Chronic Kidney Disease patients have an increased risk of acquiring Clostridium Difficile (C. diff) through unknown mechanisms. The germ causes nausea, cramping and diarrhea so bad it is often disabling. Transplanting fecal matter has been one of the best remedies at treating this tough bacterial infection. However, "Fecal Transplants" (giving people that are infected stool from a healthy donor) are currently given through invasive procedures like colonoscopies or throat tubes. Doctors also have tried giving the stool through enemas but the treatment does not always take hold. Now scientists have found a method to give all the benefits of previous treatments in an easily tolerable tiny pill.
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This new pill method is a "less yucky" way to conduct Fecal Transplants and Canadian researchers relayed that 27 patients who tried this treatment were all cured after strong antibiotics failed to help. It is a gross topic but a serious problem, as 500,000 Americans get C diff. infections each year, and about 14,000 die. A very potent and pricey antibiotic can kill C. diff but also destroys good bacteria that live in the gut, leaving it more susceptible to future infections.
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Recently, studies have shown that fecal transplants -- giving infected people stool from a healthy donor -- can restore that balance. A New England Journal of Medicine study revealed that "poop transplants were better than antibiotics during a clinical trial." Another study presented at the Infectious Diseases Society of America meeting in October 2012 said that 43 out of 49 patients in Detroit who received fecal transplants recovered quickly and had no complications three months later.
Dr. Thomas Louie, Infectious Disease Specialist at the University of Calgary, devised a one-time treatment that is custom-made for each individual patient that is infected with C. diff. In his method, donor stool from a relative is processed in the lab to take out food, extract bacteria and clean it. It is packed into triple-coated gel capsules so they will not dissolve until they reach the intestines. "There's no stool left - just stool bugs. These people are not eating poop," and there are no smelly burps because the contents aren't released until they're well past the stomach, Louie said.
It takes 24 to 34 capsules for a single treatment, and patients swallow them in one sitting. The pills make their way to the colon and seed it with the normal variety of bacteria. Margaret Corbin, 69, a retired nurse's aide from Calgary, told of the misery of C diff. "It lasted for two years. It was horrible. I thought I was dying. I couldn't eat. Every time I ate anything or drank water I was into the bathroom," she said. "I never went anywhere, I stayed home all the time." With her daughter as the donor, she took pills made by Louie two years ago, and "I've been perfectly fine since," Corbin said.
Dr. Curtis Donskey of the Cleveland Veterans Affairs Medical Center, who has done fecal transplants through colonoscopies, praised the work. "The approach that Dr. Louie has is completely novel - no one else has done this," he said. "I am optimistic that this type of preparation will make these procedures much easier for patients and for physicians."
The treatment now must be made fresh for each patient so the pills do not start to dissolve at room temperature, because their water content would break down the gel coating. Minnesota doctors are testing freezing stool, which doesn't kill the bacteria, so it could be stored and shipped anywhere a patient needed it. Louie sees potential for the poop pills for other people with out-of-whack gut bacteria, such as hospitalized patients vulnerable to antibiotic-resistant germs. "This approach, to me, has wide application in medicine," he said. "So it's not just about C diff." KidneyBuzz.com encourages CKD patients to discuss this new treatment to combat C. diff with their Nephrologist, should you contract the virus.
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"Poop Pill May Treat Stubborn, Deadly C. Diff Bacteria." CBSNews. CBS Interactive
"Chronic Kidney Disease as a Risk Factor for Clostridium Difficile Infection." US National Library of Medicine National Institutes of Health.
"Duodenal Infusion of Donor Feces for Recurrent Clostridium Difficile." New England Journal of Medicine.