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I know it sounds gross and weird, but one day in the not-too-distant future designer poop may alter your brain.
It all starts with poop sharing.
Believe it or not, there’s a thing called a fecal transplant: a doctor harvests the poop of a healthy person and infuses it into the colon of someone who is ill. It’s not really the feces that they’re after. Lots of bacteria are hiding inside the poop and they are the gold for which the doctors are mining. About 40 trillion bacteria are living inside your body right now. Most of them reside in your gut and don’t cause any health problems. Besides all those little bugs, you are composed of roughly 30 trillion human cells. Based on widely accepted democratic principles, if each cell in your body were given a vote, a bacteria would be elected president in a landslide.
Why would anyone want to transplant poop?
Well, there are good bacteria and bad bacteria. When your colon is dominated by agreeable bacteria, your body can be balanced in healthy harmony.
When the evil bacteria rise to hegemony over your bowels, you are in trouble. There are several reasons why the balance between good and evil may get out of whack. As for many things in life, the problem may arise due to an unintended consequence of the putatively benign actions of someone in authority (in this case a doctor). If you are treated for an infection elsewhere in your body, the antibiotics that the doctor prescribes may decimate the healthful bacteria that are living peacefully in your bowels. Nature hates a vacuum, so the bad bacteria take over.
One of the worst actors is called Clostridium difficile or C. diff. Most C. diff infections are treatable, but many are resistant to antibiotics (after all, that’s how they took over in the first place). C. diff produces toxins that can make you sick with diarrhea and colitis (colon inflammation). If a C. diff infection gets out of control, it may lead to toxic megacolon, which is as bad as it sounds. Toxic megacolon can be deadly because it puts you at risk for infection throughout the body, shock, and dehydration.
That’s where the fecal transplant comes in. In those cases, when C. diff is raging and cannot be stopped by the biggest antibiotic guns, the doctors become desperate to find a way to help. To win the fight, the doctors launch an indirect attack. The doctors find it impossible to decrease the numbers of bad bacteria, C. Diff, so they restore the balance by introducing good bacteria. Although it’s pretty gross, the doctors make a suspension of the poop of a healthy person (like a poop smoothie). They infuse the feces into the gastrointestinal tract of a patient who is ill, and the healthy person’s good bacteria are dragged along; passengers on the poop ride. The strong, healthful bacteria take up residence in the patient's colon and become the dominant force. They outcompete the C. Diff for resources and thereby beat back the illness. Those transplanted bacteria may flourish in their new home and help the patient’s body resist C. diff in the future. Hooray.
With fecal transplant as a hammer, suddenly everything looks like a nail.
After the victory at the battle of C. diff, the doctors knew that they were on to something. One of the pioneers of fecal transplant may have been overheard saying, “It may smell like sh*t to you, but it’s gold to me.”
But just which bacteria are the gold? The panoply of microorganisms (bacteria, fungi, virus, etc.), including their genetic material, which naturally exist within your body are called the microbiome, with the majority being gut microbiota. The good bacteria are called probiotics. Probiotics are living microorganisms that may provide health benefits that go beyond basic nutrition. It is well known that probiotics maintain a balanced gut microbiota and are essential to physical health. The uber probiotics belong to the bacterial families of Lactobacillus and Bifidobacteria. Runners up include certain types of Streptococcus and Lactococcus.
Don’t get the wrong idea. Fecal transplants are only used as a last resort. The best way to maintain a healthy balance of gut bacteria is to live a healthy lifestyle and eat well. Certain foods, like yogurt, are chock full of live active cultures. If you choose your yogurt wisely, it may have billions of probiotics in each cup.
The science is by no means settled, but fecal transplant has been subjected to medical trials for the treatment of inflammatory bowel disease (ulcerative colitis and Crohn's disease), irritable bowel disease and constipation. Some onclologists have suggested that fecal transplant is of benefit for certain patients suffering from colorectal cancer. Fecal transplant is believed to have reversed liver failure (cirrhosis) in some cases.
Fecal transplant has also been explored for extra-gastrointestinal disorders. Some doctors believe that by using fecal transplant to sufficiently change the microbiota, they might mitigate certain types of diabetes and reverse nerve damage associated with diabetes (diabetic neuropathy). Fecal transplant has met with some preliminary success at easing certain complications (graft-versus-host disease) after bone marrow or solid organ transplant. Some studies suggested a beneficial effect of fecal transplant on Guillain-Barré syndrome (a post-viral syndrome that may result in paralysis and ventilator dependence). Some doctors have reason to believe that, in certain cases, fecal transplant may help return obese people to normal body weight. Doctors have also reported that fecal transplant has eliminated food allergies in some people.
What does any of this have to do with your brain?
A healthy microbiome is important for more than just your colonic health. Science has revealed that probiotics can also benefit the brain. The gastrointestinal tract and the brain are chemically connected by a bi-directional signaling pathway called the brain gut axis.
The gut communicates with the brain through your gut microbes, which produce molecules that carry information to the brain. Each of these bacteria can produce different substances that might affect the brain. These include bacterial genetic material, short-chain fatty acids, neurotransmitters, and amino acids. Gut bacteria can also influence the brain and central nervous system by controlling inflammation, modulating the immune system and hormone production (neuroendocrine mechanisms). Some bacteria and their metabolites might target the brain via a different pathway; stimulation of the vagus nerve (an extremely long nerve that wanders from the brain along the breadth of the gastrointestinal tract).
