Bioethics Blogs

You Won’t Believe What’s In These Pills

Fecal pills

Credit:: Hoffmann lab

Clostridium difficile, or more commonly “C. diff,” is a nasty bacterium that claims the lives of 14,000 Americans every year. Most at risk are people with conditions requiring prolonged use of antibiotics, which have the unfortunate side effect of wiping out the natural, good bacteria in the colon—thus allowing bad bugs like C. diff to multiply unchecked. In many folks, C. diff infection can be treated by halting the original antibiotics and switching to other types of antibiotics. But for some people, that doesn’t work—C. diff is either resistant to treatment or makes a hasty comeback.

What’s to be done then? Well, researchers have known for some time that taking microbe-rich stool samples from healthy people and transplanting them into C. diff patients helps to improve their symptoms. The challenge has been figuring out a safe and effective way to do this that is acceptable to patients and doesn’t involve invasive procedures, such as colonoscopy or nasogastric tubes [1,2]. Could there be a simple solution? To put it more bluntly: what about poop pills?

A team of NIH-funded researchers at Massachusetts General Hospital in Boston have now successfully tested that very strategy: they purified healthy stool samples in a way that concentrated the good bacteria, placed the resulting material into capsules, and then froze the capsules. The researchers led by Ilan Youngster and Elizabeth Hohmann, both infectious disease specialists, tested these frozen poop pills on 20 volunteers who had experienced at least three C. diff infections and failed to respond to a six-to-eight week course of the antibiotic vancomycin—the usual treatment for ridding the body of this microbe.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.