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Medicine

Feces-Filled Capsules Treat Bacterial Infection 135

Posted by timothy from the you'll-note-not-many-politicians-die-of-c-diff dept.
sciencehabit writes Clostridium difficile infections kill approximately 14,000 Americans every year, often because the diarrhea-causing bacteria are highly resistant to standard antibiotics. Now, scientists have found an unusual way to combat the bugs: human feces in pill form. In the new study, researchers show that frozen fecal matter encapsulated in clear, 1.6 g synthetic pills was just as safe and effective as traditional fecal transplant techniques at treating C. difficile. Within 8 weeks or less, 18 out of 20 participants saw a complete resolution of diarrhea after consuming 30 or 60 of the feces-filled capsules. "It's probably not the best experience of your life," says team leader Ilan Youngster, a pediatric infectious disease doctor at Harvard University. "But it beats getting a tube stuck down your throat or a colonoscopy or having C. diff."
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Feces-Filled Capsules Treat Bacterial Infection More

Feces-Filled Capsules Treat Bacterial Infection

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  • It's probably not the best experience of your life (Score:5, Funny)

    by Psicopatico ( 1005433 ) on Sunday October 12, 2014 @01:28PM (#48125009)

    It's probably not the best experience of your life

    Talk about the poor chinese laborer who assembles the pills...

  • "Eat shit!" "Joke's on you. I already am."

  • Ugh. (Score:2, Funny)

    by Anonymous Coward
    I realize they were just trying to cure a case of C. difficile, but "Two girls, one pill" would have been much easier to watch.
  • I bet you could stick them up your arse for all the good they'd do you.
    • Fry: "I can't swallow that!" Farnsworth: "Well then, good news! It's a suppository."

    • Suppository form works just fine. (Score:5, Interesting)

      by jpellino ( 202698 ) on Sunday October 12, 2014 @01:52PM (#48125133)
      Yes, that's been the preferred method so far. People gong on massive antibiotics have stockpiled frozen fecal suppositories with perfectly good results. Not FDA approves since it's not been properly tested until recently.
      • I'm left wondering what is new here. For years, folks have taken probiotics, often in pill form, during antibiotic treatment to restore intestinal flora, and to combat systemic yeast infections. How is this not just a very crude version of the same thing?

        • Re: Suppository form works just fine. (Score:4, Funny)

          by phantomfive ( 622387 ) on Sunday October 12, 2014 @02:12PM (#48125217) Journal

          I'm left wondering what is new here. For years, folks have taken probiotics, often in pill form, during antibiotic treatment to restore intestinal flora, and to combat systemic yeast infections. How is this not just a very crude version of the same thing?

          According to wikipedia, it has better results than probiotics. That is the end of my knowledge on the topic.

        • Re: Suppository form works just fine. (Score:5, Interesting)

          by Bite The Pillow ( 3087109 ) on Sunday October 12, 2014 @03:32PM (#48125619)

          Probiotics are a very general class of things. And specifically taking bacteria pills (that is, a specific type of probiotic) like acidophilus is not as effective.

          When you take antibiotics, you are disturbing an ecosystem that has evolved over years. Everything you eat could contribute to the bacteria makeup. Dirt is supposed to have beneficial "feel good" bacteria, and the microbiome may affect mood. Acidophilus and Bifidus and Bulgaricus alone will not restore what you just killed with antibiotics, or what you lost through diarrhea.

          Healthy donor stool is the easiest, quickest way to get all of the bacteria. One pill won't do it, because your microbiome is likely to just kill most of the intruders. Not the immune system, but the existing bacteria - maybe just by starving them out. Repeated doses gives you a good chance to let the varied bacteria strains get established.

          Why don't we just figure out which bacteria are needed and give you those? Man, you are brilliant. So brilliant, that you won't be surprised to find out that lots of people are trying to figure out which ones are good, useless, or bad. As you can imagine, isolating the effects of a single type of bacterium on humans, without negatively impacting health, which would throw off the results of such a study, is complicated.

          And it is by no means crude. Crude is having someone poop in a jar, putting it in a blender, and giving yourself a poop enema. This method seems to be a simpler and cleaner way, as well as being possible to get it further into the intestines than you can do at home safely.

          • Re: (Score:2)

            by dgatwood ( 11270 )

            Acidophilus and Bifidus and Bulgaricus alone will not restore what you just killed with antibiotics, or what you lost through diarrhea.

            No, but that's what your appendix is for. Besides, the last probiotic I took contained fifteen different kinds of bacteria, not just a couple. Granted, that's still less than a tenth of the predominant strains in a typical human gut, but the same techniques could just as easily produce a few hundred strains as fifteen.

