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“Poop Pill” Offers a New Option to Treat C. Diff Diarrhea

by Dr. Sharon Orrange on November 12, 2015 at 1:25 pm

You may have heard about “fecal transplants” for the treatment of Clostridium difficile (C. diff) infection. Clearly, there is a yuck factor involved in having an emema of someone else’s stool but this treatment may be life altering and even life-saving for folks with C. diff diarrhea.
Now, there is another option: yes, a poop pill.
What is a fecal transplant?
Typically, fecal (stool) transplants, using feces from healthy donors, are delivered by enema, colonoscopy or a tube through your nose to your stomach (a nasogastric tube).  The result of fecal transplant is a rebalancing of the bacteria in the gastrointestinal system of patients with recurrent C. diff infections.
How can a pill help—and why is it even an option?
Now several studies have confirmed that a stool capsule is just as effective.  In one study, the pill formulation was 100% effective in the first 32 patients treated, when checked at a 3-month follow-up. Some of those patients have been followed for up to 3 years since that check, and they remain C. diff-free.
A more recent study (November 2014 JAMA) demonstrated that taking stool capsules orally had an overall rate of resolution of diarrhea of 90% in patients with C. diff. Those rates are the same as fresh stool transfers, which is excellent news. It does take a little longer for symptoms to resolve with the capsule though: 4 days vs 2 days.
How do you make this pill (and do I want to know)?
It’s complicated. Stool from donors is packaged into a capsule utilizing concentrated cryopreserved fecal-derived bacteria and is given orally to patients. In studies, it is generally shown to be an effective, safe and well-tolerated therapy for recurrent c-diff—and so much better than the alternative.
Dr. O

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