The noses of New York Times readers were collectively wrinkling this week over a piece in the paper’s health section. According to research by a Dutch scientist published in the New England Journal of Medicine, something called fecal therapy cures patients of devastating—sometimes life-threatening—diarrhea, vomiting and fever. The intestinal upset is caused by rampaging bacterial infections.
Alas, fecal therapy is exactly what you’re thinking it is. The patients in question have usually taken a course of antibiotics, which along with killing some “bad” bacteria has also depleted much of the “good” bacteria in their guts. This has left them susceptible to another bacterial infection known as C. difficile, which can prove hard or impossible to treat with standard antibiotics. That’s where the feces come in.
Using a probe, enema, or nose tube, doctors transfer waste material from a healthy donor (usually a spouse or other family member) into the intestines of the sufferer. Within that donor stool are populations of good bacteria. Injected into the afflicted gut, these healthy microbes duke it out with the C. difficile bacteria, and eventually help stabilize—doctors say “cure”—patients’ roiling bowels.
Because it was the first to be done under controlled conditions, the Dutch study positions fecal therapy to become an accepted, routine treatment for these bacterial infections, rather than the freaky last resort alternative that’s been offered on the sly in the offices of gastroenterologists and infectious disease docs over the past few years.
But as exciting as this is for human medicine, it’s also a superb example of how much MDs could be learning from their colleagues on the other side of the species divide. In fact, veterinarians and vet nutritionists have known about fecal therapy for decades (at least).
Zoo vets have told us it’s a routine therapy for many exotic animals in their care, including primates, particularly after a round of antibiotics. They say fecal therapy is especially effective for restoring gut health in mother-infant pairs. On farms there are healthy cows and horses who serve as donor animals for sick herd-mates. Their bug-rich gastric juices are extracted through a special, permanent window (called a fistula) in their sides, and transferred to ailing animals. (See photos)
(Denise Grady referred to this in a sentence in her New York Times piece: “Fecal therapy has often been used to cure gut trouble in cows and horses.”)
In fact, gut microbes are so front-and-center in the thinking of veterinarians that one zoo nutritionist we interviewed said she was trained to “feed the gut bugs first, then the animal.” Clearly this is something that most human doctors are just beginning to appreciate.
While writing Zoobiquity, we constantly searched for the practical applications of the many fascinating connections that exist across species. Fecal therapy is a major “so what” for One Health-style approaches. We hope it opens medical minds to the power of the microbiome, including its role in weight gain and loss. For example, meat farmers have routinely altered animal intestinal microflora to promote weight-gain in pigs, cattle, and poultry. By giving animals antibiotics, they can reliably fatten animals, using less feed. What might that tell us about the effects of antibiotics on human populations?
So while simply thinking about fecal therapy might help us reduce our appetites for a day or two, the veterinary knowledge that underlies it could have a much more lasting impact on human weight management and health.
C. Difficile: By Content Providers(s): CDC/Dr. Holdeman [Public domain], via Wikimedia Commons
Fistulated Steer: By Federal Government of the United States [Public domain], via Wikimedia Commons
Fistulated Horse: By Todd Huffman (originally posted to Flickr as Fistulation) [CC-BY-2.0 (http://creativecommons.org/licenses/by/2.0)], via Wikimedia Commons