Eat poop and live

May 10, 2016 7:30 AM

Josiah Zayner’s gut was making his life hell — so he embarked on an extreme DIY fecal transplant (SL Verge) [Previously]
posted by motdiem2 (31 comments total)

So it appears from the article that one can be a poop donor.
/ick
posted by oozy rat in a sanitary zoo at 8:11 AM on May 10, 2016

Eat shit.... AND LIVE!
posted by maryr at 8:18 AM on May 10, 2016 [14 favorites]

I'm glad it seems to have worked out for him, but if I were his new roommates, I'd keep a close watch for future weird-science experiments in their shared kitchen....
posted by easily confused at 8:24 AM on May 10, 2016

"I lost ten pounds with one minor change in my diet— ask me how!"
posted by roger ackroyd at 8:35 AM on May 10, 2016 [8 favorites]

Money quote here:

To get reliable results, scientific researchers typically follow rigorous protocols: multiple participants, control groups, perfectly controlled conditions. Zayner did none of that. Jason Koval, a microbiologist who does independent sequencing work in Argonne’s labs, replicated Zayner’s analysis, and his results were almost identical to Zayner’s. But because of Zayner’s lack of rigor, he was more skeptical of the experiment’s conclusion. The small number of samples Zayner collected means that it would be almost impossible to tell if the differences he found between various samples are statistically significant. As a result, his experiment is more of an anecdote than science, Koval said. "It’s a fascinating pilot study," but "you can’t firmly say ‘yes, this happened.’"

None of this is proof of anything other than a guy ate some of his friend's shit after taking some antibiotics.
posted by Existential Dread at 8:37 AM on May 10, 2016 [8 favorites]

Coincidentally, analingus is apparently seeing a surge in poopularity.
posted by yesster at 8:40 AM on May 10, 2016 [2 favorites]

He's not even sure what it is he thinks he's got and is trying to cure.
posted by Segundus at 8:44 AM on May 10, 2016 [2 favorites]

Yeah, he's got... some issues, some of which are bowel-related. He takes a mini-break, does some weird poop related stuff that he designed to make himself feel better, and... boom! A very likely chance of the placebo effect!

This is the biohacker's version of going to Lourdes.
posted by The River Ivel at 8:49 AM on May 10, 2016 [8 favorites]

None of this is proof of anything other than a guy ate some of his friend's shit after taking some antibiotics.

Well they did find that his shit is now more closely linked to his friend's shit than his (previously produced) own though

He's not even sure what it is he thinks he's got and is trying to cure.

Yes for all we know, his gut might have adapted due to entirely other factors. Or it could be a really strong placebo effect/self fullfilling prophecy - who knows - human bodies are weird. It fascinates me more as almost an art project than a medical one. The fact that his tastes have changed for example - is almost a prompt for fiction to take it from there.
posted by motdiem2 at 8:50 AM on May 10, 2016 [1 favorite]

He's not even sure what it is he thinks he's got and is trying to cure.

In fairness I've been sick for three years, none of my doctors know what I have, and they nonetheless have been perfectly comfortable prescribing me all kinds of medications to see what happens.
posted by 1adam12 at 8:50 AM on May 10, 2016 [31 favorites]

Zayner did a Reddit AMA a couple of days ago. He also has links to some of his data if you're curious (Warning: most are on Google Docs and will link/share to any open Google account you have when opened)
posted by JoeZydeco at 8:57 AM on May 10, 2016

Well they did find that his shit is now more closely linked to his friend's shit than his (previously produced) own though

Perhaps. Without actually understanding the mechanism or having a statistically significant sample size, there's not really a conclusion one can draw from his one or two samples. Maybe he's just working his friend's shit through his bowels, and his native flora will out-compete them and he'll return to baseline in a few months, or weeks, or days. There's literally no scientific conclusion one can draw here.

The microbiome is the great new hope for woo-woo pseudoscience cure-alls. Used to be systemic candidiasis, or immune boosters, or whatever. There is potential here, but until there's actual scientific rigor applied, these results are basically nothing but shit.
posted by Existential Dread at 8:58 AM on May 10, 2016 [2 favorites]

This is the biohacker's version of going to Lourdes.

My mom is going to Lourdes in June. I'm glad I will now be thinking about eating poop whenever she tells me about her trip.
posted by bondcliff at 9:04 AM on May 10, 2016 [4 favorites]

My dominating thought is that I really want to see a follow-up article, and that meal he had sounds pretty good. Glad that he can eat that.
posted by yueliang at 9:06 AM on May 10, 2016

Previously.
(maybe linked in the other previouslies)
posted by Fig at 9:06 AM on May 10, 2016 [1 favorite]

When pressed, he admits that he doesn't remember what his physician told him in college — he could have IBS or inflammatory bowel disease. And a search through his medical records is inconclusive. "I don’t think I made it up or am remembering wrong, but who knows?" he wrote me in a text.

