Designer $hit: Could Poo Cure What Ails You?

By Karen Gordon

Rating: B+

If you saw Toronto writer, director, and editor Saffron Cassaday and her partner Al Mukadam in real life, you’d think they had the world by the tail. They’re gorgeous, they have a terrific relationship, and seem to have a great life in almost every way.

Except for one major problem: Cassaday has ulcerative colitis, an obnoxious, painful, difficult-to-manage chronic condition for which there is no cure, and treatment options are limited.

And if you know anyone with similar issues like Crohn’s disease or irritable bowel syndrome (IBS), you know how truly awful it can be for those who suffer. For many, current medications are only so-so. There is ongoing research and trials but no breakthroughs towards a cure or something that can put the disease in remission.

However, there is one very surprising treatment being studied, with an accessible ingredient and some anecdotal positives. The ingredient is human poo, taken from a physically healthy person, and with minimal processing, injected into the colon of a sufferer in the hope that it can restore a healthy microbiome of the sufferer. It’s called a Fecal Microbiota Transplant (FMT).

In Designer $hit, Cassaday turns the lens on herself as she takes the procedure on, in an intimate first-person documentary that is both lighthearted and informative.

Cassaday beings by approaching her gastroenterologist who, in the absence of solid scientific evidence, won’t help her.

Frustrated, desperately wanting life to be better, Cassaday begins to explore on her own, talking to a range of experts from an Australian doctor who has had success with the technique, to researchers, and a look at an ongoing controlled study. She also talks to a few sufferers who have had success with FMT, both in a clinical setting and self-administered.

Without the endorsement of her doctor, Cassaday can’t get into a medical study. And so, she turns to her experts to get the criteria for an appropriate donor. Then, she gets her ‘how to’ instructions from a mother and son who successfully put the son’s issues into remission with a rigorous regimen they did together that involved harvesting the healthy poo from mom, processing it, and injecting it into the patient.

Luckily for Cassaday, finding an appropriate donor is easy: her partner fits the criteria, and he is willing to supply the specimens. The equipment for processing the poo so it can be injected is accessible. The method itself isn’t complicated but has a yuck factor.

Cassaday isn’t daunted. She takes us through the process of preparing and self-dosing. The film follows how it affects her health over the course of several years.

Making a documentary about poo — the thing that can turn a grown-up into a giggling eight-year-old —requires finding the right tone. Cassaday does that effortlessly, directing with a light touch, without undermining the awful medical issue that many suffer from. She gives us a pretty serious sense of her chronic illness and the credibility of this surprising potential cure.

One of the strengths of the film is imparting what it’s like to live with a painful chronic disease that can’t be controlled; the frustration and embarrassment of living with a disease that involves sudden, unexpected bowel movements.

Self-injecting lightly processed poo sounds weird if you haven’t heard of it. But FMT is serious business. It’s currently being studied not just for treatment of digestive ailments like colitis, IBS, and Crohn’s, but for a range of physical and mental health issues, including Parkinson’s, cancer, COVID, obesity and bi-polar depression, and autism. And several pharmaceutical companies are keeping a close eye on the research.

Cassaday is the director and the subject and is excellent in both roles. She’s self-aware, curious, and not afraid to be honest. Designer $hit is a compelling story about living with a chronic illness and the constant yearning for a cure that comes with that.

Designer $hit. Written, directed, and edited by Saffron Cassaday. Available via VOD November 14.