Poo pills

What happens when your diarrhoea just won’t stop?

One common source of recurrent diarrhoea is the bacterial species Clostridium difficile. These bacteria don’t always cause a big problem and can be found in soils and in the normal gut ‘microbiome’ of some adults.

However, when the normal balance of gut bacteria is disrupted, such as after prolonged antibiotic use, there may be reduced competition from other types of bacteria. While C. difficile isn’t specifically resistant to antibiotics, it is more resilient than other gut bacteria and is capable of producing a toxin that causes diarrhoea. If the C. difficile population gets past a tipping point, then the resulting inflammation of the colon and severe diarrhoea prevent a return to a normal healthy gut microbiota.

One of the easiest and most effective ways to tackle C. difficile infections is to address the imbalance by providing more bacterial competition. This can be done by introducing a healthy population of bacteria via a faecal transplant. By transferring some poo from a healthy donor into the gut of someone whose gut microbiota has become unstable or detrimental, a healthy population of diverse bacteria can re-establish in the patient.

The treatment seems to be quite effective, although it has its downfalls and isn’t widely available for numerous reasons, not least of all due to the colonoscopy required for transplant. If only there was a way to get the healthy gut-microbiota into the gut without the need for invasive hospital treatments …

Enter the poo pill! AKA the ‘crapsule’.

Researchers from the University of Alberta provided the transplant via an oral capsule, directly comparing it to colonoscopy treatments. And yes—it is exactly what you are thinking it is (we’re told that it doesn’t smell as bad when frozen). The capsule doesn’t break open until it reaches the intestine, just where the bacteria need to go.

The study included treating 116 patients with either the normal colonoscopy-based faecal transplant, or via a capsule-based transplant. The outcome? Taking the capsules is at least as good as the colonoscopy treatment in terms of treating C. difficile infections. Around 96 per cent of both test groups didn’t have any recurrence of C. difficile overpopulations within 12 weeks of treatment.

The pill has lots of benefits. It's cheaper for a start. It’s also more acceptable to patients, makes it easier to standardise care, is at least as effective and is easier to transport than the alternative.

And while the idea of taking a poo pill may turn you off, 66 per cent of the patients who trialled the pill rated their experience as ‘not at all unpleasant’.

Popping this pill is a whole lot better than a colonoscopy … just make sure to swallow it whole.