By Pam Belluck
The New York Times • Sunday October 12, 2014 9:35 AM
This pill goes down easier if you forget what is in it.
Inside the experimental capsule are human feces — strained, centrifuged and frozen.
Taking them for just two days can cure a dangerous bacterial infection that has defied Antibiotics and kills 14,000 Americans each year, researchers said yesterday.
If the results are replicated in larger trials, the pill, developed at Massachusetts General Hospital in Boston, promises an easier, cheaper and most likely safer alternative to an unpleasant procedure highlighted in both medical journals and on YouTube: fecal transplants.
Studies show that transplanting feces in liquid form from healthy people to patients with stubborn Clostridium difficile, or
C. diff, infections can stop the wrenching intestinal symptoms, apparently by restoring healthy gut bacteria.
But fecal transplants are not easy. The procedure requires delivery of a fecal solution via the rectum or a tube inserted through the nose. As with colon-oscopies, patients must flush their bowels first.
Finding and screening donors is time-consuming and can delay the transplant. And the costs can be significant.
“Capsules are going to replace the way we’ve been doing this,” said Dr. Colleen Kelly, a gastroenterologist with the Women’s Medicine Collaborative in Providence, R.I., who was not involved in the study. Kelly performs five or six fecal transplants a month, but demand is so great she is booked through January.
“It’s so labor-intensive,” she said. “You have to find a donor, have to screen a donor. If you can just open a freezer and take out a poop pill, that’s wonderful.”
While the pills are not being marketed yet, the authors of the study, published in JAMA, already are making them available to qualified patients.
Their study was small and preliminary, but results were striking: 19 of 20 patients with C. diff infections were cured of diarrhea and related symptoms. Most saw improvements after one two-day round of pills, said Dr. Ilan Youngster, the lead investigator.
Other research teams, and at least one private company, are developing and testing fecal pills. Pills marketed commercially would have to meet Food and Drug Administration licensing regulations.