


Do You Really Need Poo-in-a-Pill?

Story at-a-glance -

  • Fecal transplants, in which donor feces from a healthy person are transplanted into a patient, are showing remarkable results in treating health conditions such as Crohn’s disease and Clostridium difficile infection
  • Capsules containing fecal bacteria from healthy donors are another, less invasive way to “transplant” healthy bacteria into your gut, according to more recent research
  • It is highly probable that many of our modern diseases are the end result of a dramatic disconnect from the natural world, which teems with microbiota, as predicted by the so-called Hygiene Hypothesis
  • Maintaining a healthy environment in your gut, by eating unpasteurized fermented foods and/or taking a high-quality probiotic supplement, along with avoiding antibiotics, will support your overall health and well-being

By Dr. Mercola


Many still fail to recognize that the microbes in your gut influence far more than your digestion—their influence actually extends to your brain, your heart, your skin, your mood, your weight, even genetic expression…

Colicky babies who are exclusively breastfed may also benefit from probiotics, according to recent research.1 In many ways, your health is deeply rooted in your gut bacteria, both in terms of maintaining emotional and physical wellness and preventing chronic disease.

Modern living, with its obsession with keeping our surroundings as sterile and germ-free as possible appears to have backfired in a most dramatic way, by making us more prone to sickness. Germ-free living, it turns out, is not in your best interest.

Fecal Transplants—the Latest Advance in the Battle Against Severe Disease

Two years ago, I reported on the emergence of fecal transplants, a relatively simple process in which feces from a healthy donor is transplanted into a patient, typically via an enema or colonoscopy. The procedure has shown remarkable results in treating a wide range of health conditions.

Sad to say, earlier this year a relative of a good friend of mine was hospitalized and came down with a serious C. diff infection. I strongly advised the family to get a fecal transplant. However, the family refused, and listened to their conventional doctor. The relative died a few days later. So this is serious, and you need to pay attention as this might affect someone you know.

According to Dr. Mark Mellow, medical director of the Digestive Health Center at Integris Baptist Medical Center in Oklahoma City, fecal transplants lead to rapid resolution of symptoms in 98 percent of patients with Clostridium difficile who don't respond to multiple previous treatments.

C. difficile is a bacterial infection that is often resistant to antibiotics, is often debilitating, and can be fatal. Research has also found that fecal transplants show promise in the treatment of Crohn's disease and ulcerative colitis, with symptoms sometimes improving in mere days.

Preliminary research2 from the Netherlands has even revealed that transplanting fecal matter from healthy thin people into obese people with metabolic syndrome led to an improvement in insulin sensitivity, which adds further credence to the immense role healthy gut bacteria can play in your health.

It's not surprising then to learn that conventional medicine is taking such findings to the next level—this time by putting donated fecal bacteria in a pill... However, I would dissuade you from thinking that this might be a magical route to fix less than life threatening conditions.

While I believe fecal transplantation can be lifesaving in some circumstances, I want to make it clear that you will likely never have to resort to receiving donated feces if you address your gut health on a daily basis—by avoiding factors that kill off your beneficial gut bacteria, and continuously "reseeding" your gut through a healthy diet.

Also, any time you take an antibiotic, it is important to take probiotics to repopulate the beneficial bacteria in your gut that are killed by the antibiotic right along with the pathogenic bacteria. If you don't, you're leaving the door wide open for further health problems.


Fecal Bacteria in a Pill May Successfully Treat Gut Infection

That said, as reported in the featured article,3 capsules containing fecal bacteria from healthy donors are another, less invasive way to "transplant" healthy bacteria into your gut, should you suffer with chronic, debilitating gut infections. According to Thomas Louie, an infectious-disease specialist at the University of Calgary in Alberta, Canada, 30 out of 31 patients were successfully cured of recurring Clostridium difficile infection with such pills.4

As reported by Scientific American:5

"C. difficile often sets in after antibiotic use has disrupted a person's normal balance of gut bacteria. A gut microbiome transplant using bacteria from the feces of a healthy donor restores that balance, and can be highly effective against C. difficile, which is notoriously difficult to treat with antibiotics.

...The patients in Louie's study each swallowed 24–34 freshly assembled capsules of bacteria, which were coated with gelatin to survive the stomach and reach the intestines. The team followed the patients' progress for up to one year afterwards by sequencing the gut microbiome. They found that C. difficile had disappeared and bacteria associated with a healthy gut microbiome, such as Bacteroides, Clostridium coccoides, Clostridium leptum, Prevotella, Bifidobacteria and Desulfovibrio, increased in numbers."

