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POOP. Also BUTT.

poop

This cartoon is from a serious article on fecal transplants, part of my course on gut bacteria. Also, it says POOP and BUTT a lot, hee hee!

As horrifying as the very idea of fecal transplants might be, it’s one of the most promising treatments to come along in ages, particularly for dealing with Clostridium difficile. C. diff, as I devoutly hope none of us knows from experience, is a truly nasty bacterial infection of the gut and highly resistant to antibiotics, even the stupid expensive new ones. From the article:

A study published in The New England Journal of Medicine in January of this year [2013] found that 13 out of 16 people treated with fecal transplants were cured of C. diff. Two of the remaining three were cured with a second transplant. The results were so impressive that the researchers found it unethical to continue the other study group on antibiotics, and they received transplants as well.

When it works, it works overnight. Word.

So why aren’t fecal transplants the first line of defense against C. diff? Simple: money, honey. Drug companies can do little to capitalize on or patent human feces. It’s highly unlikely that, without an opportunity to make money, transplants will get the research funding they deserve. Without more research, they remain controversial — a lot of doctors won’t perform them, and some C. diff sufferers resort to at-home transplants [ack! – Weasel]. To further complicate things, the FDA tried earlier this year to regulate transplants by classifying human stool as a biologic drug. That means doctors would have to get an IND (Investigational New Drug) application before performing a transplant, slowing down the process and delaying life-saving treatment. Thankfully the FDA backed off, but it’s possible they’ll attempt regulation again in the future.

This lady was completely cured of her C. diff after a single transplant from her (horribly embarrassed) nine-year-old niece. I should add, though, she still has a nasty, lifelong dose of inflammatory bowel disease, so it ain’t everything. Still.

I used to think blaming drug companies for not following up unprofitable treatments was a bit unfair. Well, actually, I still think it’s unfair — it costs bzillions to research a new drug and carry it through to approval, so of course they don’t follow up on things they can’t patent. It would be a dereliction of duty to their shareholders to do otherwise. Now I blame medical research for not stepping up just a little better. And the regulatory state for getting in the way, of course.

So that’s Week 4 of 6 – two weeks of POOP and BUTT studies yet to come!

Comments


Comment from Uncle Al
Time: June 7, 2017, 9:15 pm

…it costs bzillions to research a new drug and carry it through to approval…

Why, that’s simply terrible! I wonder why it’s so expensive?

…blame…the regulatory state for getting in the way…

Question answered.

You can look a long, long time for a govt regulation that did not have as its genesis a way to thwart potential competitors to established institutions of one kind or another. As for the pharmaceutical world’s regulations, patient safety came second.


Comment from Veeshir
Time: June 7, 2017, 9:24 pm

Why does only one person have a nose in that strip?
Is that some fecal transplant joke?


Comment from durnedyankee
Time: June 7, 2017, 9:25 pm

I just find it hard to believe our politicians (by this I mean both yours and ours) aren’t involved in this!

They are, by and large, experts on creating laws for useless (other ruder word for poop goes here) most of which they pull out of their own (other ruder word for butt goes here).

Perhaps this being useful poo, they can’t quite figure out what to do with it.


Comment from Monty James
Time: June 7, 2017, 9:49 pm

Why were you taking that class?

Anyway, all that will happen, if the heavy hand of the FDA imposes regulation, is that sufferers will simply cross the border to pharmacias and injectorias in Mexico to have stranger’s turds shoved up their hinders.

Good lord, I hope there’s no such thing as typing and cross matching for this. Fecal banks. Dookie drives for the American Brown Cross. Won’t you give today?


Comment from Ric Fan
Time: June 7, 2017, 9:59 pm

I dont believe it. It seems that people who suffer from these illnesses are the juicers, weird diets, new age sorts, obsessed with their poop. I think it is all in their head.


Comment from S. Weasel
Time: June 7, 2017, 10:09 pm

Funny you should say that, Monty. There is a poop bank and you are not the first person to refer to it as the Brown Cross. Congrats.

I’m taking the class because I really wanted to be a doctor. Then I learned you had to take hard things like math and, you know, chemistry. It turns out, I’m awfully lazy and a bit stupid.


Comment from Deborah HH
Time: June 7, 2017, 10:31 pm

It does cost the earth to research a new drug. I participated in a breast cancer drug trial underwritten by the U.S. Department of Defense. Brooks Army Medical Center in San Antonio was one of the centers chosen to conduct the trial and I just happened to be in the right place at the right time. It was a five year commitment—I was enrolled from 2011 to 2016—and I will never know if I got the drug or the placebo. It was a series of inoculations with follow-up blood test to see if my body was making antibodies.

