Fecal Transplants May Soon Be Available in a Pill

When you have Clostridium difficile (C. difficile), a potentially life-endangering infection characterized by diarrhea, you’ll try anything to cure it—even a fecal transplant, which studies have shown to be 90% effective against the infection. But once you get over the initial ickiness of infusing someone else’s poop-derived gut bacteria into your own disturbed microbial colonies, you still have the procedure to stomach. These days, fecal transplants are done either by colonoscopy or by a tube that runs through the nose into the stomach, but a new study published in JAMA shows that there may be a less unsavory—but equally effective—route by way of a pill.

In the study, 20 patients with c. difficile were given a series of pills filled with frozen fecal material from healthy donors. The pills were made by blending up stool with saline, straining the solution, extracting the bacteria, using a pipette to put the material into pills and freezing them. Each patient swallowed 30 capsules of the stuff over two days—after which, 90% of the patients’ diarrhea was cured.

Using frozen fecal material might also have some safety advantages to fresh donations. Researchers can retest donors for potential incubating infections before using their frozen material, the study says. And using capsules cuts down on risks associated with the two more traditional (and invasive) procedures, colonoscopy and nasogastric tube, Youngster says. “Both of these things are very unpleasant and have potential for complications.”

The team isn’t the first to work on developing a pill made of poop; in 2013, a group put the fecal bacteria into capsules, too. But this is one of the first rigorous tests that shows how effective oral fecal transplants can be, says study author Ilan Youngster, MD, of Massachusetts General Hospital, Boston. “It’s just a much easier and less invasive way of doing it,” he says.