The fecal matter in question is typically donated by a healthy family member, so the pills are made for each individual patient. To make them, the feces are processed until only bacteria remains, which are then encapsulated inside a triple-layer of gelatin in order to safely make it through your digestive system into your intestines before dissolving. According to Dr. Ravi Kamepalli, MD, an infectious diseases physician and author of a study on fecal transplantation tolerance, fecal transplantation has a 98 percent success rate, and the vast majority of patients report being overall satisfied with the ease and effectiveness of the procedure.

"Human beings are 90 percent bacteria and once that balance is altered with antibiotics, opportunistic infections can cause serious problems. All we are doing with this treatment is resetting the balance," Dr. Kamepalli told Medical News Today.6

What Bush-Men Are Teaching Modern Scientists About Microbial Balance

An interesting article published by The Human Food Project7 highlights the dramatic differences between our ancestral behavior and modern living, in terms of how we maintain this crucially important balance with microbes of all kinds. In it, the author, Jeff Leach, a Human Food Project researcher, describes a recent visit to the Hadzu, a tribe of traditional hunter-gatherers in Tanzania.

"I had come to Tanzania as part of a collaboration of US, Canadian, and Tanzanian researchers to try and understand what the gut microbiome might look like in a group that still hunts and forage's 95-100% of its food..." he writes.

To his amazement, after killing, skinning, and gutting an Impala, the Hadza men scrubbed the blood off their hands using a handful of the animal's stomach content. They also consumed partially raw chunks of the Impala's intestines that had been quickly roasted over an open fire for about a minute. Leach continues:

"Whether it's an Impala, Dik Dik, Zebra, bush pig, Kudu or any other of the myriad of mammals they hunt and eat, becoming one with the deceased's microbes in any number of ways is common place – same goes for 700 plus species of birds they hunt (minus abundant amounts of stomach contents for hand sanitizer!). While less obvious than at the 'kill site,' the transfer of microbes continued back in camp when women, children and other men handled the newly arrived raw meat, internal organs, and skin. The transfer continued as the hunters engaged (touching) other members of the camp."

Despite the ingrained fear of germs in Western societies, it is highly probable that many of our modern diseases are the end result of a dramatic disconnect from the natural world, which is teeming with microbiota. The so-called hygiene hypothesis states that early exposure to dirt and germs actually programs your immune system to properly identify threats. According to this theory, if you're healthy, exposure to bacteria and viruses can serve as "natural vaccines" that strengthen your immune system and provide long-lasting immunity against disease.

As Leach discusses in his article, there's compelling evidence showing that we probably need to be exposed to FAR more microbial organisms than we currently allow ourselves to be:

"[C]learly our hunter-gatherer ancestors had a more intimate involvement in the total microbial metacommunity of the environments they inhabited than we do in the concrete jungles we call home.  It's tantalizing to think that as part of this microbial web, that our ancestors didn't benefit in some way with the nearly daily sampling and exchange of microbes with animals as diverse as zebra, impala, birds, or even carnivores... or from a dizzying number of plants sprouting from soil teeming with bacteria (and their genes) worth sampling and possibly utilizing for our mutual benefit. Not only is this plausible, it's highly likely."

Gut Health Begins at Birth

A baby's initial exposure to microbes occurs during the birth process itself. As he is squeezed through the birth canal, your baby receives his first dose of bacteria. This initial transfer of microbes from mother to infant is the reason why it's so crucial for pregnant women to optimize their gut flora before and during pregnancy. Failure to do so can have wide-ranging consequences for the child's health.


In short, abnormal gut flora sets the stage and can have a dramatic impact on your child's overall mental and physical development. Add to this the tendency for modern mothers to carry disinfectant lotions, sprays and wipes everywhere they go, in case little Junior should happen across a piece of dirt, and this initial abnormal composition of microbiota could easily be compounded.

Inappropriate use of antibiotic drugs is another factor. Despite repeated warnings that antibiotics do not work for most cases of sore throat and bronchitis for example, doctors are still prescribing them8 for these conditions. Not only does this unnecessarily decimate your gut bacteria, which are critical for the optimal functioning of your immune system, this kind of misuse is also driving the rise in antibiotic-resistant infections that are far more deadly.

