Monday, December 12, 2011

Necessity as the Mother of Invention

Necessity is the mother of invention. When desperate, innovation often issues forth as seen in the Wired article Fecal Transplants: They Work, the Regulations Don’t

to whit.

For months, physicians kept trying different drug regimens, while Thompson’s hair fell out and her muscles wasted. By summer, she was down 40 pounds and close to desperate. Scouring the internet for alternatives, she found a description of a treatment that didn’t use drugs. It was a fecal transplant, which is just what it sounds like: inserting strained, diluted feces harvested from someone with a healthy gut into the sick person’s large intestine, in hopes of replacing the devastated colony of bacteria living there with a fresh, robust one.

In two hours, she started feeling better. In three years, her C. diff has never recurred.

but, as per the the status quo,

Fecal transplants remain a niche therapy, practiced only by gastroenterologists who work for broad-minded institutions and who have overcome the ick factor. To become widely accepted, recommended by professional societies and reimbursed by insurers, the transplants will need to be rigorously studied in a randomized clinical trial, in which people taking a treatment are assessed alongside people who are not.

From the perspective of yours truly, it's follow the money as dung cannot be monetized, something big pharma realizes when seen in Merck's marketing of  Proscar vs Saw Palmetto in treating an enlarged prostate as Proscar costs three times as much and has more side effects then Saw Palmetto. Because we have a for profit medical system, solutions that are cheap, like fecal transplants, are often marginalized but there's hope, with a touch of irony.

So, to be clear, what we have is a treatment that is minimally invasive, reliable, cheap, and with a long clinical history: The earliest documented use in humans goes back to 1958, and it has a longer and still current use in veterinary medicine, especially in racehorses. Also, it works, in more than 9 out of 10 patients. Kelly told me: “There is no drug, for anything” with a cure rate routinely that high.

Being a horse has it's advantages, don't you think?
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