The world of fecal microbiota transplants

Healthy poop sample for fecal microbiota transplant

Bankable feces? Image by Sharyn Morrow

Fecal microbiota transplant (FMT) is the therapeutic process of transplanting feces from a healthy individual to an ailing recipient. Despite the obvious “ick” factor of receiving healthy poop from your sister, husband, or friend, people suffering from debilitating Clostridium difficile bacterial infections are overlooking the ick in hopes of a C. difficile cure. Currently the only indication for which FMT is approved by the FDA is C. difficile colitis and there is contention as to the efficacy of FMT for C. difficile treatment. A concise PLoS blog post by Ricki Lewis offers an explanation of the process and recent research into FMT that is approved even for the squeamish.

Poop pills or bacteria pills

Not to be confused with these oral poop pills, FMT requires transplantation directly into the colon

Regardless of success rate, FMT intrigues scientists and the public alike. A great example is the year of fecal sampling Eric Alm, a professor at MIT, and his former graduate student and now professor at Duke University, Lawrence David, undertook and recently published. In The Atlantic article on this adventure in weird science, David comments, “I vividly remember the first time I did it because it smelled really bad.”

For the project, the two poop pioneers collected and saved samples. This aligns with Alm’s non-profit OpenBiome, the first feces bank and provider of healthy poop for fecal transplants to treat C. difficile colitis. Fecal banking is as controversial as the FMT therapy it supports. Erika Engelhaupt discusses OpenBiome and the regulatory implications surrounding the whole system for ScienceNews. Most of the issues surround the regulation of feces as a drug by the FDA when it is intended for use in FMT. It’s hard to think of poop as a drug (though probably not one prone to abuse), but it is when “transplanted” between people.

To monitor their bowel movements and record sample collection data in a publication acceptable format, Alm and David used their own customized Tap Forms; but for quantified self enthusiasts and people serious about their bowel movements’ impact on their health, Live Science offers up five apps for tracking your poop: PoopLog, Poop Diary, Bowel Mover Pro, Places I’ve Pooped, and PoopMD.

Logo for the Poop Diary app  that tracks bowel movements

The logo for the Android app Poop Diary

An additional tool, The Poo App is a comprehensive stool tracker for iPhones that is based on the easy to use Bristol Stool Chart. This allows you to keep things organized and to identify changes in your feces from day-to-day. It generates comprehensive graphs that are both fun and informative. The app will also help you communicate your log effectively to others including your doctor. There is even a Baby Poo app for tracking the health of your infant and it gives parents another way to share about their offspring’s bowel movements!

These apps will monitor how you go, when you go, where you go, and what your go looks like, but not what your go is made of. To truly quantify yourself, you need to know what is in your feces and how that changes over time. The uBiome “gut over time” kit allows you to do that by sequencing the bacteria in your feces at three different times and is available here.

Even the most ardent citizen scientist, quantified selfer, or curious explorer may not be thrilled at the prospect of tracking their own bowel movements, but most of us track something about ourselves: the number of steps we take, our weight, our calories, what we wear each day, and more. Wearables and mobile apps make record keeping easy, and with new products popping up daily, it can be difficult to stay on top of what is new, best, and/or most popular. If you have a minute, please let us know what you track and how you do it here.

Contributed by Brooke Anderson-White, PhD, uBiome Scientist