There's also been a significant decrease in breastfeeding since the advent of infant formula, and this too plays a role. We now know that breastfed babies develop entirely different gut flora compared to bottle-fed babies. Infant formula never was, and never will be a healthy replacement to breast milk, for a number of reasons, and altered gut flora is one of them.

Your Health Hinges on What You Put Onto and Into Your Body

As discussed by Dr. Robynne Chutkan, MD in a recent interview by The Atlantic9 about her new book Gutbliss: A 10-Day Plan to Ban Bloat, Flush Toxins, and Dump Your Digestive Baggage, your health is really dependent on your digestive wellness, and it all begins with what you do and do not put into your mouth.

Dr. Chutkan's expertise is in the area of Crohn's disease and ulcerative colitis, but the impact of gut microbes go far beyond that. For example, she rightfully points out how your skin "mirrors" the state of your GI tract. Skin problems like Rosacea, for example, can be effectively cleared up by addressing your intestinal health. According to Dr. Chutkan, Rosacea is frequently assocated with dysbiosis, a condition caused by microbial imbalances in your body.

Now, since your gut bacteria are an active and integrated part of your body, as such these microbes are heavily dependent on your diet and vulnerable to your lifestyle. If you consume a lot of processed foods and sweetened drinks for instance, your gut bacteria are likely going to be severely compromised because processed foods in general will destroy healthy microflora, and sugars of all kinds feed bad bacteria and yeast. So avoiding processed foods and sugary foods is a critical first step to optimize your gut flora. Your gut bacteria are also very sensitive to:

  • Antibiotics, both in the form of oral medicines and meats from animals raised in confined animal feeding operations (CAFOs). Livestock antibiotic use accounts for 80 percent of the total antibiotics sold in the US, so if you regularly eat CAFO meats, you're exposed to a continuous supply of low-dose antibiotics
  • Agricultural chemicals (particularly glyphosate, the active ingredient in Roundup, which is used in large amounts on genetically engineered "Roundup Ready" crops)
  • Chlorinated and fluoridated water
  • Antibacterial soap
  • Pollution

Since most of us are exposed to these detrimental factors at least occasionally, it's generally a good idea to "reseed" the good bacteria in your gut by taking a high-quality probiotic supplement or eating fermented foods. This is important for everyone, but as mentioned earlier, it's imperative if you are a woman who is pregnant, as your newborn depends on you for its initial gut flora. Many women of reproductive age are deficient in a wide range of vitally important probiotic strains—a deficiency that transfers to their offspring, and may set the stage for any number of problems.

You Don't Need Poo-in-a-Pill to Achieve Digestive Health

The micro-organisms living in your digestive tract form an important inner ecosystem that influences countless aspects of your health. Since virtually all of us are exposed to factors that destroy beneficial bacteria in your gut, such as antibiotics (whether you take them for an illness or get them from contaminated animal products), chlorinated water, antibacterial soap, agricultural chemicals and pollution, ensuring your gut bacteria remain balanced should be considered an ongoing process.

Barring an emergency situation, in which a fecal microbiota transplant could be the difference between life and death, the easiest and best way to reseed your gut with healthy bacteria is to include fermented foods in your diet. Additionally, one of the major side benefits of eating a healthy whole food-based diet like the one described in my nutrition plan is that it automatically supports your gut health by allowing beneficial gut bacteria to flourish.

While you could certainly use a high-quality probiotic supplement, fermented foods can supply your body with good bacteria FAR more effectively and inexpensively than a supplement. As an example, it's unusual to find a probiotic supplement containing more than 10 billion colony-forming units, but when my team tested fermented vegetables produced using a probiotic starter cultures, they had 10 trillion colony-forming units of bacteria. Literally, one serving of vegetables was equal to an entire bottle of a high potency probiotic!

So clearly, you're far better off using fermented foods. Again, when choosing fermented foods, steer clear of pasteurized versions, as pasteurization will destroy many of the naturally occurring probiotics. Examples of traditionally fermented foods include:

  • Fermented vegetables
  • Lassi (an Indian yoghurt drink)
  • Fermented milk, such as kefir (like fermented vegetables, a quart of unpasteurized kefir also has far more active bacteria than you can get from a probiotic supplement)
  • Natto (fermented soy)

If you do not eat fermented foods on a regular basis, taking a high-quality probiotic supplement is definitely recommended. It can also be incredibly useful to help maintain a well-functioning digestive system should you occasionally stray from your healthy diet and consume excess grains or sugar, or if you have to take an antibiotic.