            And it is by no means crude. Crude is having someone po

        • Re: Suppository form works just fine. (Score:4, Interesting)

          by Anonymous Coward on Sunday October 12, 2014 @03:35PM (#48125637)

          Probiotics are only effective to prevent [medpagetoday.com] C diff. Useless once you have it, except maybe to prevent recurrence. Once you have C diff, it is imperative to get treatment, either fecal transfer (either as a pill or via colonoscopic instillation; enemas or nasoduodenal routes are less effective [medscape.com]) or go on to a special antibiotic regiment.

          The problem is that C diff has become to common that it is starting to become resistant to the typical treatment (metronidazole or oral vancomycin). This is starting to become dangerous, because unchecked C diff can be lethal (I have seen people die from this) or result in the removal of the entire colon - if your surgeon can get to you in time.

          And before you DIYer get any ideas....this is not something to mess around with. It's kinda like packing your own parachute, you better know what the hell you're doing cause you probably only have one shot at this.

          • Indeed, not to be messed around with. I was lucky a few years ago in that I developed C-diff but the standard antibiotic took care of it and it never recurred. I have read horror stories of people having chronic C-diff that goes away with treatment but just comes back. Didn't know it had turned lethal, but it is damned unpleasant. Not something I would want to live with on a chronic basis.
          • A few years back my girlfriend had C. Diff, pretty badly. At the time, fecal transplants were still new / in testing (or, at least, the doctors hadn't even mentioned it, but we had read about them online). She happened to be browsing journals and found an article that mentioned Saccharomyces boulardii as a possible treatment. A few weeks after starting a pretty healthy regimen, her symptoms cleared up and have been gone ever since. In that respect, a probiotic was effective as a cure.

            It truly is the sort

            • Re: (Score:2)

              by dgatwood ( 11270 )

              Wow. Why does a fifty-year-old, easily synthesized antibiotic that hasn't been under patent protection since the 1980s still cost $1,500? And particularly one that is getting less and less effective against real-world bacteria.... *sigh*

  • Within 8 weeks or less, 18 out of 20 participants saw a complete resolution of diarrhea after consuming 30 or 60 of the feces-filled capsules.

    No wonder they have such a small sample. After the informed consent form I'm sure lots of people told the researchers to gtfo.

    Also, could an MD please provide the usual time frame in which diarrhea runs its course? 8 weeks being an improvement sounds just weird.

    • Re:Timeframe? (Score:5, Insightful)

      by Greyfox ( 87712 ) on Sunday October 12, 2014 @01:59PM (#48125163) Homepage Journal
      Once you've been crapping your organs out for a couple months, I'm sure you'd be willing to try just about anything.

    • Re: Timeframe? (Score:5, Interesting)

      by Anonymous Coward on Sunday October 12, 2014 @02:26PM (#48125285)

      My stepfather had c. Diff last year. It isn't run of the mill diarrhea. Remember that scene in dumb and dumber with the laxative pill? Something like that. You are physically exhausted and your body is destroying itself. It spreads infection, your immune system goes haywire, your kidneys and liver work overtime breaking things down.

      They quarantined my stepfather and told us that he probably wouldn't make it due to his age. He was put on antibiotics and morphine. I kept complaining to nurses that antibiotics actually caused this (he cut his fingertip and they gave him a dose 3x higher than necessary, if he needed it at all) and to look at alternatives but they don't really care. So many patients to treat, so little time. Nurses said the poop transplant was the option of last resort(even with 90% success rate) and that they would continue with antibiotics. My stepfather was pretty lucky to survive it and is now cautious about antibiotic use.

      If standard diarrhea clears up in 8 weeks, is that in any way useful if you're dead in two?

      • Re: Timeframe? (Score:5, Interesting)

        by Fwipp ( 1473271 ) on Sunday October 12, 2014 @02:53PM (#48125423)

        Yep, the antibiotic regimen they put you on is no joke, either. It wipes out all your intestinal flora, leaving you super vulnerable to recolonization (and those spores are real fucking hard to eliminate).

        My grandmother had a fecal transplant and she cleared up in days, after literal months of illness.

        Source: I used to be closely involved with an MD whose primary focus was this bug. Well, the grandma part was sourced from my mom.

        • I wonder why they use poop instead of nice clean odorless freezedried bacteria, like they are sold over the counter in healthshops for many decades.

      • Re: (Score:2)

        by tibit ( 1762298 )

        The diarrhea might be the least of your worries. Eventually you might develop sepsis from the immune reaction to all the toxins and you die, even if well-hydrated.

    • Re: (Score:2)

      by bware ( 148533 )

      No wonder they have such a small sample. After the informed consent form I'm sure lots of people told the researchers to gtfo.

      If you had C. diff, you'd be doing everything including licking doorknobs at a urgent care clinic to try to get some healthy gut bacteria back.

