First Airbnb, Then Uber, Now…Poop? Welcome to the Sharing Economy.

Are you an organ donor? Why stop there? 

Today, the microbiome, made up of trillions of organisms, and upward of 100 unique bacterial genes for each human one, is dominating the global conversation on nutrition and immunity (maybe even more than cricket protein), with some scientists, researchers, doctors, and advocates arguing that gut bacteria could give rise to a wellspring of miracle cures.

One of those cures is already working its magic: FMT. Fecal Microbiota Transplantation is exactly what it sounds like…a poop transfusion.

Here’s how it works: 

People who suffer various diseases, disorders, and conditions resulting from a deficiency of good gut bacteria – which itself has eroded across segments of the species in the wake of a lacking Western diet, rampant antibiotics like vancomycin, and overly sterile environments – recover their constitution with the introduction of beneficial donor samples, received via colonoscope and/or orally, that can neutralize pathogens.

These procedures often take place in hospitals and clinics, but they can also take place in the comfort of one’s own bathroom.

“It’s a repulsive thought, and people are still repulsed by it,” Stanford microbiologist Stanley Falkow recently told The New Yorker. Falkow was fired from a Newport, R.I., hospital more than 50 years ago for “feeding the patients shit,” as one administrator dismissed it. Indeed, Falkow had been developing capsules of post-op patients’ stool intended to help fight infection.

While hard proof exists only for the treatment of C. difficile, a cousin of Crohn’s, there’s a range of speculation, experiments, and increasing anecdotal evidence for promising results with ulcerative colitis, celiac disease, rheumatoid arthritis, diabetes, anxiety and depression, and perhaps even Parkinson’s and MS somewhere down the line.

In the galaxy of our microbiome might lie the source of all inflammation – as well as a successful defense.

So, how did human waste go from commode to commodity so quickly?

In 2011, two years before the first clinical trials for FMT, a friend of Mark B. Smith’s was suffering from C. difficile after having gallbladder surgery. Smith, then a Ph.D. candidate at MIT, watched this twenty something struggle through multiple rounds of ineffective antibiotics, getting sicker all the while. After finally performing a home version of an FMT using a roommate’s donation, his health turned around.

Soon after, Smith co-founded OpenBiome (also known as Microbiome Health Research Institute Inc.), based in Cambridge, Mass. Partnering with medical practitioners here in the United States and around the world, OpenBiome operates as a stool bank, providing safe access to FMT resources.

“We rigorously screen, process, and deliver frozen fecal microbiota preparations for upper and lower delivery to treat recurrent C. difficile infections not responsive to standard therapies. We also provide tailored assistance in molecular characterization, computational analysis, clinical trial design, and regulatory support for scientific and clinical research,” says the nonprofit, which charges anywhere from a few hundred bucks to $1,500 for its services.

OpenBiome has delivered treatments to more than 290 hospitals and clinics in 45 states and 5 countries, and is supporting 23 research studies. But even though OpenBiome has convinced many of its mission, the FDA has yet to assent. In fact, the agency currently classifies feces as a drug, putting Smith’s project in danger of an eventual shut-down given the stringent regulation and lag time that typically drag down the approval process.

With the increasing popularity of the microbiome in fields as disparate as neuroscience to nutrition though, our guess is that we might be passed the point of no return for the FDA to step in. The shit has hit the proverbial fan.

What are your thoughts on this debate? Would you try FMT for an illness that has seen encouraging treatment? Or is it a flash in the can? Let us know in the comments!

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