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Gross, yes, but Buffalo doctor says a 'poop pill' could one day save your life

It may seem hard to imagine that inserting healthy stool into someone’s colon could dramatically improve their health, but doctors already have started using the practice to treat a stubborn, sometimes fatal infection called Clostridium difficile that can sometimes run rampant through hospitals and nursing homes.

“It’s extremely effective, like in the range of 85 percent, of one dose curing a C. diff infection,” said Dr. Thomas Mahl, chief of gastroenterology at the Veterans Affairs Medical Center and clinical professor and interim chief of gastroenterology and nutrition in the University at Buffalo Department of Medicine.

Mahl and other doctors envision a time, not that far off, when inserting poop into someone’s bowel can help treat – and possibly cure – a variety of autoimmune diseases, including colitis, Crohn’s and Parkinson’s.

Research conducted on small groups of people suggests that it also may be possible to insert stool from someone healthy and thin into somone sick and fat, to help the obese person get healthier and lose weight.

Mahl even envisions a day when a “poop pill” can be taken to boost health.

I’m not making this up.

This is what the gastro specialist and I talked about one day late last week during an interview for this weekend’s WNY Refresh cover story on the importance of good gut health.

“There are billions of bacteria in your gut,” he said, “probably 500 different species. We can only grow about 5 percent of those in the laboratory, so you have to use special techniques even to know what the bacteria are.

“It’s a real challenge to figure out what is there, what is normal, what is abnormal, what is pathogenic, and, can you alter that? I think most gastroenterologists feel that this is the next big thing in GI: to understand the relationship between our own bacterial/viral flora and how that relates to health and disease.”

Mahl is hardly alone. A growing number of doctors, researchers and nutritionists have begun to pay greater heed to the interplay between roughly a trillion bacteria in our gut and the far lesser number of human cells that make up our organs.

Slowly, they have begun to get a better picture about the importance of this relationship.

In the process, a variety of bacteria are getting a good name.

“The bacteria on our body are not necessarily bad and we should treat them with a little more respect,” Julie Segre, a senior researcher with the National Institutes of Health Human Microbiome Project, says in a video on the project’s website. “... We have to lose this language of warfare and thinking about bacteria as only pathogenic.

“Bacteria in the gut aid in digestion. Bacteria on the skin aid in keeping your skin moisturized and supple. And if you have a very smooth skin then you don’t have cracks in your skin where bad bacteria can get in. And the good bacteria ... are essentially holding the property on your skin.”

Mahl isn’t willing yet to concede that prebiotics, probiotics and certain foods can help rebalance the flora in our intestines – he maintained research hasn’t definitively proven this yet – but many nutritionists have no such hesitation. They can point to clients who have eliminated varying foods from their diets, added more fruits, vegetables and water, and experienced an easing in their gastrointestinal tracts.

I chose to focus this weekend’s WNY Refresh cover story in areas where most medical and food-related specialists can agree.

The debate between these groups is expected to heat up as gut research continues to flourish in upcoming years – despite reservations some experts have over the potential for cloudiness in some of the findings.

Take pesticide and antibiotics on crops and farm animals, traces of which we ingest, said Barbara Bolen, a Long Island psychologist and health coach who is the expert on Irritable Bowel Syndrome (IBS). Last year, she and Lewiston resident Kathleen Bradley, a health consultant and certified professional coach who has struggled with IBS, wrote “The Everything Guide to the Low-FODMAP Diet: A healthy plan for managing IBS and other digestive disorders.”

“The hard thing about those studies,” Bolen said, “is who wants to pay for them? There's plenty of people to pay for studies that suggest conventionally raised animals are healthy or pesticides and chemicals are healthy, but those studies are sponsored by the factory animal farmers or the pharmaceutical or pesticide companies. The challenge there is that research reflects who’s got the deep pockets.”

Bolen is among those who strongly believe that gut health can impact overall health and disease in the body.

A faulty gut lining, she said, can allow unhealthy bacteria into other parts of the body, triggering an autoimmune response and inflammation – considered the underlying cause of many diseases.

“If you view the intestinal wall like the compounds in a war zone,” she said, “you want to let the friendly guys in and keep the bad guys out. When the integrity of the intestinal wall is compromised, the bad guys are slipping in, and when they’re slipping in you’ve got to do something about it.

“So the good guys are attacking the bad guys. When the immune system attacks that bad protein that’s not supposed to be there, it’s also attacking the body’s tissue and causing the irritation.”

The more “good guys” you recruit into the digestive tract, Bolen maintained, the more fortified your digestive tract.

Poor gut health can impact acne and arthritis, she said. “There’s some discussion that it could be related to autism.”

Troubling intestinal conditions including colitis and Crohn’s disease are considered autoimmune diseases and research is looking into the role the gut lining plays in those, she said, IBS isn’t connected to the strength of the lining, she said, “but certainly is connected to the bacteria balance in the gut.”

Because so little is known about our intestinal microbiome, disagreement will continue.

But one area where many can agree is the prospect that healthy feces may become a very good thing, treatment-wise.

Doctors and researchers with the Mayo Clinic are among leading medical experts who laud the practice when it comes to the potentially deadly C. diff bacteria, a danger particularly among the elderly. See a related story here.

There’s a lot of research going on in terms of gut health, said Mahl, the Buffalo gastroenterologist, but he stressed that much involves the study of small groups of people and remains in the investigative stage.

The future of a healthier gut is on the horizon, he said, and,whether it may make us hold our figurative noses or not, healthy poop likely will play a big role.

“The more difficult part of this is that … you’ve got to get poop from somebody, screen them for various diseases to make sure it’s as clean a poop as you can get – and nobody likes to take enemas or have this given as a colonoscopy, particularly if you’re sick.”

One website already offers frozen, prescreened human stool at the ready for just such a procedure.

Scientists also are working on “frozen pills full of poop" that you can ingest, Mahl said.

“What’s coming," he said "is the real interesting stuff.”


Twitter: @BNrefresh

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