Someone who isn't sure if they have IBD or IBS has not meaningfully attempted to work within conventional medicine to address their disease. There are many evidence based treatments for IBD that are not nearly as dangerous as home FMT (which has been studied and found ineffective in the treatment of IBD) and it appears that Zayner never tried any of them.

For someone who is obviously as scientifically literate as Zayner to say he "isn't sure" if he has IBD is, to me, evidence that he is either willfully refusing treatment so that he can engage in a mad scientist fantasy or pretending that he might have IBD to make the results of his "experiment" seem more significant.
posted by telegraph at 9:07 AM on May 10, 2016 [12 favorites]

This is a disgraceful example of incompetent science journalism. There is TONS of well-reported information (and examples) out there already about self-FMT, and there are currently many scientific studies underway (including at UCSF, just a few miles from where the 'drama' scenes of this story took place). This is needlessly sensationalist, and the author and editor should be ashamed.
posted by twsf at 9:10 AM on May 10, 2016 [2 favorites]

I found this the opposite of sensationalist. The writer pointed out the ways Zayner deviated from standard protocols but also that he self-reported feeling better and that it worked. You could just as easily accuse the writer of being too pro-self-treatment, especially since the amount of description made it easy for other people to do what Zayner did. She followed Zayner and interviewed doctors in the relevant field. That's just reporting.
posted by emjaybee at 9:19 AM on May 10, 2016 [4 favorites]

It's a fascinating and rapidly developing field. As one who administers fecal transplants or fecal microbiota transpalnt (FMT) per a colonoscope, I would advise not to DIY.

Donors are screened medically for possible GI disease by history (no recent antibiotic, no IBD, IBS, etc.) and with stool cultures for pathogens, parasite antigen tests, microscopic exams for O&P, and testing for HBV, HIV, HCV, etc. Diseases can be transmitted by any random donor. There can sometimes be significant barriers to fecal donation as all this testing costs lots of money. Insurance won't pay for it as the testing is not done on the covered individual and it is not an FDA approved (*). Individual donors sometimes bear the expense; thus, they are most commonly relatives. Random donor FMT products are not available.

* The FDA views FMT as an IND (investigational new drug) which normally requires a protocol, filing an IND application with the FDA, approval by the local IRB, etc. The FDA has stated that they will not aggressively enforce the regulations, but hospitals and doctors have been scared off because that opens them up to liability if there was a poor outcome - like the recipient C. diff is cured but they acquire HIV.

Still, applications to inflammatory bowel disease, infant necrotizing entercolitis, IBS, and other GI disorders are active. Some observations have been provocative - like animals and people becoming fat after receiving FMT from obese donors. There were at least 2 companies looking into this for commercial applications in 2015. It seems increasingly apparent that the gut microbiome cross-talks with the endocrine and immune system. Who know what the potential applications may be?
posted by sudogeek at 9:25 AM on May 10, 2016 [24 favorites]

The microbiome is the great new hope for woo-woo pseudoscience cure-alls

Maybe so, but interminable post-antbiotic IBS is no fucking joke and I wish my PCP had something to say about it besides, "that course was probably a tad aggressive. sorry."
posted by j_curiouser at 9:33 AM on May 10, 2016 [2 favorites]

My mom is going to Lourdes in June. I'm glad I will now be thinking about eating poop whenever she tells me about her trip.

Well they do give you bottles of water to take home and drink after people have been sitting in it.
posted by biffa at 9:35 AM on May 10, 2016 [2 favorites]

extreme DIY fecal transplant

Dibs on the band name.
posted by The Tensor at 9:44 AM on May 10, 2016 [2 favorites]

this is only slightly off topic but it just BURNS MY BUTT that people with IBS don't know the difference between IBS and IBD. Those of us with IBD are very well aware of the differences.
posted by janey47 at 10:12 AM on May 10, 2016 [8 favorites]

extreme DIY fecal transplant

Dibs on the band name.

Sounds like a Municipal Waste EP title
posted by Existential Dread at 10:14 AM on May 10, 2016 [2 favorites]

The possible interactions between the human microbiome and human illnesses is absolutely fascinating, and it's really exciting that we're getting better and better tools for investigating it. It almost feels like a city planner trying to fix problems solely by building and modifying infrastructure has suddenly been given access to actually talk to the people that live there.
posted by lucidium at 11:42 AM on May 10, 2016 [3 favorites]

extreme DIY fecal transplant

Dibs on the band name.

