Transplanting poop can be life-saving for people with stubborn bacterial infections, so doctors have come up with a way to make them more palatable: the frozen poop pill.
It’s not for the squeamish, but there’s a relatively new medical procedure called faecal transplanting which is outperforming antibiotics against severe infections. Doctors essentially take poo from a healthy person, freeze it, liquidise it in a blender, then add it to a sick person’s bowel either by a tube through the nose or via the rectum.
The method, which colonises the gut with healthy bacteria, has a 85 percent success rate against life-threatening infections such as Clostridium compared to only 20 percent for standard antibiotic treatment.
Researchers at Massachusetts General Hospital figured they could improve on that. First they tried delivering the fecal transplant through a tube snaked down the nose and into the stomach. It delivered the healthy bugs but wasn’t much fun.
Amazingly, the poop pill wouldn’t require invasive procedures, the researchers speculated, and would be less likely to cause vomiting. And if they froze the pills, donors wouldn’t need to be standing by.
To test that hypothesis, the researchers got donations from young, healthy volunteers screened to make sure they didn’t have HIV, hepatitis or other infectious diseases. They froze the material and waited four weeks to test the donors again. Once the donors got a clean bill of health, pill production began.
By now you’re probably wondering what a poop pill looks like.
“When I first started doing this, I had in my mind that it would be a little red-and-white banded capsule, like a Tylenol capsule,” Hohmann says. “That was my dream.” But alas, the capsules had to be acid-resistant so they could make their way past the stomach into the large intestine, where the good microbes work their magic.
And acid-resistant capsules only come in translucent.
So they are sort of brownish-colored capsules. Fortunately, because they’re frozen, when you take them out of the freezer they sort of frost up a bit and they’re not too gross,” Hohmann says.
Australian regulators are yet to make a decision on the use of faecal transplants but local clinics are reportedly offering the procedure. A report in the British Medical Journal (BMJ) says long term trials and monitoring are urgently needed to provide sensible advice to patients. However, so far few adverse effects are being reported after more than 7,000 transplants.
And the transplants seem relatively safe for elderly patients and those with impaired immune systems, say Tim Spector from King’s College London and Rob Knight from the University of California San Diego.
More than 500 centres in the US now offer faecal transplantation, with most using frozen donations from the not-for-profit stool bank organisation, OpenBiome, in Boston. The UK regulator (MRHA) has temporarily classed faecal transplants as a medicinal product.
Faecal transplantation is also being tested for other conditions including obesity, diabetes, irritable bowel syndrome and colitis. However, Spector and Knight say claims that faecal transplantation could be a cure-all for many diseases are probably too optimistic. And there are risks of infection. And the transfer of microbes to a new host could include transferring susceptibility to obesity and even mental illness.
These possible risks suggest that faecal transplantation, although an exciting new tool, should be carefully monitored and refined to include most of the key beneficial microbes,” Spector and Knight write in the BMJ.