      I'm guessing they had people lined up and turned away for the study. Except they'd have to have their friends line up, because if you have C. diff, you can't wait in a line. For anything. Including the toilet.

      Also, could an MD please provid

  • Special combination deal: 10% off when you buy with breath mints.

  • Former C. Diff Patient here ... (Score:1)

    by Anonymous Coward

    ... Your options are not only "getting a tube stuck down your throat or a colonoscopy or having C. diff." or taking these pills. There are indeed stronger antibiotics which work.

    • MD here... (Score:5, Informative)

      by tpjunkie ( 911544 ) on Sunday October 12, 2014 @02:01PM (#48125175) Journal
      These are for patients who have recurrent C. diff, who have already failed PO vancomycin or fidaxomycin (difficid). Those are the only two antibiotics we really have after you fail metronidazole therapy. It's not an issue of strongness; it's penetrating into encysted bacteria which vancomycin does fairly poorly, and fidaxomycin does only moderately better. At that point, options are fecal therapy, another round of vanc or difficid with increasingly diminishing returns, or in severe cases, colectomy.

    • Re: Former C. Diff Patient here ... (Score:1)

      by Anonymous Coward

      C. Diff infections are always caused by antibiotic overdose. So treating it with a stronger antibiotic seems like insanity.

      I can confirm that it does work, but not all the time. And with the very serious drawback of increasing antibiotic resistance yet again.

      Eating the pill filled with poop has a 90% effectiveness. With the neat side effect of not increasing the arms race in antibiotic resistance. the strong antibiotic currently used can instead be used for more serious infections that don't have other trea

      • C. diff infections are NOT always caused by antibiotic "overdose," which isn't really a thing - there's dose related toxicity for some classes of antibiotics, but not overdose. In the healthcare setting, infections are usually caused by overgrowth in the setting of depleted colonic flora, but symptomatic infections can also happen with contact with a patient already experiencing a C. diff infection - two years ago, a resident at my hospital ended up with such a severe infection she picked up from a patient

  • researchers show that frozen fecal matter encapsulated in clear, 1.6 g synthetic pills

    I don't see anything about "clear" in the linked article's linked article. I'd think opaque ones would be a lot more popular.

    Might be worth pointing out that they don't just squirt poop into a capsule. It does at least go through a bit of processing and filtration first.

    • In another report I read on this topic, the lead research said he wanted opaque pills but they needed something that could survive the stomach and make it to the long intestines. Those thicker capsules only came in clear. The freezing process lightens the contents and also puts some frost on the outside to make it less obvious...

      • The freezing process lightens the contents and also puts some frost on the outside

        Poopsicles!

        They can have that one for free.

  • Google it. Anyhow, this isn't necessarily a new thing - but that's the only person I've heard of who has done such a thing. Not exactly a great product endorser.

  • Perspective (Score:5, Informative)

    by phantomfive ( 622387 ) on Sunday October 12, 2014 @02:14PM (#48125229) Journal
    For some perspective, C. dificile kills 16,000 people per year in the United States. Compare that to how many people have died from Ebola.

    • It's funny how our media chooses something a few times a year that can tell a story and scare the public. Usually it's something from overseas, that we have to start behaving differently and checking on people coming across the border to prevent.

      I just heard a story of some moron who yelled "I have Ebola" on an airplane, and they sent him back home. Why the overreaction? Is someone shouting nonsense MORE likely to have a disease after they say; "just kidding?" than the person next to them on the plane? How

      • Re: (Score:1, Interesting)

        by Seumas ( 6865 )

        Personally, I like how everyone has completely lost their shit over Ebola overseas and oh my god we have to do something about it and blah blah blah blah.

        But as soon as there's a case of it state-side, these same people are all "oh, this could never become an issue here and more people die from sneezing themselves to death each year in this country than have died of Ebola blah blah blah".

        I mean, pick your concern and try to be consistent about it.

        Besides, the same could be said about all of these global coo

        • Personally, I like how everyone has completely lost their shit over Ebola overseas and oh my god we have to do something about it and blah blah blah blah.

          But as soon as there's a case of it state-side, these same people are all "oh, this could never become an issue here and more people die from sneezing themselves to death each year in this country than have died of Ebola blah blah blah".

          I mean, pick your concern and try to be consistent about it.

          I haven't seen that pair of positions at all. I wish I had, because those are consistent. Ebola is so dangerous in Africa because sanitary conditions and medical facilities are so poor there. All of those deaths are a tragedy, and the deaths of healthcare workers sacrificing themselves are a tragedy that tugs the heartstrings.

          On the other hand, Ebola is truly not dangerous here, because we do have good public health infrastructure.

