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Don't Chew The Pills!

A Massachusetts General Hospital-led team of researchers have developed a decidedly unappetizing approach for treating patients suffering from Clostridium difficile infections — poop pills.

In research described in The Journal of the American Medical Association, the scientists say they have successfully tested fecal microbiota transplantation capsules on C. difficile patients as an alternative method to more invasive fecal transplants. Such transplants, which involve the transfer of fresh stool from a donor to a patient, have shown utility in treating C. difficile infection, but the procedure faces certain challenges, such as the prior identification and screening of a suitable donor, as well as the limited viability of fresh stool samples, according to the researchers.

As a workaround to the problems, the Mass Gen researchers purified healthy fecal samples, resulting in concentrated good bacteria, which they then placed into capsules and subsequently froze them. The frozen capsules were then tested on 20 volunteers who experienced a minimum of three mild-to-moderate C. difficile infections and failed to respond to a six-to-eight-week course of vancomycin, a common treatment for C. difficile.

The patients received 30 of the fecal pills during a two-day period. After the initial course of treatment, 14 of the 20 patients were found to feel better and their bouts of diarrhea decreased and stopped after eight weeks. The remaining six patients did not respond to the initial treatment course and were given a second round of treatments, with four of these six successfully treated.

NIH Director Francis Collins calls the study "great news" on his blog but acknowledges that the idea of taking a dose of number two in a pill form may not go over so well with patients. However, he notes that the patients in the JAMA research reported no unpleasant consequences from taking the pills, and one even compared it to swallowing small ice chips.

The researchers said that larger, controlled studies will need to be conducted to evaluate the utility of their poop pill.