How To Read a Microbiome Study Like a Scientist

bmahersciwriter (2955569) writes Scientific reports have increasingly linked the bacteria in your gut to health and maladies, often making wild-sounding claims. Did you hear about the mice who were given fecal transplants from skinny humans and totally got skinny! Well, some of the more gut-busting results might not be as solid as they seem. Epidemiologist Bill Hanage offers five critical questions to ask when confronted by the latest microbiome research.

Home fecal transplant went wrong

[nbauman]

There was an article this week in the New England Journal of Medicine about a guy who tried a home fecal transplant, and wound up in the hospital. He gave himself cytomegalovirus, with very bad gastrointestinal symptoms.

He had a 7-year history of ulcerative colitis. The doctors made recommendations but he declined many of them. Instead, he gave himself a "home brew" fecal microbiota transplant. He used stool from his wife and 10-month-old child. Some people think that stool from children is more "pristine" than stool from adults, and doesn't need testing for infectious disease. Actually, children are a bad source of stool, because they get frequent viral infections, especially if they attend day care.

He finally started following doctors' recommendations and the ulcerative colitis and cytomegalovirus cleared up after a couple of weeks.

Fecal microbiota transplant actually works well for Clostridium difficile, with more than 90% effectiveness, which is great since C. difficile can be fatal and is often antibiotic-resistant. However, in the few studies with ulcerative colitis it didn't work too well and sometimes made it worse.

The article found two other cases of people who got infections from fecal transplant.

http://www.nejm.org/doi/full/1... [nejm.org]

case records of the massachusetts general hospital
Case 25-2014 — A 37-Year-Old Man with Ulcerative Colitis and Bloody Diarrhea
Elizabeth L. Hohmann, M.D., Ashwin N. Ananthakrishnan, M.D., M.P.H., and Vikram Deshpande, M.D.
N Engl J Med 2014; 371:668-675
August 14, 2014DOI: 10.1056/NEJMcpc1400842

A 37-year-old man with ulcerative colitis was admitted to the hospital because of abdominal cramping, diarrhea, hematochezia, fever to a peak temperature of 38.8C, and drenching night sweats. Several weeks earlier, he had performed home fecal transplantation.

Re:Ask about everything

[crmarvin42]

The really frustrating part is when people who will rant against drug companies and a supposed lack of testing (which could not be further from the truth) will in the same breath rave about the latest dietary supplement (for which no testing is actually required, and over which the FDA has little legal oversight).

The food supplements industry is largely unregulated in the US due to an impressive mis-information campaign back in the 1980's which resulted in a special section of the regulations for dietary supplements. Animal feed is more tightly regulated than feed supplements. Feed additives have to prove, to the satisfaction of the FDA, that they are effective for a specific purpose. No similar requirement exists for dietary supplements.