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Feces-Filled Capsules Treat Bacterial Infection

sciencehabit writes Clostridium difficile infections kill approximately 14,000 Americans every year, often because the diarrhea-causing bacteria are highly resistant to standard antibiotics. Now, scientists have found an unusual way to combat the bugs: human feces in pill form. In the new study, researchers show that frozen fecal matter encapsulated in clear, 1.6 g synthetic pills was just as safe and effective as traditional fecal transplant techniques at treating C. difficile. Within 8 weeks or less, 18 out of 20 participants saw a complete resolution of diarrhea after consuming 30 or 60 of the feces-filled capsules. "It's probably not the best experience of your life," says team leader Ilan Youngster, a pediatric infectious disease doctor at Harvard University. "But it beats getting a tube stuck down your throat or a colonoscopy or having C. diff."

34 of 135 comments (clear)

  1. It's probably not the best experience of your life by Psicopatico · · Score: 5, Funny

    It's probably not the best experience of your life

    Talk about the poor chinese laborer who assembles the pills...

    --
    Mastering the English language is fucking easy: all you have to do is to put an f* word in every fucking sentence.
  2. Ugh. by Anonymous Coward · · Score: 2, Funny

    I realize they were just trying to cure a case of C. difficile, but "Two girls, one pill" would have been much easier to watch.

  3. Re:It's probably not the best experience of your l by Skiboy941 · · Score: 4, Funny

    Great. Now I'm imagining a bunch of guys pooping on a conveyor belt. Hershey Kisses anyone?

  4. Re:It's probably not the best experience of your l by ColdWetDog · · Score: 3, Insightful

    Typically the stuff has been spun down and freeze dried so it's not so bad....

    --
    Faster! Faster! Faster would be better!
  5. Re:I don't believe them by Skiboy941 · · Score: 2

    Fry: "I can't swallow that!" Farnsworth: "Well then, good news! It's a suppository."

  6. Re:Well, that ruins an old insult by K.+S.+Kyosuke · · Score: 2

    Or just fetch a package of Wrigley's Helminth.

    --
    Ezekiel 23:20
  7. Timeframe? by Nauglamir · · Score: 2

    Within 8 weeks or less, 18 out of 20 participants saw a complete resolution of diarrhea after consuming 30 or 60 of the feces-filled capsules.

    No wonder they have such a small sample. After the informed consent form I'm sure lots of people told the researchers to gtfo.

    Also, could an MD please provide the usual time frame in which diarrhea runs its course? 8 weeks being an improvement sounds just weird.

    --
    i *had* a low uid, but lost it in my lawn
    1. Re:Timeframe? by Greyfox · · Score: 5, Insightful

      Once you've been crapping your organs out for a couple months, I'm sure you'd be willing to try just about anything.

      --

      I'm trying to teach myself to set people on fire with my mind... Is it hot in here?

    2. Re: Timeframe? by Anonymous Coward · · Score: 5, Interesting

      My stepfather had c. Diff last year. It isn't run of the mill diarrhea. Remember that scene in dumb and dumber with the laxative pill? Something like that. You are physically exhausted and your body is destroying itself. It spreads infection, your immune system goes haywire, your kidneys and liver work overtime breaking things down.

      They quarantined my stepfather and told us that he probably wouldn't make it due to his age. He was put on antibiotics and morphine. I kept complaining to nurses that antibiotics actually caused this (he cut his fingertip and they gave him a dose 3x higher than necessary, if he needed it at all) and to look at alternatives but they don't really care. So many patients to treat, so little time. Nurses said the poop transplant was the option of last resort(even with 90% success rate) and that they would continue with antibiotics. My stepfather was pretty lucky to survive it and is now cautious about antibiotic use.

      If standard diarrhea clears up in 8 weeks, is that in any way useful if you're dead in two?

