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What is the gut microbiome, and what are the symptoms of an unhealthy gut?

Gut health is closely linked to the gut microbiome, a community of trillions of bacteria, viruses and fungi that live in your digestive tract, primarily in the large intestine. While some bacteria cause disease, others are essential to your immune system, heart, weight, and a variety of other health factors.

The most common symptoms of an unhealthy gut are an upset stomach, sleep disturbances, skin irritation, autoimmune conditions, and food intolerance. Many factors, such as the food we eat and our stress levels, as well as lack of sleep and antibiotic use, can have an impact on our gut health and immune system, which is important for cancer prevention as well as protecting the body from potentially harmful substances and germs. An imbalance in our gut microbiome can lead to health problems and, if untreated, chronic conditions.

If gut microbiome is so important, why haven’t I heard it before?

It is no surprise that many people, even doctors have not heard of, or are unfamiliar with the intricacies of the gut microbiome but you may have heard about the rising popularity of probiotic supplements and foods containing good bacteria, such as yoghurt drinks. Whilst scientists have always known of the existence of the gut microbiome, it has only been in the last decade that new insights and practical applications of the gut microbiome have been developed, unveiling more secrets of the microbiome effects on human health.

What is gut microbiome transplant (GMT)?

Gut microbiome transplant (GMT) also known as faecal microbiota transplantation (FMT), is the transfer of healthy bacteria-rich stool from a healthy person into the gastrointestinal tract of a sick person in order to restore microbial balance. The thousands of bacteria, fungi, and other microbes that live in our gut are vital to our health.

What diseases are currently treatable with GMT, and who are the ones likely affected?

GMT is a widely accepted treatment for recurrent Clostridium difficile (C. diff) infections or CDI, with cure rates of up to 90%.1 This treatment has been carried out at Singapore’s National University Hospital since 2014 and was pioneered in the region by AMILI co-founder Adjunct Associate Professor David Ong, who was the head of gastroenterology at NUH until 2021.

C. diff is a bacteria that can cause severe diarrhoea, fever, stomach pain, loss of appetite, and nausea. This bacteria spreads when people come in contact with contaminated food, surfaces, or objects. This infection can be very mild at times, but it can also be very serious, leading to death. When people have severe diarrhoea, they do not have enough fluid in their bodies, which can lead to kidney damage.

People who have taken antibiotics, particularly high-risk patients (those over the age of 65, those with a weakened immune system, those who have had surgery, or those with colon problems such as colon cancer), are frequently affected by C. diff. This is because, while antibiotics can kill bacteria that cause illness, they also kill bacteria that keep our bodies healthy. Without that balance, harmful bacteria can take control.

What are the current solutions to treat C. diff?

Currently, the most promising treatment for C. diff is GMT, which is the transfer of healthy bacteria into the gastrointestinal tract of the patient. The success rate is high, ranging from 85% to 95%, with the majority of patients experiencing minimal to no symptoms of the condition. However, due to the limited availability of safely processed stool samples for clinicians and researchers to conduct studies, it is not widely used around the world.

How is GMT done?

GMT can be performed via colonoscopy. However, depending on the circumstances, some physicians may choose to perform the transplant through a nasogastric tube, enema or through ingestion of oral capsules containing GMT material.

GMT is an outpatient procedure that takes about two hours to complete. The actual stool transplant is usually completed in under 10 minutes. GMT capsules are even simpler and can be taken in a clinic setting after which patients can simply go home. As the microbiota materials are encapsulated in pill form, they have no taste or odour.

What are the side effects of GMT?

GMT is generally regarded as safe. Following an GMT, it is common for patients to experience changes in stool, including transient diarrhoea. Other common side effects include abdominal cramps or pain, low-grade fever, bloating, flatulence, and constipation. These usually subside in a few days after the procedure.

What are some potential future indications or uses for GMT?

GMT is being investigated as a potential therapy for more than 60 diseases and conditions in over 300 controlled clinical trials. Potential indications include autism, Crohn’s disease, prostate cancer and melanoma. Those who have cryopreserved their healthy microbiome will have more medical options once these clinical trials result in successful therapies. They can also participate in one of the ongoing clinical trials.

What is gut microbiome banking service?

The gut microbiome banking service designed by Cordlife and AMILI is the first-of-its-kind offering in Singapore and Southeast Asia. The service allows individuals to bank their microbiome whilst healthy in anticipation of future use if afflicted by diseases appropriate for microbiome modification as part of the treatment plan.

If I do not have any health issues, do I still opt for this new gut microbiome banking service?

The best time to store your gut microbiome is when you are healthy. The microbiome changes with time and is affected by medication, diseases and ageing. Thus, it is best to bank the ‘best’ version of yourself for future therapeutic use.

I am interested to store my gut microbiome. How do I know if I am eligible to store?

To be eligible for gut microbiome banking, you have to be 5 years of age or older, and meet the prevailing screening criteria, which include a health history questionnaire, stool sample culture test, and infectious disease testing.

How much does it cost to bank my gut microbiome with Cordlife?

For pricing matters, please contact us for more information.

If I live overseas, can I opt for this service with Cordlife?

No, because fresh stool must be sent to the laboratory and processed for storage within 2 to 6 hours of collection to ensure that the gut microbes retain maximum viability for future use. If you are keen to bank your gut microbiome, we recommend you to spend a few days in Singapore to complete the screening and stool collection process.

Where can I find more information about this new gut microbiome banking service?

You can find out more about Cordlife’s gut microbiome banking service by calling our hotline at 6238 0808 or emailing us at gutmicrobiome@cordlife.com, and one of our consultants will get in touch with you. You can also visit www.cordlifetech.com/gutmicrobiome for more information.

References

  • 1: Baunwall S, Lee MM, Eriksen MK, et al. Faecal microbiota transplantation for recurrent Clostridioides difficile infection: An updated systematic review and meta-analysis. EClinicalMedicine. 2020;29-30.https://doi.org/10.1016/j.eclinm.2020.100642. Accessed 23 May 2022.