The DoD put up the money because a lot of the people who work for the Dod are females, and DoD thought it was a good investment in the future of their work force. I agree 🙂


Comment from Armybrat
Time: June 7, 2017, 10:59 pm

I work at a hospital that is the leading researcher for fecal transplant. Ummmmm, I have pooped for science. As a healthcare worker at a major teaching/research hospital, I participate in a lot of studies. In fact, I’m a highly sought after subject. O-, CMV -. And as a healthcare professional, I’ve been exposed to one of every thing. For all I know, the lady cured of c-diff might have been cured by MY poop!


Comment from Bob B
Time: June 8, 2017, 1:59 am

I recall reading an article and watching the video of one of the professors at Caltech talking about curing clinical depression by altering gut flora.


Comment from Ric Fan
Time: June 8, 2017, 10:12 am

Isnt this how HIV/Aids got started?


Comment from F X Muldoon
Time: June 8, 2017, 11:25 am

I dont believe it. It seems that people who suffer from these illnesses are the juicers, weird diets, new age sorts, obsessed with their poop. I think it is all in their head.

Not at all. One of the, if not the, most common causes of C. difficile colitis is use of an antibiotic to treat another infection which kills off the good flora that normally would inhibit colonization by C. difficile. Other causes include chemotherapy and other immunosuppressants that have the same effect. C. difficile colitis is not benign and can lead to such treats as intestinal perforations, peritonits, and even death in more extreme cases.

As far as transmitting disease via a transplant goes, the risk is minimal if done by professionals as the donors and their, ahem, transplant material, are screened for the presence of pathogens (as Armybrat pointed out) and if present, rejected as being suitable.

Regarding the drug companies, they will be getting in on the act. Researchers at MIT hand other places have shown that transplantation of normal flora via a capsule is both viable, and readily accepted by patients.


Comment from durnedyankee
Time: June 8, 2017, 12:09 pm

Sounds crazy don’t it.
Then again the old claims about vampires being reinvigorated by the blood of, well, virgins (which presumes on the whole a certain level of youth) sounds dodgy.
Then damned if someone doesn’t do a study transfusing young people’s blood into old people and starts claiming the old people were re-invigorated.

Or – here, let me stick this goop from a cowpox lesion into your hand.

Go figure.
They discovered all of this without CO2 climate warming computer models!


Comment from Ric Fan
Time: June 8, 2017, 12:58 pm

Whats next? You all going to have poop parties and swap poop?? 😛


Comment from Wolfus Aurelius
Time: June 8, 2017, 1:03 pm

Clostridium, if I recall my readings of Berton Rouche’s tales of medical detection aright, is the genus that also contains such charming visitors as botulism and tetanus. It’s one of the few surviving anaerobic bacteria — by which the scientistas mean that it is actually poisoned by oxygen and grows best in oxygen-free conditions, not that it refuses to jog or do Pilates.

And that cleans me all up (phrase chosen most carefully) with Clostridium.


Comment from Ric Fan
Time: June 8, 2017, 1:06 pm

Again, I have to wonder why it takes so long to ID victims in the UK. There was no explosion yet people were looking for their loved ones for days before notified that they were murdered. Granted, the young guy from Spain who came to the aid of a young woman being stabbed – his body was found in the Thames and that would account for the delay.

This whole thing sucks big time and I want to see some major stomping of terrorist ass. I want to visit the UK again but I’m old and have a bad back. I cant out run a bastard with a knife or a SUV. 🙁

And with all the stabbing and shootings in London that is youth gang related, Khan needs to shut his lying mouth.


Comment from S. Weasel
Time: June 8, 2017, 1:49 pm

She used a relative’s poop, Armybrat, but your…errr…contribution to medical science is noted. You might find the article interesting, as to the differences between their procedures and yours.

She was instructed to bring her donor poop in a brand new blender, so medical staff would have a minimum of handling!


Comment from S. Weasel
Time: June 8, 2017, 1:51 pm

Stay out of the cities, Ric Fan, and you’ll be fine. The contrast between urban and rural here couldn’t be more stark.


Comment from Niña
Time: June 8, 2017, 4:19 pm

Science. It gets you coming and going.


Comment from Carl
Time: June 8, 2017, 5:44 pm

Ric Fan “Again, I have to wonder why it takes so long to ID victims in the UK.”

The police often know the identities but they do not normally release the names until the next-of-kin have been informed and they have been formally identified by relatives or close associates.

In the case of the latest London incident, it was made more difficult because only one of the 8 victims was British. There were 3 Australians, 3 French, 1 Canadian and 1 Spaniard. Three of them were tourists.


Comment from Rich Rostrom
Time: June 9, 2017, 3:30 am

Ms. Weasel: I posted a comment that seems to have been spam-trapped (for one lousy link?). Please check?

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