Poop pill' capsule research paves the way for simpler C. difficile treatment

An Alberta-led clinical trial has shown Faecal Microbiota Transplant (FMT) is effective in treating clostridium difficile (C. difficile) infections whether delivered by colonoscopy or by swallowing capsules. The finding could revolutionize and broaden the use of FMT, which restores the healthy balance of bacteria living in the intestine by transferring a healthy donor’s stool to the gut of a person with C. difficile.

Dr. Thomas Louie, clinical professor at the Cumming School of Medicine and the Calgary FMT study co-lead and senior author, pioneered the development of the FMT pill in 2013. “Recurrent C. difficile infection is such a miserable experience and patients are so distraught that many ask for faecal transplantation because they’ve heard of its success,” says Louie. “Many people might find the idea of faecal transplantation off-putting, but those with recurrent infection are thankful to have a treatment that works.”

“This will transform the way people think about how we deliver Faecal Microbiota Transplant,” says Dr. Dina Kao, an associate professor with the University of Alberta’s Faculty of Medicine and Dentistry and lead author of the study. “Capsules have numerous advantages over colonoscopy. They are non-invasive, they’re less expensive, they don’t have any of the risks associated with sedation and they can be administered in a doctor’s office.”

Capsules containing frozen donor bacteria taken orally were shown to be 96-per-cent effective in treating C. difficile, the same success rate as those receiving transplant by colonoscopy. The pills have no scent or taste. They are made by processing faeces until it contains only bacteria, then encapsulating the bacteria concentrate inside three layers of gelatin capsule. “The pills are a one-shot deal, not a continuing treatment,” says Louie. “They are easier for patients and are well tolerated.”

Humans are host to hundreds of different species of gut bacteria, which together help the digestive and immune systems to function properly. However, when a harmful infection requires treatment with antibiotics, those same antibiotics can disrupt the healthy balance of the gut bacteria, allowing opportunistic microorganisms such as C. difficile to cause illness.

People with C. difficile infections suffer from diarrhoea, cramping and other gastrointestinal difficulties. In advanced cases, it may be necessary to remove the large intestine. Although rare, C. difficile can be extremely debilitating and resistant to treatment by antibiotics. In some cases, it can be fatal. In Alberta, there are about 200 C. difficile cases every year, of which between 20 and 40 are fatal.

University of Calgary

www.ucalgary.ca/utoday/issue/2017-11-29/poop-pill-capsule-research-paves-way-simpler-c-difficile-treatment