    3. Re: Timeframe? by Fwipp · · Score: 4, Interesting

      Yep, the antibiotic regimen they put you on is no joke, either. It wipes out all your intestinal flora, leaving you super vulnerable to recolonization (and those spores are real fucking hard to eliminate).

      My grandmother had a fecal transplant and she cleared up in days, after literal months of illness.

      Source: I used to be closely involved with an MD whose primary focus was this bug. Well, the grandma part was sourced from my mom.

  8. Suppository form works just fine. by jpellino · · Score: 5, Interesting

    Yes, that's been the preferred method so far. People gong on massive antibiotics have stockpiled frozen fecal suppositories with perfectly good results. Not FDA approves since it's not been properly tested until recently.

    --
    "Win treats sysadmins better than users. Mac treats users better than sysadmins. Linux treats everyone like sysadmins."
    1. Re: Suppository form works just fine. by dgatwood · · Score: 2

      I'm left wondering what is new here. For years, folks have taken probiotics, often in pill form, during antibiotic treatment to restore intestinal flora, and to combat systemic yeast infections. How is this not just a very crude version of the same thing?

      --

      Check out my sci-fi/humor trilogy at PatriotsBooks.

    2. Re: Suppository form works just fine. by phantomfive · · Score: 3, Funny

      I'm left wondering what is new here. For years, folks have taken probiotics, often in pill form, during antibiotic treatment to restore intestinal flora, and to combat systemic yeast infections. How is this not just a very crude version of the same thing?

      According to wikipedia, it has better results than probiotics. That is the end of my knowledge on the topic.

      --
      "First they came for the slanderers and i said nothing."
    3. Re: Suppository form works just fine. by Jarik+C-Bol · · Score: 4, Informative

      The reason for this is probably because even the best probiotics hold maybe a dozen of the various things that populate the intestinal tract, while these pills, by virtue of being a direct sample, contain essentially ALL of the thousands of things that make up our intestinal flora.

      --
      I've decided to Diversify my Holdings. I've divided my cash between my left and right pockets, instead of all in one.
    4. Re: Suppository form works just fine. by Bite+The+Pillow · · Score: 4, Interesting

      Probiotics are a very general class of things. And specifically taking bacteria pills (that is, a specific type of probiotic) like acidophilus is not as effective.

      When you take antibiotics, you are disturbing an ecosystem that has evolved over years. Everything you eat could contribute to the bacteria makeup. Dirt is supposed to have beneficial "feel good" bacteria, and the microbiome may affect mood. Acidophilus and Bifidus and Bulgaricus alone will not restore what you just killed with antibiotics, or what you lost through diarrhea.

      Healthy donor stool is the easiest, quickest way to get all of the bacteria. One pill won't do it, because your microbiome is likely to just kill most of the intruders. Not the immune system, but the existing bacteria - maybe just by starving them out. Repeated doses gives you a good chance to let the varied bacteria strains get established.

      Why don't we just figure out which bacteria are needed and give you those? Man, you are brilliant. So brilliant, that you won't be surprised to find out that lots of people are trying to figure out which ones are good, useless, or bad. As you can imagine, isolating the effects of a single type of bacterium on humans, without negatively impacting health, which would throw off the results of such a study, is complicated.

      And it is by no means crude. Crude is having someone poop in a jar, putting it in a blender, and giving yourself a poop enema. This method seems to be a simpler and cleaner way, as well as being possible to get it further into the intestines than you can do at home safely.

    5. Re: Suppository form works just fine. by Anonymous Coward · · Score: 4, Interesting

      Probiotics are only effective to prevent C diff. Useless once you have it, except maybe to prevent recurrence. Once you have C diff, it is imperative to get treatment, either fecal transfer (either as a pill or via colonoscopic instillation; enemas or nasoduodenal routes are less effective) or go on to a special antibiotic regiment.

      The problem is that C diff has become to common that it is starting to become resistant to the typical treatment (metronidazole or oral vancomycin). This is starting to become dangerous, because unchecked C diff can be lethal (I have seen people die from this) or result in the removal of the entire colon - if your surgeon can get to you in time.