          There's nothing at all inconsistent about those two perspectives, unless

      • It's funny how our media chooses something a few times a year that can tell a story and scare the public.

        It's not so much that they "choose" something. It's the fundamental difference between "news" and "not news" colliding with the way humans have evolved to give cognitive weight to things they hear about frequently and which can be associated with strong narratives.

        C. dificile killing 16K people annually isn't news, because it's been happening for years. It's part of the background, not something which jumps up and begs to be called out. If a few thousand people in Africa had been dying at a steady pace fr

    • Of course, the number of C. dificile infections is not doubling every few weeks these days.

  • Eat shit and ... (Score:4, Funny)

    by CaptainDork ( 3678879 ) on Sunday October 12, 2014 @02:40PM (#48125345)

    ... live.

  • has a chapter on this, done up in her usual hilarious style.

    The capsules are clear because they have to survive the stomach to get the icky contents into the intestine. For whatever reason they only make those capsules clear.

  • Feces filled capsules... (Score:1)

    by Anonymous Coward

    ... also known as Taco Bell burritos.

  • "Eat shit and live".

  • Within 8 weeks ... saw a complete resolution of diarrhea after consuming 30 or 60 of the feces-filled capsules.

    Um... that's an improvement? That's like advertizing "We found a new cure for hemorrhoids! It takes 2 months and involves a soldering iron!"

    • Within 8 weeks ... saw a complete resolution of diarrhea after consuming 30 or 60 of the feces-filled capsules.

      Um... that's an improvement? That's like advertizing "We found a new cure for hemorrhoids! It takes 2 months and involves a soldering iron!"

      It's an improvement over suffering from diarrhea until you die, months later. And *a* cure for hemorrhoids actually does involve something like a soldering iron (laser). It's just a bit faster than 2 months, although recovery will be quite a few days. And incredibly painful if you're part of the unlucky 2% or so of the population who have nerve endings in the wrong place.

  • Is this the patient's own faeces, or someone else's?

    • Re: Whose? (Score:1)

      by Anonymous Coward

      Hrmm, think about it for a sec. Seriously. Once you have C. Diff. You need these fecal pills to resolve the diarrhea, so obviously the bacteria you need to restore the intestinal flora isn't in the diarrhea you are suffering from if you have C. Diff. Which is a result of the broad spectrum antibiotics you just took. This means that before you start taking the antibiotics you need to stock up on stool for them to process at the lab.

      I presume it takes quite a while to process stool into a consumable pill, and

      • I presume it takes quite a while to process stool into a consumable pill, and to make sure the poo isn't going to give you something else.

        According to Mary Roach it only takes a few minutes.

    • Someone else's. You need to ingest capsules that have only the non-disease-causing bacteria.

  • that'll teach those heathen "pill first" types to properly sip of the water and THEN put the pill in their mouths.

  • Killing healthcare workers prevents Ebola and I'll just betcha that injecting hemorrhaged blood from an Ebola victim in his family will vaccinate against Ebola.

    In fact, let's get rid of public sanitation. What a regressive idea.

  • ..

    Now we need better gelatin capsules that don't get caught and dissolve in the back of your throat.

    Because.. I just don't want to think about that.

    *shudder*

  • We need to update the saying... (Score:3)

    by argStyopa ( 232550 ) on Sunday October 12, 2014 @08:23PM (#48126869) Journal

    So it's no longer "eat shit and die"?

  • The blue pill or the red one (Score:2, Funny)

    by Anonymous Coward

    "You take the blue pill - you wake up in your bed, a victim of projectile diarrhea. You take the red pill - I show you how deep the rabbit hole goes...but you still suffer from projectile diarrhea."

  • For the love of god, why oh why do the pills have to be clear?!?

  • Call me a conspiracy nut, or whatever you want; but I question what's going on here. Is there someone with a background that can explain?

    A fecal transplant can be done with an enema, and my understanding is that it's quite effective. But some doctors aren't interested, preferring either to deliver the dose via a colonoscopy or endoscopy. My father had C. Diff last year, but began to get nauseated when they tried putting tubes up his nose. So the doctor was going to recommend as an alternative—and I sw

    • Re: (Score:2)

      by pnutjam ( 523990 )
      I think your trolling, but the reason a colonoscopy is preferred probably to do with inserting the bacteria far enough into your body to avoid having them killed by your natural defenses. Eaten bacteria would generally be killed by your stomach acid. i'm not sure how the other end protects itself.

  • So we'll have a bunch of idiots reading this type of article or seeing it somewhere in the news, and immediately start feeding their sick family members their own shit to save money. This spells disaster all over it. Rather than "Please Wash Your Hands" signs, people will expect "Please Poop On Your Hands" signs in their place -- for health reasons, of course.

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