When you go into the bathroom, you might expect to see graffiti on the wall, right?
I recently saw something very different that left me surprised.
Around Sacramento a new kind of “writing on the wall” is showing up in some bathrooms in the form of essentially a paper advertisement taped to the stall wall making an unusual request.
The company behind this new effort, AdvancingBio, is asking people to donate their fecal matter to save lives.
Some people are perhaps understandably squeamish about talking about fecal matter and even more so about transplanting it from one person to another, but Fecal Microbiota Transplant (FMT) has shown promise as an innovative therapy. The FDA views it as an investigational new drug.
On their FAQ page the company cites a 90% cure rate for Clostridium difficile infection (C. diff) from the American College of Gastroenterology. This seems like a very outside-the-box way to help others via something that you might otherwise just flush.
As an innovative new medicine, I don’t see any risk to being a donor, although being a recipient is likely to have possibly risks in addition to benefits. For perspective, however, it is not unusual for patients with the most severe C. diff infections to die.
AdvancingBio is a non-profit company owned by BloodSource, a company that distributes blood in Northern California. I briefly talked to AdvancingBio on the phone and it seems like what they are trying to accomplish is a very positive thing. According to an article in the SacBee on the company, it is one of only two such stool banks in the country:
“Unlike OpenBiome, a stool bank in Massachusetts that offers $40 per stool sample, AdvancingBio does not offer any financial incentive to donors, instead relying on their willingness to help those in need, much like a blood bank.”
If the very promising efficacy and safety profile of FMT hold up with further study, we might expect to see more requests for this unusual type of donation on bathroom walls and elsewhere.
People have turned to do it yourself donors but there are some issues, https://www.researchgate.net/publication/265165760_From_Junk_Science_Pawn_to_Public-Led_Trials On the other hand resourceful patient scientists have made incredible but little know contributions to health science http://blogs.bmj.com/bmj/2014/10/17/amy-price-patients-doing-research-for-themselves/ Having a responsible company that offers this intervention at a reasonable cost is a plus. The RCTs on the same in Europe were stopped early because of overwhelming benefit for C-Diff resolution.
C. diff contributed to the death of my father-in-law; he got infected while in a Sacramento hospital getting a pacemaker. We would have agreed to this treatment for him.
A friend got C diff while taking an OTC PPI for GERD; she cried while talking about the months-long ordeal of getting well again.
This is a horrible infection; I hope this therapy helps!
Hi Paul, Consider the possibility that it is actually the entire bacterial ecosystem that confers a benefit, including its local environmental components. This or that species/subsecies of bacteria may not be the issue. This idea has been around for a long time now. The “drug” designation is premature, illogical, inappropriate and counterproductive.
Yeah, it may be very difficult to narrow down the potential beneficial components to specific factors that be produced in a lab as a product. As to the investigational drug designation, it is controversial with strong arguments on both sides. This recent story got a lot of attention suggesting risks: http://www.bbc.com/news/health-31168511. The fecal depository folks also pointed out that the poop has a large number of cells of the donor in it along with the bacteria.
There is great potential here, but surely there must be a way of doing this without the obvious risks of transferring feces from one person to another.
The idea long-term is to figure out the specific bacteria that are helping, grow them in a clinical lab, and administer just those. That would be a whole lot more precise. What is going on now uses a “product” that contains a vast number of different components including the donor’s cells.