Recently I have been reading about the not-too-distant future when our toilet tissue will give us a reading on the microbial chemicals in our intestines, with recommendations of foods that we should eat to correct for any imbalance.
Currently the Human Microbiome Project is aimed to discover how and to what extent humans rely on the collective genes of bacteria, fungi, protozoa, and viruses that live inside and on our bodies. These microbes digest food, synthetize vitamins, metabolize drugs, stimulate cell renewal in the gut, and activate our immune system. Perhaps over 8 million unique microbial genes function in and on the human body, far exceeding the 20 000 to 25 000 protein-manipulating genes discovered in the Human Genome Project. It is estimated that these beneficial microscopic colonizers may add up to 1 kg in weight to a human weighing 100 kg.
Already, therapeutic use has been made of human fecal microbe transplantation in the treatment of recurrent Clostridium difficile infection, and there are therapeutic promises in the treatment of inflammatory bowel disease and for a cluster of conditions included in the metabolic syndrome: increased blood pressure, excess body fat around the waist, abnormal cholesterol or triglyceride levels, which are related to increasing risk of heart disease, stroke, and diabetes. Historically, first records of fecal transplantation date back to 4th-century China for gastrointestinal complaints. Ancient Bedouins also ingested the stool of camels to combat dysentery. In the 17th century a German-born physician, Christian Paullini, reported therapeutic potential of ingesting human excretions. Van Leeuwenhock, peering into his primitive microscope in the late 17th century, described microbes in his stool and thus, along with Elie Metchnikoff, became the founder of modern microbiological studies.
Metchnikoff popularized fermented food products. He hypothetized that lactic acid bacteria altered the balance in colonic microbes, protecting the body from senescence-accelerating toxins. In the Second World War, German scientists saved many Afrika Korps soldiers from dying of dysentery. Witnessing the local population using fresh camel stool for the disease, they isolated Bacillus subtilis from camel dung and administered cultures to resolve the problem. In the 1950s bacteriologist Stanley Falkow, concerned about side effects of antibiotics in surgical patients, converted the stools of half of his patients into pill form, to be taken daily during their postsurgical recovery. Apparently, the treatment group had better outcomes than the nontreatment group, but the results were never published. Dr Falkow was dismissed from his post for engaging in what was then thought to be a repelling research project. In contrast to Dr Falkow’s experience, Dr Dina Kao, a gastroenterologist at the University of Alberta Hospital and associate professor in the Faculty of Medicine, is one of a handful of clinical researchers in Canada testing the use of fecal microbial transplant to treat a variety of diseases. Treatments are delivered in a number of ways, including an enema, colonoscopy, and a feeding tube into the stomach. Pills are not yet available.
And as to smart toilet tissue that might signal the need for a microbial transplant, it’s quite likely that someone, somewhere, is working on it.
—George Szasz, CM, MD
Suggested reading
de Groot PF, Frissen MN, de Clercq NC, Nieuwdorp M. Fecal microbiota transplantation in metabolic syndrome: History, present and future. Gut Microbes 2017;8:253-267.
The human microbiome project: Extending the definition of what constitute a human. National Human Genome Research Institute. Accessed 12 June 2018. www.genome.gov/275494000/the-human-microbiome-project...July 16, 2012.
Medical researcher gets the scoop on poop. Folio. Accessed 12 June 2018. www.folio.ca/medical-researcher-gets-the-scoop-on-poop.
This posting has not been peer reviewed by the BCMJ Editorial Board.