2015

The Demand for Poop

"Passing a stool-screening test may be the hardest part of the process. “It’s actually more difficult than getting into Harvard,” says Smith. Only about four per cent of people who volunteer to be stool donors pass the three-step screening process, which involves a questionnaire, and stool and blood test, meant to rule out the presence of any known pathogens. (It’s easier to pass the mail-in variety lab test, which collect much less information.)

Despite the rigorous screening process, OpenBiome still manages to collect enough stool to supply 371 clinics and hospitals in 48 states and five countries. The bank collected its first sample in October 2013 and treated six patients by the end of the year. In 2014, they treated 2,000 patients, and by now they’ve provided stool for 5,419 treatments, and counting. “I didn’t really anticipate that it was going to grow as quickly as it has,” says Smith. And while there’s a distinct ick factor tied to his product, Smith says the stuff sells itself. “What’s kind of crazy about this thing is I sent out one email to a group of clinicians who were doing fecal transplants, and since then we’ve just been responding to requests.”"

There's a Huge Advancement in Poop Science That Could Save Thousands of Lives

MICYellow.png

"This latest advancement could change lives. Instead of a colonoscopy, enema or tube up the nose, C. diff can now be treated by swallowing a small capsule. 

Yes, the pills are actually filled with poop. They contain essentially healthy fecal matter covered in an oil layer to protect the capsule, Edelstein said. Like the traditional FMT liquid, the pills are frozen to protect the bacteria.

You need a good sense of humor if you're going to work with poop all day. When Smith tells people about his line of work, "it usually leads to a very long conversation," he said. "It's very fun." People get excited about it — "maybe too excited about it," Smith continued. "People ask, 'What's it like to mail poo to strangers?'"

Save Your Microbiome for a Rainy Day

"Many of these transplants, which now only require swallowing a pill, have been done with OpenBiome’s material. The group serves as a repository and screening facility for willing "poop donors" and has provided safe transplant material to 7,000 patients. Now, it is piloting a new service called PersonalBiome, which will allow people who are vulnerable to C. diff infections to proactively save their own microbiome for a rainy day. Burgess compares it to the way a woman might freeze her eggs, if she’s worried about her future fertility."

Find out about how to participate in OpenBiome's pilot launch of PersonalBiome here

Fecal Transplants Made (Somewhat) More Palatable

"Dr. Jessica R. Allegretti, a physician at Brigham and Women’s Hospital in Boston, is putting together trials of the capsules against Crohn’s disease, obesity and primary C. difficile.

“It really does reduce the time from evaluation to procedure. It really does broaden who can get treated on a much larger scale, and for that, capsules are the wave of the future,” she said — especially, she added, for disorders that appear to require multiple treatments, or “maintenance” doses."

(Headlined "Waste As Its Own Solution" in the print edition.)

Should We Bank Our Own Stool?

"Why, I wondered, didn’t doctors work harder to prevent this collateral damage, not with store-bought probiotics, but with “microbial restoration”? Why didn’t we re-infuse patients with their own microbes after antibiotics?"

 

Find out about how to participate in OpenBiome's pilot launch of PersonalBiome here

One Man's Poop is Another's Medicine [VIDEO]

Click to view on CNN.com

Click to view on CNN.com

In this video, CNN Health correspondent Elizabeth Cohen spends a morning with Eric, an OpenBiome donor, to capture the experience of what it takes to donate stool for medicine, and how his stool gets processed into treatments (featuring Lab Technician Christina Kim).  

Stool Bank May Be Answer to Recurrent Gut Infections

"It’s a landscape that Openbiome needs to navigate, says Edelstein, but she sees advantages in going the repository route. 'In addition to being selective about the stool that we use, we can monitor the use of stool and follow up with patients a lot more systematically on a much broader scale,' she says. 'Also, we can source donors and use them over multiple treatments, so we can spread the cost of finding donors.'" 

 

 

Poop Transplants and Microbiome Makeovers

"When I talk to Smith, he seems relieved that I don’t want to talk about how he is paying people for their poop (that story’s been done, and done, and done.) I wanted to talk about where the poop was going. Because OpenBiome isn’t just sending raw material for C. diff patients: For investigators who have applied for and received the FDA’s approval, it’s also assisting in a growing number of clinical trials for many other kinds of diseases. A U.S. government database of current clinical trials around the world lists 82 results for "fecal matter transplant" related to conditions as diverse as liver diseasemetabolic syndrome and obesityHIVCrohn’s diseasepancreatitis, and Type 2 diabetes.

