Perils of a Hyper Hygenic Existence
A clear trend in U.S. society over the last several decades is a dedicated attempt to rid our world of “germs” through increased use of antibiotics in soaps, creams, sprays, and pills. As time passes it is becoming clear that our quest for a completely hygienic world has some noteworthy downsides.
For example, multiple studies have shown that children who spend time in more bacteria-laden environments, such as households with large families or day care facilities, grow into healthier adults. It’s one of the best examples I can think of to support the old adage “What does not kill you makes your stronger,” as the exposure to and triumph over the bacteria trains and improves childrens’ immune systems in a manner which persists through adulthood. Unfortunately, this same old adage applies to bacteria as well. As we have subjected bacteria to a barrage of antibiotics over the last several decades, they have been made stronger as well by evolving to become drug-resistant, unleashing antibiotic-resistant strains of diseases ranging from tuberculosis to gonorrhea.
Broad-spectrum antibiotics, such as Cipro, in addition to being effective against certain pathogenic bacteria, often eliminate beneficial bacteria as well. Beneficial bacteria are far more important to the proper functioning of the human body than most people appreciate. Perhaps the following factoid will help to provide some perspective: most of the DNA within your body is not “you,” but rather the genetic material of the bacteria living within you. There are a host of health problems which occur when the population of beneficial bacteria is depleted within a particular organ or system. One clear example, one with promising initial results which will surprise and perhaps even disgust you, is the infection of the large intestine by a bacteria known as Clostridium Difficile, or C. Diff from here on out.
C. Diff is a relatively common bacterium which exists in the soil and water. A healthy person exposed to C. Diff is unlikely to become ill. However, when a person is exposed after recently taking a broad spectrum antibiotic which has reduced their population of beneficial bacteria, C. Diff. can take hold in your intestines, causing potentially life threatening inflammation and diarrhea.
For the past few decades C. Diff infections have been treated with antibiotics. Being subjected to a broad array of antibiotics resulted in the evolution around the year 2000 of a new, drug-resistant strain of C. Diff. Recent reports show that the cure rate of antibiotics for C. Diff infections has now fallen to only 34%. As a result, tens of thousands of primarily elderly people per year in the U.S. are left to struggle with an infection, attempting to manage it through diet and other supportive treatment, with significant negative impact to their quality of life. Recently however, a rather surprising medical treatment has shown great promise in fighting C. Diff., the fecal transplant.
As I mentioned above, a person with a healthy balance of bacteria in their intestines generally does not become ill when exposed to C. Diff. Effectively, the good bacteria keep it in check. Some imaginative doctors have discovered that even a person with a chronic C. Diff infection can be cured, at rates of greater than 90%, by having the feces of a healthy person introduced into their intestines. The treatment recolonizes the patient’s intestine with the proper balance of bacteria.
In order for this treatment to become wide-spread, the FDA will need to approve and monitor clinical trials for fecal transplants just like any new therapy. Unfortunately, while clinical trials have begun in Canada, they have yet to start in the U.S. because of a bureaucratic hurdle. FDA-approved clinical trials are intended for investigational drugs and procedures. The FDA has yet to allow for feces to be treated as an investigational drug. This is unfortunate and unnecessary. We already transplant body parts from person to person in a variety of FDA-approved procedures. They just need to stop being queasy about it and move forward. Sick people are waiting.
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