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cover of episode 2024 In Review: Would You Buy Poop On the Internet?

2024 In Review: Would You Buy Poop On the Internet?

2024/12/27
logo of podcast What Next: TBD | Tech, power, and the future

What Next: TBD | Tech, power, and the future

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Lizzie O'Leary
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Luke Winkie
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Lizzie O'Leary: 本期节目探讨了粪便微生物移植(FMT)的非监管市场以及人们为了寻求医疗救助而采取的非常规手段。FMT是指将健康人的粪便移植到患病人的体内,以修复肠道问题。文章讲述了Alexandra的故事,她是一位66岁的退休人员,因肠胃问题寻求非常规治疗方法,最终通过网络购买了粪便进行FMT。网络上的Reddit和Facebook群组中存在自行进行FMT的社区,一些人认为FMT可以治疗超出肠道疾病范围的其他疾病,如精神分裂症或抑郁症。目前FMT仅被批准用于治疗艰难梭菌感染(C. diff),且仅在其他治疗失败后才能使用。对FMT的误解和传统医疗的信任缺失,导致人们寻求非常规途径。人们对治疗的渴望、对医生的不满以及互联网的开放性,促成了DIY FMT社区的形成。Human Microbes网站是一个在线的粪便交易平台,通过问卷筛选捐赠者,并提供一个谷歌文档供买家选择捐赠者。网站创始人Michael Harrop认为理想的粪便捐赠者应该是年轻、健康且未接受过抗生素治疗的人。对传统医学的不信任感和对FMT简单逻辑的认同感,是DIY FMT社区存在的原因之一。Human Microbes网站允许购买者留下反馈,评价FMT的效果。通过Human Microbes购买粪便的平均价格为1000美元,捐赠者和网站创始人平分。Human Microbes网站是一个点对点的粪便交易平台,网站创始人充当中间人。Human Microbes网站要求捐赠者进行粪便检测,但检测并非优先事项。与非正规的FMT相比,正规的FMT对粪便捐赠者的筛选非常严格。自行进行FMT的方法有两种:口服胶囊或灌肠。通过Human Microbes购买的粪便,可能是胶囊形式,也可能是冷冻的粪便样本。医生认为DIY FMT非常危险,将非正规FMT比作非正规输血,存在安全隐患。曾有因FMT导致感染甚至死亡的案例。Human Microbes网站创始人Michael Harrop承认FMT存在风险,且其自身也未从FMT中获益。尽管存在风险和不确定性,Michael Harrop和Alexandra仍然相信FMT的有效性。DIY FMT社区存在着一种共识,即大家都在摸索和尝试。FDA已向Human Microbes网站发出警告信,要求其停止未经许可的FMT业务。FDA认为Human Microbes网站的FMT业务违规,因为它未经许可且治疗范围超出了C. diff。 Luke Winkie: 我相信FMT未来可能成为一种更广泛应用的治疗方法。我提到一个案例,一位父亲带患有自闭症的儿子去墨西哥接受FMT治疗,并声称效果显著。一些研究表明FMT可能对自闭症症状有缓解作用。我认为FMT可能成为一种更自然健康的治疗方式。

Deep Dive

Key Insights

What is FMT and why is it used?

FMT, or fecal microbiota transplant, is the process of transferring stool from a healthy donor to a recipient to restore healthy gut bacteria. It is primarily used to treat Clostridium difficile (C. diff) infections, but some believe it can help with other conditions like IBS, autism, and mental health issues.

Why do people turn to the internet for FMT?

People often turn to the internet for FMT when traditional medical systems fail them. Many, like Alexandra, feel ignored or dismissed by doctors and seek alternative treatments online, where they find DIY communities and unregulated marketplaces for fecal transplants.

What are the risks of DIY FMT?

DIY FMT carries significant risks, including exposure to unscreened stool that may contain harmful pathogens. There have been cases of people developing infections, such as E. coli, and even deaths linked to improperly screened FMT procedures.

How does the online black market for FMT operate?

The online black market for FMT operates through platforms like Human Microbes, where donors and recipients are matched. Donors fill out questionnaires, and recipients can choose donors based on profiles. Stool is harvested, frozen, and shipped via mail, often without rigorous medical screening.

What do medical professionals think about DIY FMT?

Medical professionals strongly oppose DIY FMT, calling it a 'horrible idea' due to the lack of screening and regulation. They compare it to unsafe practices like bootleg blood transfusions, emphasizing the potential for serious health risks.

What is the FDA's stance on FMT?

The FDA only approves FMT for treating C. diff infections when other treatments fail. It has issued warnings against unregulated FMT practices, such as those by Human Microbes, and requires proper screening and licensing for legal use.

Could FMT become a widely accepted medical treatment in the future?

Some believe FMT could revolutionize medicine, with ongoing research exploring its potential for treating conditions like Crohn's disease and autism. However, widespread acceptance would require rigorous testing, regulation, and standardized procedures, not the current DIY methods.

How much does DIY FMT cost?

The average cost for DIY FMT through platforms like Human Microbes is around $1,000 per order, split evenly between the donor and the platform operator. Recipients can choose between oral capsules or enemas for administration.

Shownotes Transcript

“Fecal microbial transplants” treat someone’s unhealthy gut with poop from someone else’s healthy gut, and proponents of FMT claim it can help treat everything from IBS to autism. But if your doctor isn’t ready to fill you up with someone else’s poop, the internet will happily oblige. 

Guest: 

Luke Winkie), Slate staff writer who published “The Poop Broker).”

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