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."

Comments

It's probably not the best experience of your life

[Psicopatico]

It's probably not the best experience of your life

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

Re:It's probably not the best experience of your l

[Skiboy941]

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

Suppository form works just fine.

[jpellino]

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.

Re: Suppository form works just fine.

[Jarik C-Bol]

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.

Re: Suppository form works just fine.

[Bite The Pillow]

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.

Re: Suppository form works just fine.

[Anonymous Coward]

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.

Re:Timeframe?

[Greyfox]

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

MD here...

[tpjunkie]

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.

Re:Insults

[0xdeadbeef]

"Eat shit and live, motherfucker!"

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

Perspective

[phantomfive]

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.

Re: Timeframe?

[Anonymous Coward]

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?

Re: Timeframe?

[Fwipp]

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.

Re:Dunno about you but

[FatdogHaiku]

This article is full of Sh!t

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

Re:Dunno about you but

[93 Escort Wagon]

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

Re:It's probably not the best experience of your l

[sandytaru]

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.