We are essentially puppets of our guts. The doctor described a seemingly repulsive treatment method

A fecal transplant is a process in which a doctor transplants stool from a healthy donor to another person to restore the balance of microorganisms in the intestines. So far, the procedure in the Czech Republic only helps in the treatment of clostridial colitis, unpleasant diarrhea caused by the bacteria Clostridioides difficile and can lead to life-threatening conditions.

However, according to scientists, the therapy could help in the treatment of obesity, depression, or even autism spectrum disorders in the future. Intestinal microflora plays a significant role in all problems. “The gut carries more genetic information than the brain. If I overdo it, we are essentially its puppets,” says infectious disease specialist Jakub Jarý from the Masaryk Hospital in Ústí nad Labem.

Although it may appear to be a modern medical procedure, its roots go back nearly two millennia, according to Indian Dr. Lija Thomas. It was an ancient Chinese researcher from the fourth century named Ge Hong who first used the so-called “yellow soup”, as the excrement solution was called by healers at the time, to help patients with severe diarrhea.

At that time, the solution was administered orally, which patients do not have to worry about today. “I prepare a liquid solution from one portion of stool, and I either administer it to the lower part of the intestines through the anus, or to the upper part of the tract through a tube through the nose,” the doctor explains, adding that despite the frightening tone, the patient does not experience any pain during application. “It’s about as thin as spaghetti. At most it shimmers or leads to sneezing,” he adds.

The issue of fecal transplantation interested Jaré already ten years ago, when he was studying medicine. “It seemed like a nice method, so I wanted to learn more about it. And when I joined the infectious disease department of Masaryk Hospital, about a year later, a colleague started it here and I took it over from her,” he says. Now he conducts transplants in around twelve patients a year. It is rare for people to refuse a fecal transplant. “I could count them on the fingers of one hand,” comments the expert.

Feeling good about donating is not enough

Finding a stool donor is a difficult task. Many are put off by the number of examinations that are part of the process, while others cannot tolerate carrying stool from home to the doctor’s office. “Many find it funny, many find it disgusting. People don’t want to talk about it. This leads to the fact that the lay public is not aware of this type of help. They usually become interested in the issue only when they or their loved ones are about to undergo a transplant.” explains Jarý, noting that donors are most often young doctors who learn about the treatment at school.

According to Jaré, it would help infectious disease specialists if insurance companies rewarded volunteers for their help, similar to the case of blood donation. “When you donate blood, you can take time off, you can receive financial compensation and receive certain benefits. Even the stool donor has to make several visits to the doctor. And we have nothing to offer him in return, only the good feeling he can get from helping others,” he explains Spring.

Donated stool can be useful to doctors for up to half a year. The Masaryk Hospital uses a freezer to preserve it, which is capable of deep shock freezing down to minus 85 degrees.

A smoker’s stool can be addictive

It is essential for the doctor that the donor is completely healthy, both physically and mentally. “They must not take any medications, smoke or suffer from obesity or depression. The microorganisms living in the intestines carry information that can lead to the development of these phenomena in the recipient,” says Jarý. Intestinal flora affects the human nervous system thanks to nerve endings, which are at least as abundant in the intestines as in the spinal cord. The genetic information of an obese person can thus lead to an increase in weight in the recipient due to the cooperation between the gut and the brain, and the solution from the stool of a smoker can start an addiction in the patient.

However, Jarý sees potential in the phenomenon, according to him, fecal transplantation could help with problems that seem to have nothing to do with the digestive tract in the future. “There is also talk about the treatment of eating disorders, it could also help with weight loss. If it worked, I am convinced that one stool would not be enough for the patient. There would certainly have to be repeated transplants,” the doctor explains.

In addition to the family anamnesis, the doctor will also perform a basic mineralogram on the donor, an examination that will determine whether the patient is sufficiently nourished and whether his body is missing any substances. “We can’t risk anything. Sometimes a person looks obese at first impression, but at the same time suffers from malnutrition,” warns the expert. This is followed by blood sampling, testing of stool samples and examination of a rectal swab. “This is the only way we can be sure that the donor will not transmit any infection to the recipient of the transplant,” he describes. At the end of the journey, a collection container awaits the donor.

“It’s getting scary. Antibiotics stop working, hundreds of Czechs die every year (link to article with video here)