'I think there’s a lot of hype in this space. A lot of people look at the success that we have had for C. difficile, and think it will work 90% of the time for more complicated conditions. But if even a fraction of the hype is true—and I think it probably will be—then that’s going to have a huge impact,' says Smith."

OpenBiome featured on BBCTwo programme Trust Me, I'm a Doctor

"Surgeon Gabriel Weston travelled to Rhode Island in the US to watch Dr Colleen Kelly perform a faecal transplant — a procedure that has a 90% success rate when used to treat the life-threatening bacterial infection Clostridium difficile.

It is vital that the poo being used in the transplant is properly screened for infections and disease and it’s actually much harder to be a poo donor than you might think. At Open Biome in Boston, a non-profit company that provides screened, filtered and frozen poo for clinical use, only 6% of potential donors make it through the rigorous testing programme." 

To read more, click HERE.   UK audiences may watch the clip HERE.  

Stool Transplants Save Lives. Why Don't We Use Them Early For Deadly C. Diff?

There is better efficacy data for FMT treatment than for many things that we do to our patients. Isn’t it time that we got over our juvenile squeamishness and offered our patients life-saving stool transplants initially, without cumbersome barriers? This treatment appears more efficacious and is almost certainly cost-effective as well. It’s time for widespread adaptation of this technique, including in those who are acutely ill.

Click here for the full article.

 

You Can Earn $13,000 A Year Selling Your Poop

"It's harder to become a donor than it is to get into MIT," joked co-founder Mark Smith (who would know, as he got his PhD in microbiology there). Of the 1,000 or so potential donors who've expressed interest on his Web site over the past two years, only about 4 percent have passed the extensive medical questioning and stool testing.

The screening process can cost up to $5,000 -- so when someone makes it through, Smith and his co-founders hold on tight.

"We get most of our donors to come in three or four times a week, which is pretty awesome," Smith said. "You're usually helping three or four patients out with each sample, and we keep track of that and let you know."

Two Men Behind Fecal Transplants

Interview with OpenBiome co-founders James Burgess and Mark Smith:  

NE: Is the future of good health really in the form of poop pills?
JB & MS: When it comes to personalized medicine, this is about as personal as it gets, right? It’s definitely the beginning of engineering the microbiome; a lot of the excitement is there are so many conditions—from gastrointestinal issues to obesity to depression—that are associated with the microbiome. It's a crude way of doing it, taking everything you’ve got and putting it in someone else. We're just really scratching the surface on how to do this type of engineering and ultimately this will have broad reaching effects on how we improve everyday health, treat infectious diseases, or more complex conditions.

 

Mark Smith named to The Verge Top 50

OpenBiome co-founder Dr. Mark Smith has been named one of The Verge's Top 50 most important people at the intersection of technology, art, science, and culture.  Here is an excerpt from the piece: 

"His efforts have made the [fecal transplant] procedure — one that's surprisingly effective — far more accessible than ever before. Prior to 2013, when OpenBiome started the project, people suffering from a C. diffinfection had to try to find their own donors, and the stool sample had to be fresh. But Smith and his colleagues changed all that. He calls OpenBiome "Red Cross, but for poop," and it has the potential to turn poop into something truly life-saving."

Mark's profile can be found here and the full collection can be viewed here

The Excrement Experiment

"The inspiration for OpenBiome was a friend of Smith’s, an otherwise healthy man in his twenties who, in 2011, acquired C. difficile following gallbladder surgery. 'He ended up on seven rounds of vancomycin over a year and half,' Smith told me. 'He was very sick.' 

The man found a doctor who was open to the idea of performing a fecal transplant and waited six months while the doctor researched the procedure. Finally, unable to wait any longer, he gave himself a transplant using his roommate’s stool. 'It worked for him,' Smith, who was then completing his Ph.D., said. 'But the whole thing seemed very bizarre to me: why is it so hard to get a treatment that is very effective?'" 

Read the full story here

OpenBiome remains open to serve the medical community

Members of OpenBiome's leadership authored a Letter to the Editor of Nature Biotechnology in the September 2014 edition, correcting an article that gave the impression that FDA regulations had changed and OpenBiome was no longer in operation.  Here is an excerpt: 

"The article contained a box titled “Stool bank shut down,” indicating that OpenBiome would no longer be able to supply processed stool from rigorously screened anonymous donors for FMT. We would like to clarify that this is not the case. Current FDA guidance allows clinicians to provide FMT for patients with recurrent Clostridium difficile infection (CDI) using material either from patient-identified donors or from stool banks, such as OpenBiome. Indeed, as of July 10, OpenBiome has provided material for >600 treatments to 65 hospitals and clinics in 27 states."

The full letter, which is behind a paywall, may be available to some readers here