A clinical trial led by doctors and researchers in Alberta has found that fecal transplants delivered orally by capsule may be just as effective as transplants done by colonoscopy in treating C. difficile infections.
The findings, , found that capsules containing frozen donor bacteria were 96 per cent effective in treating C. difficile, a bacterial infection that can cause diarrhea and, in serious cases, life-threatening inflammation of the colon.
The patients who received the capsule treatment had the same success rate as those receiving fecal transplant by colonoscopy.
C. difficile infections are common among older people in hospitals or nursing homes, and they sometimes don鈥檛 respond to antibiotic treatments.
However, doctors have reported great success rates when treating C. difficile patients with fecal microbiota transplants, or FMTs. The process involves transplanting the stool of healthy patients into the intestines of patients with hard-to-treat infections, like C. diff. The fecal transplants work by re-introducing healthy gut bacteria into the patient鈥檚 system.
The Alberta researchers say FMTs delivered by capsule could revolutionize the treatment of C. diff and other intestinal infections.
鈥淚t is more convenient, it is cheaper and it is safer for the patients to receive the capsules than the traditional ways of receiving the (fecal) transplants,鈥� Dr. Dina Kao, the study鈥檚 lead author, and an Alberta Health Services gastroenterologist, told 麻豆影视.
鈥淧atients come back to tell me that they often feel almost immediately different the day of the procedure,鈥� she said. 鈥淭hey just feel the surge of energy come back and their appetites come back and they just feel very different. It is just like a light switch has turned on for them again.鈥�
The researchers estimate that the use of FMT capsules would likely save the health system a minimum of $1,000 per patient.
The clinical trial divided 116 patients with recurrent C. difficile infections into two groups. One group received the capsule treatment, while the other received stool transplants by colonoscopy.
More patients who took the capsules rated their experience as 鈥渘ot at all unpleasant,鈥� the study says. The capsules don鈥檛 contain actual feces, just the microbes present in the stool collected from donors.
Karen Shandro, one of the patients who took the capsules, said she had a 鈥渄ebilitating鈥� C. difficile infection for two months before the treatment.
鈥淗aving C. diff is indescribable,鈥� the Ardrossan, Alta. woman told 麻豆影视. She said constant diarrhea left her weak and 鈥渢rapped鈥� in her home.
Shandro said she 鈥渂asically camped out in her bedroom and bathroom鈥� with excruciating pain caused by the infection.
As part of the clinical trial, she had to take 59 FMT capsules, but said she felt better immediately.
鈥淚t is indescribable. It was literally within two days that I felt normal,鈥� she said.
Infectious diseases expert Dr. Tom Louie, who pioneered the use of fecal transplants for C. difficile in Canada and developed the FMT pills, said the latest study is 鈥渧erification鈥� of the capsules鈥� effectiveness.
鈥淭hese fecal capsules are a convenient way of restoring the gut microbiome,鈥� the Calgary doctor told 麻豆影视.
While 鈥渢here鈥檚 probably a small of degree of 鈥榠ck鈥欌�� initially, all patients who took the FMT pills were 鈥渋mmediately quite accepting,鈥� Dr. Louie said.
鈥淭hey can have their lives back in a flash.鈥�
Other doctors see the pills as having an enormous potential to treat illnesses like Crohn鈥檚 disease.
鈥淚f we are to treat Crohn's disease with FMT then we will need this technology to deliver enough 鈥榟ealthy stool鈥� over a long enough time frame to the inflamed area,鈥� Dr. Paul Moayyedi, the director of the gastroenterology division at McMaster University鈥檚 department of medicine, said.
Doctors in Edmonton have just started testing the pills for Crohn's disease, and McMaster University鈥檚 medical centre in Hamilton, Ont., is also expected to begin recruiting patients.
With a report from CTV鈥檚 medical affairs specialist Avis Favaro and Elizabeth St. Philip
