Let’s Talk Shit Disease, Digestion & Fecal Transplants
Let’s Talk Sh!t is a humorous, easy to digest explanation of gastrointestinal disorders, their current treatments, as well as next generation hope for heart disease, obesity, autism, Alzheimer’s, and more. From constipation to cancer, research indicates that our unique microbiomes may be the basis for future advances in health and wellness.
Let’s Talk Sh!t examines the human microbiome—the dynamic world of bacteria, fungus, and viruses that comprises more than 50% of our mortal selves.
Dr. Sabine Hazan and Dr. Thomas Borody, leaders in microbiome research, explore the reason therapies may not be working for many and why fecal transplants may be part of the solution. They also share nutritional tips to avoid illness, improve digestion, and support our own microbiomes.
About the Authors
Sabine Hazan was the first of four children born to two government accountants in Morocco. In 1974 the family moved to Montreal, Canada to provide better education and greater opportunities. There, the Hazans raised their children with the ambition to match their potential—all became doctors.
Throughout her life, Sabine’s peers questioned her dream to become a physician. But their challenges only fueled her ambitions. Even though her primary language was French, she enrolled in Concordia University, an English-speaking college.
Medical school admittance was difficult and more so for a woman. Sabine was asked: What if you become pregnant? What would you do if your child was sick and you also had a sick patient needing care? Whom would you choose? She wondered how many men were asked such questions.
She graduated from Dalhousie Medical School in Halifax, Nova Scotia. Curious about the American health care system, she chose to do her residency in Internal Medicine at Jackson Memorial Hospital, a notoriously demanding and rigorous county hospital in Miami. There, during the height of the HIV/AIDS crisis, she was under fire, learning to care for the most underserved patients who were desperately ill and dying. She fell further in love with medicine and with a fellow resident whom she married in 1993.
During her early medical career, she was keenly interested in gastroenterology. “It’s a man’s specialty,” she was told repeatedly. She would never be accepted. The naysayers again had the opposite effect and emboldened her resolve. In 1995, She became the first female Gastroenterology Fellow accepted at the University of Florida in Jacksonville. As a fellow, she discovered that she really enjoyed and excelled in clinical research, which led to awards from the university’s Dean for Research as well as recognition from the American College of Physicians. At the time, her primary research was in esophageal diseases, part of her work with her formidable mentor, Dr. Sami Achem. Her husband, Dr. Alon Steinberg, completed his Cardiology Fellowship at the same time and the couple had their first daughter in 1996.
Following her fellowship, Dr. Hazan returned to Montreal and opened a practice across the border in Upstate New York. Her enviable reputation grew quickly and due to socialized medicine in Canada, long wait lists for procedures like colonoscopies brought in many Canadian patients in need of gastroenterology care.
Just as Apple and Tesla were visionaries of technology, Dr. Hazan pursued innovation in medicine. Some perceived her as a threat. A perfectionist in her scientific approach and focused in her quest for excellence, the multi-tasking Hazan was never one for bureaucracy and red tape. She was reported to the medical board, cited for poor record keeping and required to take a course. The experience changed her. She became a warrior who vowed to extend her methodical approach in medical care to its documentation. In the ensuing years she emphasized extreme attention to detail, not just in her work product, but in her clinical research and records. She now embraces oversight from the Food and Drug Administration (FDA) and Independent Review Board (IRB). Her clinical trials are known for their validation and verification.
After the couple’s second daughter was born in 2004, Dr. Hazan rediscovered her passion for research and launched Ventura Clinical Trials. In 2005, she and her husband established respective patient practices in Ventura. Over the years, she attended several national GI conferences where she often met with her good friend and colleague, Dr. Neil Stollman, also a Gastroenterology Fellow in Miami during their residency years. Dr. Stollman had introduced her to the world of fecal microbiota transplant (FMT) and research by Dr. Thomas Borody since the late ‘90s.
Dr. Hazan started researching the use of FMT to treat patients with C. diff, which changed the trajectory of her career. It was Dr. Stollman’s explorations that inspired her to consider the human digestive tract as the body’s Garden of Eden. She later met Dr. Thomas Borody, the father of modern FMT. The meeting proved to be the beginning of a great collaborative relationship that continues to this day as they work together on advanced clinical research of the microbiome.
After hundreds of clinical trials and treating thousands of patients, Dr. Hazan still faced persistent questions about life, death, health, illness, the gut, and how they were connected. Various curiosities, innovative concepts and ruminations kept her awake at night. Why did she crave McDonald’s when she was pregnant the first time? Why does her first daughter still love it? Alternatively, why does her youngest love vegetables, which Sabine craved often during her second pregnancy? Through research, she saw how dramatically the microbiome impacted human health, and she grew increasingly determined to understand.