      And before you DIYer get any ideas....this is not something to mess around with. It's kinda like packing your own parachute, you better know what the hell you're doing cause you probably only have one shot at this.

    6. Re: Suppository form works just fine. by Anonymous Coward · · Score: 2, Funny

      More likely, you and the grandparent are both the same AC and you are really a Democrat who is trying to cast Republicans as manipulative.

      (Of course, maybe I'm the same AC as you and the GP and I am/you are trying to cast Democrats as manipulative - only one, two, or three of us will ever know for sure! It will be a little secret among the AC community.)

    7. Re: Suppository form works just fine. by jrronimo · · Score: 2

      A few years back my girlfriend had C. Diff, pretty badly. At the time, fecal transplants were still new / in testing (or, at least, the doctors hadn't even mentioned it, but we had read about them online). She happened to be browsing journals and found an article that mentioned Saccharomyces boulardii as a possible treatment. A few weeks after starting a pretty healthy regimen, her symptoms cleared up and have been gone ever since. In that respect, a probiotic was effective as a cure.

      It truly is the sort of thing that one should seek medical attention for, I agree. However, at the time she had no insurance and the oral vancomycin that had been prescribed to her was going to be $1,500 per prescription fill, and as you said, it probably wouldn't have helped too much -- C. diff creates spores that tend to outlive most treatments, lending to its 'difficile' name. It was a scary time, but she got very, very lucky.

      We've been off-handedly following news articles about treatments like this one, and this pill is an excellent advancement of treatments. Here's hoping no-one else had to go through what she did.

  9. MD here... by tpjunkie · · Score: 4, Informative

    These are for patients who have recurrent C. diff, who have already failed PO vancomycin or fidaxomycin (difficid). Those are the only two antibiotics we really have after you fail metronidazole therapy. It's not an issue of strongness; it's penetrating into encysted bacteria which vancomycin does fairly poorly, and fidaxomycin does only moderately better. At that point, options are fecal therapy, another round of vanc or difficid with increasingly diminishing returns, or in severe cases, colectomy.

  10. Re:Insults by 0xdeadbeef · · Score: 4, Funny

    "Eat shit and live, motherfucker!"

    "Well, doctor, if you insist..."

  11. Re:Well, that ruins an old insult by wierd_w · · Score: 3, Funny

    Ahh, The eponymous doubleshit gum.

    The gum EVERYONE gives two shits over.

  12. Perspective by phantomfive · · Score: 5, Informative

    For some perspective, C. dificile kills 16,000 people per year in the United States. Compare that to how many people have died from Ebola.

    --
    "First they came for the slanderers and i said nothing."
    1. Re:Perspective by Vitriol+Angst · · Score: 2

      It's funny how our media chooses something a few times a year that can tell a story and scare the public. Usually it's something from overseas, that we have to start behaving differently and checking on people coming across the border to prevent.

      I just heard a story of some moron who yelled "I have Ebola" on an airplane, and they sent him back home. Why the overreaction? Is someone shouting nonsense MORE likely to have a disease after they say; "just kidding?" than the person next to them on the plane? How about people who get sick of stupid TSA nonsense and act out?

      If someone shouted "I have C dificile" on a plane, everyone would say; "sit down and shut up?" Right, nothing would happen. It's almost as dangerous as someone shouting "I have the flu" that kills even more people each year but it's already here -- not something on a plane that requires a background check. Ebola and Al Qaeda are just the latest Pavlovian words that we must respect, otherwise someone needs to over react. It's OK that more Americans die each year from coal pollution or police shootings -- as long as it isn't the "bad guys" from over there. We blow up thousands and a few people get beheaded on TV and everyone MUST DO SOMETHING -- let's spend another trillion dollars without question.

