Fecal Transplant Pills

                Fecal transplants are a common method for treating patients with diseases that inhabit gastrointestinal tract after antibiotic treatment for another bacterial infection. On of the most prevalent of these opportunistic gastrointestinal pathogens is clostridium difficile (C. difficile).  By transplanting a health donor’s stool into a sick patient’s colon doctors are introducing bacteria that can out compete or inhibit the growth of pathogenic organisms such as C. Difficile. Although this procedure has been found highly effective, many patients are very hesitant. Patients not only find fecal microbiota transplants to be gross, but many do not like the invasiveness of the procedure.

                With patient hesitancy in mind Dr. Thomas Louie at Cumming School of Medicine created the first fecal microbiota transplant pill in 2013. Dr. Louie believed the pill would be less invasive and less expensive. Dr. Louie also mentioned that the pill allows patients to undergo treatment without being sedated. When first hearing about a fecal transplant pill many might find oral ingestion just as disgusting if not worse than the anal transplant. However, it is important to note that through a series of fecal treatments, fecal material is removed and bacteria is all that remains. After obtaining solely bacteria, those bacteria are frozen and placed within a gelatin capsule for ingestion. Thus, fecal transplant pills do not contain fecal matter.

                Before a study conducted in 2017, Louie’s fecal transplant pill was just a feasible idea. However, in 2017 Kao and her colleagues conducted a clinical study on 116 patients with C. Difficile to test the effectiveness of both the pill and the traditional colonoscopy transplant. Of the 116 patients, 59 received a colonoscopy mediated fecal transplant and 57 received the experimental pill. After all transplants Kao and her colleagues found that both the pill and the traditional colonoscopy were 96.2% effective when treating patients with C. Difficile.

                In addition to similar effectiveness, the fecal transplant pill was found to have less adverse effects. In other words, 12.5% of patient who received the traditional colonoscopy mediated fecal transplant experienced unintentional effects from treatment, which is almost twice as much as those who received the capsule treatment (5.4%).

                With a smaller rate of adverse effects and the same effectiveness of a colonoscopy fecal transplants, there is a high chance that fecal transplant pills will become more prevalent within practicing medicine. Not only will the pill be less expensive, but it allows another effective and safe treatment for C. Difficile patients who do not feel comfortable with the invasive and off putting colonoscopy fecal transplant procedure.

References:

Kao, D. H., Roach, B., Silva, M., Beck, P. L., Rioux, K., Xu, H., . . . Louie, T. (2017). A Prospective, Non-Inferioity, Multi-Center, Randomized Trial Comparing Colonoscopy vs Oral Capsule Delivered Fecal Microbiota Transplantation in the Treatment of Recurrent Clostridium Difficile Infection. Gastroenterology, 152(5). doi:10.1016/s0016-5085(17)30947-2

University of Calgary. (2017, December 1). 'Poop pill' capsule research paves the way for simpler C. difficile treatment: Fecal pill effectiveness is similar to more invasive treatment for stubborn intestinal infection. ScienceDaily. Retrieved December 3, 2017 from www.sciencedaily.com/releases/2017/12/171201091026.htm