In 2021, an international team of scientists reported that gut microbes may even help the adult brain grow new cells (neurogenesis) or repair damaged cells. The researchers reported that some bacteria in your belly metabolize tryptophan, an essential amino acid, into small molecules called indoles. Indoles travel up to the brain and stimulate the hippocampus, a memory forming part of your brain, to grow new cells. Indoles also seem to turn on a pathway that allows the repair or replacement of damaged neurons in other areas of the brain and spinal cord.
Animal experiments suggest that fecal transplant may one day be used to help keep your brain young. In 2021, a group of scientists retrieved poop from a score of young mice and transplanted it into the colons of old mice. Using a maze running test, they discovered that the older mice displayed improved learning and spatial memory. They studied the brains under the microscope and reported that a certain brain cell, microglia (a brain immune cell) was a particular beneficiary of the youngsters’ poop. One day, your doctor may recommend a one stop, physical/mental rejuvenation: facelift, tummy tuck, designer poop infusion.
Several research teams have discovered that people with certain mental health conditions (clinically diagnosed depression, anxiety and psychological distress) also have an altered gut microbiota. It is still unknown whether the imbalance of gut bacteria contributed to the patients’ mental health conditions or whether it is merely coincidental (diet and lifestyle may have caused the gut imbalance independent from the mental condition). But, scientists reported that fecal transplant from psychologically healthy people decreased depressive and anxiety-like symptoms and behaviors in mentally ill patients. The opposite is also true: fecal transplantation of microbiota from psychiatrically ill donors to healthy recipients also transmits depressive and anxiety-like symptoms and behaviors.
An emerging field of research studies probiotics that benefit mental health. This family of probiotics has been termed psychobiotics. Bifidobacteria, Streptococcus, Lactobacillus, and Lactococcus have all been used as psychobiotics. Scientists have administered psychobiotics to both patients and healthy volunteers and have reported some interesting findings. Researchers have found that psychobiotics may affect the brain regions that control emotion and sensation. In various studies, scientists have reported that probiotics may reduce symptoms of depression, reduce negative thoughts associated with a sad mood and increase feelings of well-being. Psychobiotics, although not yet fecal transplant, have been reported to be helpful in alleviating some aspects of schizophrenia in some patients.
Other studies have shown that both probiotics and a healthy balance of good and bad gut bacteria lower levels of inflammatory markers in the blood. Some researchers, citing the salutary benefits of reduced central nervous system inflammation, have reported that probiotics may reduce the severity of multiple sclerosis in certain patients. Doctors have performed clinical trials with fecal transplant in a subset of patients with autism spectrum disorder and reported beneficial effects on neurological symptoms. Experimental trials have gone further: initial data suggests that fecal transplant may be beneficial in the treatment of Parkinson's disease, amyotrophic lateral sclerosis (Lou Ghereig’s disease), epilepsy, stroke, Alzheimer's disease and Tourette syndrome.
What is designer poop?
Designer poop is still a pipe dream. But it’s precursor, the stool bank is a reality. Filed under, they really said that, a Bulgarian doctor recently reported, “Establishing a stool bank in an Eastern European country is essential for making fecal transplant safe and more popular as a treatment method.” Once Bulgaria gets in on the action, you know it’s a thing.
Like a fingerprint, each person's microbiota is unique: The mix of bacteria in your body is different from everyone else's blend. A stool bank is formed when a multidisciplinary team of gastroenterologists, microbiologists, infectionists, and geneticists is set up to recruit healthy poop donors. The good people at OpenBiome “work with clinicians to make Fecal Transplantation easier, safer, and more widely available. (They) do so by providing hospitals with screened, frozen material ready for clinical use.” They even have a fancy webpage, https://www.openbiome.org/, which encourages people to earn money and save lives by sharing their valuable poop. Right now, the most widely accepted medical indication for a fecal transplant is a C. diff infection that has failed to be cured by other methods. Despite the tongue in cheek tone of the above, there’s no doubt that fecal transplant is a lifesaving medical advance.
The science and technology of fecal transplantation is progressing at a blistering rate. And as you know, based on your experience with tech billionaires, technology is sometimes abused, pushed to (and often through) the edge of morality. And based on available science, it seems like your gut microbiota has the ability to affect your brain through the gut-brain axis. Some people become unhappy with their faces or butts and seek plastic surgeons to lift those parts of their anatomy. How long will it be before certain people suffering the ennui of an over-privileged life become dissatisfied with their saddening gut microbiota? Of course they’ll clamor to chase their blues away with a specially designed blend of feces, chock full of supple microbiota harvested from cheerful youths. Or what about a hypercompetitive parent who is driving his distracted child towards an Ivy League school? He may insist on a fecal infusion from a blend of Rhodes Scholars and rocket scientists to provide the intellectual oomph required to push junior across the finish line.
It won’t be long before poop banks design fecal mixtures for whatever ails you. When that day comes, the illuminati will be first in line at the designer stool bank.