Her curiosity led her to Dr. Sydney Finegold at UCLA. Dr. Finegold was certain of an association between bacteria, bowels, and behavior. He was especially sure of a connection between anaerobic bacteria and autism. If bacteria could contribute to autistic behavior, Dr. Hazan wondered if other tendencies, preferences, and characteristics could also be consequences of one’s microbiome.
Could she study the bacteria in human feces and isolate it for treatment? Could she continue trailblazing through an emerging science? When preliminary research of the microbiome led to fecal material in capsules, with venture capitalists controlling the stocks of sh!t, one could say she went rogue. Strongly opposed to a “one pill fits all” solution, she felt called to pioneer her own microbiome research at the clinical level. She was determined to develop valid reproducible data and to leverage that data to emphasize the importance of individualized treatment for patients.
Resolute, she launched ProgenaBiome, a genetic sequencing research company dedicated to understanding the gut flora at the clinical level to advance FMT and other microbial-based therapies. As her professional network grew, she realized that doctors and researchers worldwide were asking the same questions. She traveled, addressed medical forums, and wrote articles in her quest for answers. Meanwhile, she worked persistently to help patients with celiac disease, Crohn’s, ulcers, colitis, and other digestive ailments that she hypothesized were caused by dysbiosis in the gut.
Dr. Sabine Hazan’s quest continues. She and Dr. Borody believe that answers to many medical mysteries and the power to heal may be within the trillions of microbes in the gut flora. Answers are close.
Science junkie Sheli Ellsworth grew up on a small farm in Texas and has seen both ends of the life cycle. She graduated magna cum laude from Texas Woman’s University and obtained her master’s degree from West Texas A&M with concentrations in psychology and biology.
After three cases of food poisoning, a son who licked the floor to gross out his sister, and a poop-eating pug—she too had questions about bacteria, behavior, and why she continues ordering chicken enchiladas.
A humorist at heart, this is her seventh book. If you enjoy Sheli’s writing, Confessions of a Pet Au Pair, an amusing guide to pet health is available on Amazon.
Microbiome pioneer Thomas Borody was born in Krakow, Poland. His father, Jan Borody, fought in the defense of Warsaw during the Nazi invasion of 1939, and then his parents then survived the German occupation of Poland. Jan, a pastor, worked as a double agent for the Polish underground while his photographer mother, Danuta, fed children trying to escape via sewage pipes from the ghetto.
His father found a way to take young Jewish girls out of ghettos and relocate them to the Krakow Carmelite nunnery where they could ultimately walk in groups over mountains to Switzerland and freedom. In Dec 1959, the family emigrated to Australia and settled in Sydney, where all three Borody children completed their Medical training. Edith became a family physician, Ian an obstetrician/ gynecologist, and Tom a gastroenterologist.
He completed his BS and MB BS degrees at the University of New South Wales then received his MD from Garvan Institute of Medical Research and University of Sydney School of Veterinary Science. He gained experience in parasitology, the treatment of TB and leprosy in the Solomon Islands then spent three years in clinical research at the Mayo Clinic, Rochester, MN. Later he earned a PhD at the University of Newcastle and his DSc at University of Technology Sydney.
Dr. Borody’s clinical interests focus on the development of novel treatments including those of human gut microbiome using fecal microbiota transplantation (FMT) to treat C. difficile infection, colitis, irritable bowel syndrome as well as neurologic and autoimmune disorders. In 1984, Dr. Borody established the Centre for Digestive Diseases (CDD) in Sydney, Australia and has overseen its growth into an active clinical research institute with 69 employees and 12 physicians treating around 10,000 patients per year. To date, Dr. Borody’s clinic has completed some 35,000 FMT treatments. He refined FMT by developing lyophilized (freeze-dried) FMT capsules and has published more than 310 research papers and has filed over 170 patents. His first FMT in 1988 was carried out on a patient with colitis who remained symptom free.
In 1985, he developed the first effective triple antibiotic therapy for H. pylori, which had a profound impact on curing hundreds of patients. The medication, was sold in the US as Helidac.
He later licensed quadruple antibiotic therapy now marketed as Pylera. He also developed the next generation, FDA-approved treatment for resistant H. pylori, Talicia.
Dr. Borody has also developed a Crohn’s disease treatment now in pivotal trials, as well as colonoscopy bowel prep products Glycoprep, Glycoprep C, Moviprep, and a capsule prep licensed to Salix.
Future Borody therapies include asthma-reversing treatment and a product to treat coronary heart disease as chronic infection. He is currently focusing on the eradication of coronavirus using repurposed, combined anti-viral therapy.