Dibs on the DIY Network show.
posted by jonathanhughes at 12:01 PM on May 10, 2016 [1 favorite]

extreme DIY fecal transplant

in a tiny house I hope.
posted by museum of fire ants at 12:40 PM on May 10, 2016

there was nothing in this article that tripped my aaaaaaaaaaaaaa meter quite like the closeup of that Ziploc bag, just leaning casually on the counter like it was full of marinade
posted by Countess Elena at 1:11 PM on May 10, 2016 [2 favorites]

There is indeed some evidence that FMT can improve IBD symptoms, but it doesn't look like a miracle cure and the evidence is not yet strong enough to recommend it, let alone a DIY version. It's also complicated because there's evidence that the different types of IBD (ileal Crohn's, non-ileal Crohn's, ulcerative colitis) are associated with different alterations in gut microbiota, and thus might be differentially helped by FMT. But from that link it looks like UC is the only type that's been studied in a randomized trial. For IBS the evidence is even weaker, I think.

Ironically I wonder if it was the antibiotics that did the trick for him, and whether the change in microbiome to resemble his friend's was kind of a red herring or just helped prevent him getting colonized with C. diff: rifaximin, an antibiotic that selectively targets the gut, is actually not an uncommon IBS treatment!
posted by en forme de poire at 3:25 PM on May 10, 2016 [2 favorites]

This guy seems like yet another example of "just because you have a PhD in one science, doesn't mean you know all sciences," as per Neil DeGrasse Tyson's pronouncements about biology and medicine.
posted by holyrood at 6:38 PM on May 10, 2016 [5 favorites]

I'm a little late to this thread, but wanted to pop in and say that I'm glad the article brings some attention to OpenBiome.org.

Poop research is astonishingly fascinating and there's a lot of incredible studies and results coming out of it. Take, for example, obesity and gut bacteria. Or studies that look at how long it takes for gut microbiota to recover after the administration of antibiotics (it ain't just a few days or even weeks).

Combine this with expanding research in biofilms, especially with the mouth, teeth and GI tract, and you've got huge new areas of research and potential avenues of treatment for a lot of things, not to mention a better understanding of how the body and its constituent parts and associated organisms work together.


When it comes to C. Difficile infections, poop transplants are a very, very big deal. It's quite literally a killer disease, and people suffer a lot and spend a lot of dough into fighting it. At what cost? Well, at the cost of cure, sometimes. The cost of essentially carpet-bombing your gut with antibiotics (metronidazole +/- vancomycin-- at least oral vancomycin isn't absorbed through the GI tract). The cost of who knows how much dough being sunk into research for new antibiotics, along with their marketing and shilling to healthcare professionals (fidaxomicin, whose trade name I won't mention, I'm looking at you).

What until recently was difficult to pursue, prepare and use has become significantly easier with OpenBiome. What can cost anywhere from US$600-$1000, >US$4k, and at least several hundred dollars for oral vancomycin, the newer fidaxomicin, and good ol' metronidazole treatment courses costs under 400 bucks for poop from OpenBiome. This, of course, does not include the cost of associated healthcare, such as visits to the doctor, labwork, follow-up care or procedural work in the event of colonoscopy-delivered poop.

OpenBiome also provides a whole bunch of support and guidance for clinicians.

This article, though, leaves much to be desired. Zayner, its subject, is also a little... wack. Yes, the roles skin and gut microflora play in our health is interesting and deserves much research, and yes, it's terrible that people suffer from illness whose symptoms might be ameliorated or cured by things western medicine hasn't adopted yet, but it's extremely short-sighted to say that it's ok if he becomes sick of in the hospital because of his actions.

It costs money, time, and effort to treat anyone in the hospital, whether you have insurance or not. We're all tied together as a society, and if you're given the opportunity to give your thoughts a larger audience, say, in the form of a web article, you should try to remember this, respect the platform and the voice it gives you. And remember to try not to look like an amateur if you're touting yourself as someone knowledgable.

Please note that I do empathize with people who suffer from IBD, IBS, C. Difficile infections, and illness in general. I do not mean to trivialize what you go through. I also don't mean to oversimplify things by using the term "poop transplants," though that's essentially what we're talking about. After a while, clinical terminology, read over and over, becomes inscrutable even to me.

Additionally, for those of you wondering: poop transplant, aka Fecal Microbiota Transplantation, is easier to pursue via the lower GI tract, either by colonoscopy or enema. The pills? Well, there's a LOT of pills you've gotta take. A shitload, even.

Finally: I have no ties, financial or otherwise, to OpenBiome. I've just been fortunate enough to have worked with subspecialists who have treated my patients with FMT from OpenBiome.

Edit: ah, just read sudogeek's comment,which is excellent and also links to OpenBiome.
posted by herrdoktor at 6:06 AM on May 18, 2016 [2 favorites]