Could your poo be lifesaving? 🧠

Are you a ‘super donor’, and should we be banking our healthiest poo?

Poo - something most of us think about only long enough to flush away - can, in the right context, be lifesaving therapy.

Poo transplants, formally known as faecal microbiota transplantation (FMT), involves transferring processed poo from a healthy donor into the gut of someone with certain serious illnesses.

It’s not about the waste itself, but the trillions of microbes living inside it.

Read on for more on poo transplants - how they work, who they’re for, and what the future may hold - should we be banking our healthiest poos for later life?

What we’ll cover today:

• What a poo transplant actually is

• The conditions it’s currently used for

• How donors are screened (yes, very carefully)

• Are you a ‘super’ donor?

• Should we bank our healthy poos?

What is a poo transplant?

A poo transplant - formally called faecal microbiota transplantation (FMT) - is a medical treatment where poo from a carefully screened healthy donor is processed and transferred into the gut of someone who is unwell.

Why poo? Because it’s packed with microbes that live in your gut and are naturally shed into poo as waste moves through your digestive system.

The aim is to help restore balance to the gut microbiome of the person being treated, which in turn may improve symptoms and support recovery.

FMT is a relatively new area of medicine - the first high-quality clinical trial was published in 2013, and clinical guidelines have supported its use for certain illnesses since 2018.

It’s an evolving field, but one with potential, as scientists continue to explore how reshaping the gut microbiome could influence health and disease.

What conditions is it used for

Right now, poo transplants are mainly used for one condition - Clostridioides difficile (C. diff) infection - particularly when antibiotics aren’t stopping it from coming back.

C. diff is a type of harmful bacteria that causes severe diarrhoea and stomach pain, and in some cases it can become very serious - leading to dehydration, kidney problems, or even life-threatening complications.

Current guidelines recommend FMT for people with repeated or hard-to-treat C. diff. It’s thought to work by restoring helpful microbes and helping the gut rebuild its natural defences.

There’s growing interest in whether FMT could help in inflammatory bowel disease, irritable bowel syndrome, and even potentially other conditions where the gut microbiome is involved.

But outside of C. diff, the evidence isn’t strong enough yet. For now, UK and US guidelines suggest that any use in other conditions is limited to clinical trials.

Donor screening: who’s poo is “good” poo?

Donor screening is one of the most important, and challenging, parts of poo transplants.

The main aim is safety. Doctors need to make sure they’re not passing on infections such as hepatitis, HIV, antibiotic-resistant bacteria, or gut pathogens like Salmonella or E. coli.

Screening is also designed to avoid donors with medical conditions that could potentially affect the gut microbiome, such as autoimmune, metabolic, or neurological diseases.

Potential donors undergo detailed health and travel questionnaires, plus extensive blood and poo testing - often stricter than blood donation - and are regularly reassessed to ensure ongoing safety.

Finding suitable donors isn’t easy, one recent study found that only 1.7% of volunteers actually qualified, and nearly 39% dropped out before screening was even completed because the process is so long and demanding.

Safety is taken seriously, is tightly regulated medical treatment - not something to try at home.

Are you a ‘super donor’?

In some studies, researchers noticed that poo transplants from certain donors seemed to work especially well - these people are sometimes nicknamed ‘super donors’.