Release date: 2014-10-21 If you are younger than 50 years old, have regular bowel movements, and are willing to go to Medford, Massachusetts for a day, then you may get $40 a day for extra money, and all you need to do is produce poop. To get this income, visit the OpenBiome. It is the only independent non-profit “fecal bank†in the United States, originally built in 2012, by the Massachusetts Institute of Technology postdoctoral mark? Founded by Mark Smith. Open biota provides stool samples to 122 hospitals in 33 states for intestinal flora transplantation. Why donate donated? These stool samples collected from the faeces are mainly used to treat a particular intestinal infection, C. difficile infection. The main symptom of this disease is diarrhea, which is often associated with disorders of the intestinal flora. C. difficile infection can cause 14,000 American patients to die each year. As the problem of antibiotic resistance becomes more serious, this intestinal infection becomes more refractory and prone to recurrence. For patients with C. difficile infection, which is difficult to treat with drugs, it is currently the most ideal treatment for transplanting intestinal flora in healthy human feces. The classic method of manure transplantation is to deliver fresh feces to the intestines through a mouth or nose or an anal cannula. In this way, the intestinal bacteria in the fresh stool can rebuild the intestinal flora in the transplanted body and alleviate the intestinal infection. In order to ensure the therapeutic effect, it is necessary for the fecal provider to have a healthy intestinal flora and to ensure that the feces are fresh to maintain the activity of the bacteria, and the "fecal bank" is born under such demand. The donation process is not easy Donating money for manure seems to be an extremely easy and enjoyable way to get rich, and in fact, it is not that easy to become a fecal donor. To ensure the quality of the stool, the donor must first fill out a questionnaire consisting of 120 questions, explaining his past medical history, travel experience and recent antibiotic use. Next, a stool check is performed to ensure that the gut flora is healthy and free of high-risk pathogens. Then, blood samples should be taken for infectious diseases such as hepatitis A, hepatitis C, syphilis and AIDS. A full set of screening costs about $1,000. Fortunately, the “fecal bank†will cover the full cost. After screening, the donor can be officially employed. Open biota hopes that fecal donors can make frequent donations within 60 days, during which donors need to come to the institution at least four times a week and put their “donation samples†into a hat-shaped collector on the toilet. . Each successful donation of a sample, the donor can get 40 dollars. A single collection of stool specimens can usually be used for the treatment of 4 to 5 patients. The collected stool samples are stored at -80 ° C and transported on dry ice. The staff of the open biota said that the effects of these frozen poops are as good as fresh ones, and they are more convenient, with a longer shelf life (up to six months) and can be stored for emergency use. With 50 grams of feces, one patient can be treated. Image from: OpenBiome The target population of “fecal banks†is mainly young people because they are usually healthier. The average age of donors here is around 30 years old. The students at the nearby Taft University also contributed a lot to the faeces library. In order to encourage people to donate, the “open biota†has set up “a month's most donation award†and “single donation maximum award†in addition to the routine remuneration, and awarded “excellent awards†to outstanding donors. "King of Poop", "Winnie the Poo", "Vladimir Pootin" (here using the homonym of Vladimir Putin's name. By the way, collecting translations...). FDA management challenges The “fecal bank†project sounds very good, but there are still many controversies about the regulation of similar medical services. How to properly evaluate and monitor fecal transplants is a major problem for the US Food and Drug Administration (FDA). The FDA noted that although in many cases, this treatment has shown good results, its safety and effectiveness have not been fully verified in controlled trials. If not handled properly, this transplant may lead to new infections, and some advertisements for fecal transplants also have a variety of exaggerated publicity. However, there are many difficulties in managing fecal transplants like the test drugs. The composition of the fecal flora is extremely complex, and the means of evaluating the drug is probably not suitable for it. Moreover, if it is considered as a test drug, patients who are clinically in need of treatment will have difficulty obtaining approval for use. At present, the FDA's attitude toward fecal transplants is actually “one eye closedâ€: allowing doctors to freely perform transplants in patients with C. difficile infections that are not routinely treated, and clear management practices have not yet been introduced. In February of this year, the US Food and Drug Administration (FDA) issued a new draft guidelines for fecal transplantation. The FDA believes that patients or doctors should clearly know who is the donor of the feces. And this requirement may be detrimental to the fecal bank - they are currently only marking the fecal provider as "donor 1" or "donor 2". Now, the FDA draft is seeking feedback, and it is still unclear how the future will be on the road to standardization. Future stool pills In the past, fecal transplantation often required intubation and enema, and the implementation process was not friendly enough to patients. A recent research advance has also solved this problem. Researchers at Harvard Medical School and the Massachusetts General Hospital used oral pills from healthy donors to make oral pills, which successfully relieved the symptoms of diarrhea in some patients with C. difficile infection (see Oral "Poop" pills for details). Simple and effective treatment of intestinal infections). The researchers found that the effect of oral stool pills to alleviate the symptoms of infection is very encouraging. But for the current small research, larger studies are needed to confirm the conclusions of this study, and further assessment of the safety of this drug is needed. If “stools†and “feces†are popularized, more patients will benefit from it in the future. 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