Fecal Transplants

Grey’s Anatomy, “In the Midnight Hour,” episode 8 of season 5 includes a fecal transplant from a recalcitrant husband to his anxious, antibiotic-compromised wife. Drama aside, fecal transplants, the introduction of gut bacteria from a healthy donor into a patient for treatment, represent a powerful potential therapy. Your gut flora may be your health destiny.

Here is a smattering of the recent biomedical research literature that is an indication of the influence of gut flora on health:

• The appendix has been identified as a bacterial reservoir to reestablish gut flora after diarrhea clears the gut.
• Fecal transplants between obese and lean patients reverses weight gain patterns.
• Hospital-acquired Clostridium infections can be treated with fecal transplants.
• Success of total gut transplants is improved by retaining the gut flora of the donor.
• Formula disrupts the gut flora of newborns leading to lower intelligence and increased morbidity.
• Prebiotics change gut flora and enhance beneficial bacteria, probiotics, that reduce inflammation and promote health.
• The National Institutes of Health have launched a major initiative to identify the bacteria that live in and on the human body.

Most of the migratory cells of the immune system are in residence in intestinal tissues that communicate with gut flora and ingested contents. What we eat determines our gut flora, but our gut bacteria also communicate with the intestines and alter our inflammatory/immune status. This gut/bacteria communication controls the shift of the gut from tolerant suppression of immunological responses to mundane food molecules, to alarmed defense against pathogens. Mistakes in communication can lead to susceptibility to pathogens or autoimmune diseases of the gut, joints, brain, etc.

The dawning recognition of the importance of the symbiotic relationship between gut and bacteria on health and disease, is also spawning numerous interventions that involve injecting donor bacteria into patient intestines. This type of procedure may be the next fad. Imagine going to a health spa for a gut flora replacement. It may soon be possible to pick your donor from a catalogue. The possibilities for celebrity gut flora are mind boggling. There may even be an upsurge in nerd transplants in preparation for college finals. You are what you eat is still true, but the potty is proving to be a measure of more than passing performance.