'Poo pill' paves the way for faecal transplants

US researchers have come up with a way of taking the 'ick' factor out of faecal transplants, which are remarkably effective in treating refractory Clostridium difficile infection.  

Using freeze-dried faecal microbiota, they have developed a capsule that can be taken orally, which could ultimately replace the uncomfortable and potentially messy techniques for faecal transplant, such as colonoscopy, enemas or nasogastric tube.

The freeze-drying technique preserves the viability of faecal mirobes and allows ease of encapsulation for transfer to the colon, according to researchers from the University of  Minnesota.

In their study, they trialled their pill in 49 patients with recurrent C. difficile who had failed at least one course of antibiotics.

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Overall, 88% of patients were cured of their infection by taking 2-3 capsules in a single dose, with success defined as two months without C. difficile recurrence.

Success rates were around the same as found in clinical trials using colonoscopy, the researchers said, although the effect of the treatment was somewhat delayed.

No preparation was needed for the capsule therapy other than fasting for several hours beforehand and waiting at least two days after discontinuation of antibiotics.   

Around one-third of patients experienced irregular bowel movement, bloating and flatulence in the weeks following the transplant.

The study also found greater microbial diversity after treatment compared with before.

A ‘poo pill’ has been seen as something of a Holy Grail in faecal microbiota transplant research, given the practical difficulties of delivering faecal microbiota via the rectum.

More information:

American Journal of Gastroenterology 2017; online.