Fecal transplants are an innovative medical procedure, but they face significant challenges in gaining clinical trial approval due to the lack of backing from pharmaceutical companies. Unlike drugs or medical devices that have corporate sponsors, fecal transplants may not attract the same investment because they do not fit the traditional profit model of treating rather than curing diseases. Khoruts highlights a financial conflict of interest, pointing out that the potential for billions in profits might discourage big pharma from supporting such treatments.

The reluctance of drug companies to endorse fecal transplants stems from their focus on chronic treatments, which ensure ongoing revenue rather than a one-time cure. This situation creates a significant barrier for this promising procedure despite its effectiveness, as companies may oppose its approval to protect their profits. Khoruts’ comment about potentially being at the bottom of the river reflects his frustration with the corporate healthcare system that prioritizes profit over patient care and innovation.