      It's so damn old and tired now how like clockwork, we get scared about some existential threat each fall. It's like our local TV stations pretending they've got hard hitting news and investigating a strip club, or the mechanic who replaces your old auto part with another old auto part and RIPS YOU OFF! Ignore the over draft fees from the bank and the hundred and one overpayments you make to a monopoly.

      I don't know if this is a plan to distract us, or just an organic process of brain dead 24 hours news chasing the last safe stories that don't hurt the feelings of a paying sponsor -- but it damn sure seems the stay away from topics of real interest regardless of whether they are paid to or not.

      --
      >>"ad space available -- low rates!!!"
  13. Eat shit and ... by CaptainDork · · Score: 3, Funny

    ... live.

    --
    It little behooves the best of us to comment on the rest of us.
  14. Re:Dunno about you but by Anonymous Coward · · Score: 2, Funny

    Gives a new meaning to "Eat shit and live".

  15. Re:Dunno about you but by FatdogHaiku · · Score: 5, Funny

    This article is full of Sh!t

    That's nothing, the pills taste like crap...

    --
    You have the right to remain sentient. If you give up the right to remain sentient, you will be elected to public office
  16. Re:um by St.Creed · · Score: 2

    Within 8 weeks ... saw a complete resolution of diarrhea after consuming 30 or 60 of the feces-filled capsules.

    Um... that's an improvement? That's like advertizing "We found a new cure for hemorrhoids! It takes 2 months and involves a soldering iron!"

    It's an improvement over suffering from diarrhea until you die, months later. And *a* cure for hemorrhoids actually does involve something like a soldering iron (laser). It's just a bit faster than 2 months, although recovery will be quite a few days. And incredibly painful if you're part of the unlucky 2% or so of the population who have nerve endings in the wrong place.

    --
    Therefore, by the (faulty) logic you're using, you're just a cow with a keyboard - osu-neko (2604)
  17. Re:Dunno about you but by 93+Escort+Wagon · · Score: 4, Funny

    In all seriousness - I imagine the pills are fine, but any subsequent burps are rather unpleasant.

    --
    #DeleteChrome
  18. Re:It's probably not the best experience of your l by sandytaru · · Score: 4, Informative

    TFA says healthy volunteers. The big improvement of this method is that they can "donate" just once, have their donation frozen, and then have it .... used over the course of a few months. The previous method required a healthy donor the day of the transplant, usually a relative of the recipient.

    --
    Occasionally living proof of the Ballmer peak.
  19. Re: Former C. Diff Patient here ... by tpjunkie · · Score: 2

    C. diff infections are NOT always caused by antibiotic "overdose," which isn't really a thing - there's dose related toxicity for some classes of antibiotics, but not overdose. In the healthcare setting, infections are usually caused by overgrowth in the setting of depleted colonic flora, but symptomatic infections can also happen with contact with a patient already experiencing a C. diff infection - two years ago, a resident at my hospital ended up with such a severe infection she picked up from a patient that she nearly ended up with a total colectomy. In the community setting, about 50% of cases occurred without any prior antibiotic exposure in the past 30-90 days, at least according to a recent meta-analysis [http://www.ncbi.nlm.nih.gov/pubmed/25058469].

  20. I was going to make a joke about this by penguinoid · · Score: 2

    ...but I decided it was just a bunch of crap.

    --
    Don't waste your vote! Vote for whoever you want, unless you live in a swing state it won't matter anyways
  21. We need to update the saying... by argStyopa · · Score: 2

    So it's no longer "eat shit and die"?

    --
    -Styopa
  22. The blue pill or the red one by Anonymous Coward · · Score: 2, Funny

    "You take the blue pill - you wake up in your bed, a victim of projectile diarrhea. You take the red pill - I show you how deep the rabbit hole goes...but you still suffer from projectile diarrhea."

  23. Re:Dunno about you but by jandersen · · Score: 2

    Whatever! Eat shit and, er, ... live?