'Crapsules': Would You Swallow Someone Else's Poo To Treat A Serious Illness?
A new study into 'poo transplants' has identified good and bad bacteria that will help treat people with chronic gut conditions. But, the discovery is a hard one to swallow.
Helen Kapsalides was diagnosed with ulcerative colitis in her early 30s during what she described as a "very stressful" divorce.
She had an acute case of the inflammatory bowel disease (IBD), which caused painful swelling and redness in her digestive tract with a host of complications.
Now in remission, Kapsalides, told 10 daily she would have done "anything" to pull through her worst days -- like ingesting a stranger's fecal matter.
READ MORE: Poolitics: What Does Your Poo Say About You?
"I would have swallowed whatever to get better, including another person's waste.
"Back then I'd go to the toilet 20 or 30 times a day. I once had to squat in a car park to relieve myself. In those dark times, I would've taken anything."
This week, researchers at the University of New South Wales discovered which bacteria works best in 'poo transplants', otherwise known as fecal microbiota transplantation (FMT).
The team analysed human samples they'd collected during the largest clinical trial on poo transplants ever conducted.
Dr Nadeem Kaakoush, a senior author of the study, told 10 daily the findings will help determine how donors are selected.
"We want to exclude donors that have high levels of some of the 'bad' bacteria we identified and include donors with the 'good' bacteria," Kaakoush said.
Poo transplants involve transferring poo from a healthy donor to a sick recipient. The gut microbiota in the donor’s poo is then believed to establish itself in the recipient’s colon.
READ MORE: 'Tis The Season To Talk About Poo
There's evidence the medical procedure dates back to ancient China, Kaakoush explained.
He paid tribute to UNSW's Professor Thomas Borody for more recently pioneering the method in non-infectious diseases.
Poo transplants are given to ulcerative colitis patients during clinical trials via transcolonoscopic infusion (followed by enemas) and also in 'crapsules'.
The amount of 'crapsules' (poop in a capsule) one must take to ideally induce remission is "a question we're still trying to figure out", according to Kaakoush.
"Studies are underway to determine the efficacy of ['crapsules'] and answer these questions for ulcerative colitis. In the long run, we can expect such therapies will require some form of maintenance," he described.
The diet of potential donors -- who are "rigorously screened" -- is very important, as what we eat has a major effect on gut microbiome composition.
While poo transplant results for ulcerative colitis patients are promising, it’s more complicated for patients with the related condition of Crohn’s disease.
"While there are reports of efficacy in some [Crohn's] patients, the evidence is not as convincing," Kaakoush shared.
Experts aren't sure why ulcerative colitis or Crohn's disease occur in some people, but a combination of genetic, environmental and infectious factors may be the cause of inflammation and thus a defective immune system.
Diagnosed with Crohn's two years ago, Thadius Greene told 10 daily he couldn't imagine taking a 'crapsule' even if it did make him feel better.
This is despite the 27-year-old suffering from symptoms like bloody stools, constant bathroom visits, ongoing fatigue and extreme weight loss.
"I'm scared to ingest something like that. I don't know what long terms effects it might have. The thought of eating s*it isn’t right to me," he stated.
The possibility of effective treatments like poo transplants for patients is welcomed by Crohns & Colitis Australia, its CEO Associate Professor Leanne Raven told 10 daily.
"There is some evidence from recent studies that FMT is effective inducing remission in people with ulcerative colitis.
It has also generated discussions on whether FMT should be regulated by the relevant government regulatory authorities and how this would be undertaken."
More young people are being diagnosed with IBD and lack access to multi-disciplinary care, a Crohns & Colitis Australia study revealed this year.
The online patient survey found 50 percent of the respondents were mentally distressed and only 15 percent were seeing a mental health clinician.
The yearly cost of caring for Australians with IBD is estimated at $3.16 billion, which is expected to rise as the disease's impact becomes more understood.
Featured image: Adam Polak, Centre of Digestive Diseases.
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