It takes guts: UW-Madison health survey asks people for stool

August 22, 2017 GMT

Derek Clark didn’t think twice when UW-Madison researchers asked him to take a health survey, and provide blood and urine samples, six years ago.

But this year, the researchers requested something more: his stool. They asked him to have a bowel movement in a small tub suspended across his toilet, use a tongue depressor to place some of the feces in a jar and store the jar, in a biohazard bag, in his refrigerator overnight.

“It’s just gross,” said Clark, 36, a welder from Green Lake, who nevertheless complied. “But it’s for science.”

Clark is among about 600 Wisconsin residents who are helping scientists on campus study if low-fiber diets or exposure to lead harm the balance of bacteria in our guts — known as the microbiome — and make people more susceptible to antibiotic resistant infections.

It’s a new part of the Survey of the Health of Wisconsin, or SHOW, an annual look at the health status of state residents, now in its 10th year. More than 6,000 people in 63 countries have participated in SHOW, which will be recruiting subjects in Dane County again next month.

As UW-Madison’s Microbiome Initiative and the National Microbiome Initiative illustrate, researchers are increasingly paying attention to how gut bacteria can contribute to conditions from obesity and asthma to heart disease and infections.

Dr. Nasia Safdar, medical director of infection control at UW Hospital, said links between low-fiber diets, the microbiome and infections such as C. diff — a stubborn bacteria that can be deadly — have been studied in hospitals and nursing homes.

“But nothing had really looked at this particular angle in the community,” Safdar said.

She got nearly $500,000 from the Wisconsin Partnership Program, at the UW School of Medicine and Public Health, to analyze stool samples and detailed diet information from SHOW participants. The Centers for Disease Control and Prevention says at least 2 million people are infected with antibiotic-resistant bacteria each year, and more than 23,000 of them die, so the research could have widespread implications.

Doctors could end up prescribing high-fiber diets, especially to people at highest risk for antibiotic-resistant infections.

Meanwhile, Shannah Eggers, a graduate student, is looking at lead levels in urine and blood from SHOW participants to see if high lead levels are correlated with more antibiotic resistant bacteria in their stool.

The leaders of SHOW supported the scientists’ goals, but they weren’t sure how receptive people would be about providing stool — just for research, not to diagnose a particular illness.

“We were all, frankly, a bit leery,” said Kristen Malecki, co-director of SHOW.

As encouragement, organizers added $100 in compensation for stool collection and providing details about what participants ate the past 24 hours, in addition to the $100 given for other parts of SHOW.

About two-thirds of people asked to provide stool have agreed, Malecki said.

They include Clark and his wife, Tara, 40, of Green Lake, about 70 miles northeast of Madison. After taking part in SHOW in April, they got test results showing she was anemic and his cholesterol level was up. She started taking iron pills, and he plans to talk to his doctor about his cholesterol.

They were happy to help with the research, but Derek Clark said he’s glad the stool part is over.

“I’ll take drawing blood over that any day,” he said.