bacteria that cause disease, such as Clostridium difficile. Currently, a poo transplant is one of the few effective treatments for C. difficile.
Several research projects have shown that more than 85% of patients with recurring C. difficile infections recover after having received a faecal transplant. In the Netherlands, poo transplants were first offered in 2016. Donor poo is obtained from volunteers who have been carefully screened. Their poo and blood are tested several times for bacteria that cause disease, viruses and parasites. Prior to the transplant, the patient is given a dose of antibiotics, after which the gut is purged with a laxative. The diluted, filtered donor poo is administered straight into the duodenum through a tube running through the nose, gullet and stomach, so the patient doesn’t taste or smell anything.
The donor poo forms a natural ecosystem containing more than 1,000 varieties of useful gut bacteria. They colonise the patient’s gut and restore its natural balance. The bacteria that caused the disease are removed and the patient recovers. Current research focuses on the effectiveness of capsules containing freeze-dried donor poo. These capsules would make the treatment a whole lot more comfortable for patients. Moreover, experts predict that it won’t be long until the creation of a standard ‘cocktail’ of bacteria, which would make poo transplants redundant.
Do want to find out more about faecal transplants or do you have any questions? If so, you can ask a Micropia lab technician at our special ‘The Lab Technician Explains’ talks, which are held daily at 1 pm and 4 pm. As part of our new Tour de Poo through the museum, the lab technicians will tell you more about the use of live gut microbes to treat gut problems.
