IT’S one of the most exciting advances in science, yet the idea is hard to stomach.
Tiny “crapsules” — yes, that’s pills filled with poo — could help save the lives of people with a host of life-threatening diseases.
The therapy, known as faecal microbiota transplant, involves administering a healthy person’s stool, and all their gut bacteria into the bowel of another unwell person.
It has the “yuck” factor, but FMT could one day be a groundbreaking treatment for a number of diseases, with trials ongoing for insomnia, Parkinson’s, allergies, bowel diseases and even cancer.
Last month Rick Dallaway, from Stratford-upon-Avon, West Mids, became the first person to finish treatment during a study looking at how FMT could help ease a rare liver disease.
The 50-year-old knows there is no cure for his chronic condition — primary sclerosing cholangitis — which causes scarring of bile ducts and can lead to cirrhosis.
Rick who works in data protection, tells Sun Health: “Because I had an interest in gut health anyway, I thought, ‘Wow, this seems like the trial for me’. I signed up the next day.”
Rick is the one of 58 people in England taking part in the Fargo trial, led by Dr Palak Trivedi, a clinician scientist at the National Institute for Health and Care Research Birmingham Biomedical Research Centre.
It will test whether FMT can improve quality of life in those with PSC, which mostly affects the under-40s.
Participants do not know if they are getting the treatment or a placebo, and their cases will be followed for 40 weeks.
Rick finished his treatment in July. Asked if he felt any different, he said: “To be honest, no I don’t. If I’d had the placebo, I suppose that would be expected.
“It did feel strange, knowing the implant came from someone else, but I was told the stool was treated in a lab. That helped with the ‘ick factor’.”
Usually, FMT is delivered via a colonoscopy or enema into the bottom or a thin tube inserted through the nose and then into the stomach.
Rick had enemas once a week, and says: “The enema is administered and then you lie down for around 30 minutes, which gives the sample time to populate the colon.
“You hold on as long as possible, because at that point you need the toilet.”
That’s not the only way “poo transplants” can be administered, though.
King’s College London scientists are making so-called “crapsules” as part of the Promise trial, to look at whether FMT can reduce infections in liver disease patients.
Chief investigator Professor Debbie Shawcross, says donors are “carefully screened” and “healthy”.
There are hundreds of global trials under way, says Dr James Kinross, a senior lecturer in colorectal surgery, consultant surgeon at Imperial College London and author of Dark Matter: The New Science Of The Microbiome.
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He adds: “It’s hugely exciting. But it is a comparatively new science.”
FMT may “hold the secret to youth”, according to researchers in China, who claimed last year it could be capable of “reversing the effects of ageing on the digestive system, the brain and vision”.
Kim Kardashian, who famously said in 2022 that she’d “eat poop every single day” if it meant she could defy ageing, will be delighted.
The interest in FMT links to the gut microbiome – the ecosystem of bacteria, fungi and viruses that live in your intestines.
Prof Shaw says: “Seventy per cent of our immune system is in our gut as we have a large population of microbes.
“In health, we live in harmony with these microbes. However that can be disrupted by antibiotics, a poor diet or an infection (food poisoning etc).
“Then pathogenic bacteria (those that cause harm) can outgrow the beneficial species.
“This leads to gut barrier damage and translocation of harmful bacteria across into our bodies, which disrupts our immune responses and leads to a greater risk of infections and chronic inflammatory diseases.
“FMT is a way of restoring good microbiota.” Dr Kinross says: “FMT is being applied for conditions like obesity, diabetes, Alzheimer’s or Parkinson’s because the common bit of our biology that connects them all is the immune system.”
How did our guts get so unwell that the only solution is to have a faecal transplant?
Dr Kinross
For now, there is only one approved use of FMT in the NHS. In August 2022, regulators gave the green light for it in adults who have had multiple episodes of clostridium difficile (C. diff) which are not resolved with antibiotics — affecting up to 500 people per year.
Simon Goldenberg, a consultant micro- biologist at Guy’s and St Thomas’, is the chief investigator on KCL’s Feraro trial, which is looking at whether FMT can cure people with antibiotic-resistant superbugs.
But he says that other than for ulcerative colitis, a type of inflammatory disease, “the evidence isn’t fantastically convincing” for FMT. Alarmingly, the FMT buzz has even seen people performing their own DIY transplants — against medics’ advice.
US film-maker Saffron Cassaday, 36, claims implanting her actor partner Al Mukadam’s stool into her gut at home cured her ulcerative colitis.
In her documentary, Designer S***, she interviewed Charlie Curtis, a thirtysomething who claims DIY transplants relieved him of Crohn’s symptoms.
But he says he developed his mum’s menopause symptoms after using her stool for four years.
The long-term side-effects of FMT are not yet clear, such as whether it could trigger the likes of type 2 diabetes or obesity.
In 2015, US docs reported a woman, 32, became “obese” after doing DIY FMT for C. diff using her overweight daughter’s poo.
Dr Kinross says that, although FMT transforms lives, “there’s a huge amount of unknown with it”.
But he sees it becoming increasingly popular. Some private clinics offer it for issues such as fatigue, brain fog or allergies, for up to £5,000.
But Dr Kinross says: “How did our guts get so unwell that the only solution is to have a faecal transplant?
“This tells us that we really have to protect the bugs within us.”
