Gulp

I asked Khoruts what exactly is in the ‘probiotic’ products seen in shops now. ‘Marketing’, he replied. Microbiologist Gregor Reid, director of the Canadian Research & Development Centre for Probiotics, seconds the sentiment. With one exception, the bacteria (if they even exist) in probiotics are aerobic; culturing, processing, and shipping bacteria in an oxygen-free environment is complicated and costly. Ninety-five percent of these products, Reid told me, ‘have never been tested in a human and should not be called probiotic.’

Inflammatory bowel diseases – irritable bowel syndrome, ulcerative colitis, Crohn’s disease – are thought to be caused by an inappropriate immune response to normal bacteria; the colon gets caught in the cross fire. This time around, the IRB refused to approve the trial until the US Food and Drug Administration (FDA) had approved it. And that’s just for the trial. Final FDA approval, the kind that makes the procedure available to anyone, is a costly process that can take upwards of a decade.

And in the case of faecal transplants, there’s no drug or medical device involved, and thus no pharmaceutical company or device maker with diverticuli deep enough to fund the multiple rounds of controlled clinical trials. If anything, drug companies might be inclined to fight the procedure’s approval. Pharmaceutical companies make money by treating diseases, not by curing them.

Most of what Khoruts says is delivered deadpan. ‘In Russia’, he told me, ‘if you smile a lot, they think something’s wrong with you.’ He has to remind himself to smile when he talks to people. Sometimes it arrives a beat or two late, like the words of a far-flung foreign correspondent reporting live on TV.