Monday 9 April 2018

The " Crap " Exchange !

The ancient Chinese world of medicine had some very brutal remedies for some ailments.  They understood that the human gut contained a vast mix of different strains of bacteria and if a bad strain predominated the answer was to introduce a good strain from someone elses gut.   That dreaded diagnosis was followed by the even more dreaded " yellow soup " treatment.

The world of medicine today knows that this tribal mix of gut bacteria can be disrupted when we take antibiotics for other medical reasons.   The whole point of antibiotics is to kill the bad bugs, but in reality it cuts a swathe through whatever bacteria lives in the gut, both good and bad.   The problem is that we often end up with a completely different tribal mix from whatever survives.

Often this includes a rather nasty species called Clostridium difficile ( C.difficle ) which causes gut inflammation and is thought to be responsible for  ulcerative colitis, Crohn's disease, and irritable bowel syndrome.  It also effects the brain and has been included in research into depression, anxiety, autism, Parkinson's disease, multiple sclerosis and obesity.

The treatment available in the past involved a procedure most people found repulsive.  It involved churning the faeces of a volunteer with good gut bacteria into a slurry and inserting this into the bowel of the person needing treatment by way of a colonoscope or an enema.

Fortunately, this line of medicine has now developed into a very civilized procedure known as a faecal microbiota transplant ( FMT ) which is now practised in a laboratory in Adelaide.  The laboratory needs volunteers to donate a faecal sample - for which they are paid - and from which the good bacteria is extracted and hygienically transferred freeze dried into a soluble capsule.  This is swallowed by the person needing treatment and the bacteria is liberated when the capsule dissolves and thus provides renewal  for the many suffering the wrong mix of gut bacteria.

It seems that this Clostridium difficile is a very common case of gut problems in Australia and we believe that it kills up to one in ten of its victims.   In 2013 the result of a study into this FMT procedure was published in the New England Journal of Medicine, which reported that the study was stopped because the results were found to be dramatic.  It was thought that the transplant was so effective that it was ruled unethical to withhold it from other participants in the study.

Despite the inevitability of toilet humour being attached to this form of treatment, the answer to an unfortunate mix of gut bacteria causing problems for many Australians now has a palatable solution by popping a pill.   The wise will not ponder the content of that pill.

No comments:

Post a Comment