Fecal Transplant Pill

I was told recently that the "fecal transplant pill" was currently available in the US. I thought, "no way!" so I googled it. When I try to look it up, I find lots of info like the FDA has "approved" fecal transplants, and that there is such thing as a fecal transplant poop pill. But I can't seem to find that it's actually available anywhere (presumably because it's not easy to mass produce such a thing?)

Does anyone know the current status of the poop pill?

It is still just used in c-diff research. ... as near as I can tell, one research study was preliminarily reported in abstract form. The researchers custom made pills by processing donor samples until only bacteria remained, and very concentrated amounts were delivered in about 20+ pills.

I suppose any center currently providing FMT during scoping could do similar processing and offer a pill alternative. Such a custom made preparation would likely be very expensive. It would likely be cheaper to have it done during scoping, but admittedly less invasive.

The original researcher seems focused on identifying which strains are key and seeing a probiotic drug developed: "future is to know which bacteria are the kingpins of gut flora, with which healthcare professionals or possibly even pharmaceutical companies can 'make true probiotic pills'."

The research was also in Canada. The US FDA is allowing FMT for c-diff, but it is a gray area whether this covers off-label administration for UC, where is has not been proven to be more effective than current meds.

I found the actual text of the poster presented at the conference.

/idsa.confex.com/idsa/2013/webprogram/Paper41627.html

^yup, i was thinking the same thing.

i did two back-to-back at-home fecal transplants in nov. 2013, and i haven't felt great like this since when i was in my teens. i'm 32 now, btw. i just hope the pills are also gonna be considered, if not approved, for both uc and cd.

Various studies have looked at FMT for IBD and the results have been mixed. There is generally some shift in microbe profile in the direction of the donor's, but it does not last.

Some studies report limited positive results after multiple FMT over time. Others have found no significant benefit. It is possible some folks had an undetected infectious colitis, and so it is unclear that FMT works better then other probiotics for IBD.

It is possible someone will now do a study of oral administration for IBD, because that removes "couldn't hold it" from the possible reasons for failure, and reaches more of the colon. But, until there is a more consistent benefit demonstrated, IMO, you are better off with available probiotics.

it is a reasonable choice for some. if other things are not working, it might be a wise choice. Since I am making progress on 5-asa and conventional probiotics, it is not a good choice for me right now.

Just to be clear though, this was c-diff research. There is some clinical FMT enema research for UC, and results of a large Canadian trial should be published soon. I have not read about any researchers planning FT pill research for UC. Like I said, it could happen if "failure to retain" emerges as a significant concern in the Canadian trial.

whoops i omitted a few words..."...unlike c-diff's success rate of over 90%..."

also, here's the link to the robotic pill study
http://online.wsj.com/news/articles/SB10001424052702304899704579389042422328308?mg=reno64-wsj&url=http%3A%2F%2Fonline.wsj.com%2Farticle%2FSB10001424052702304899704579389042422328308.html

DBwithUC said...
I found the actual text of the poster presented at the conference.

/idsa.confex.com/idsa/2013/webprogram/Paper41627.html

I basically just followed what was written in that section of the paper and made some pills myself!!

It's been three days since I took the pills and I'm feeling very calm bowel-wise. That said, I'm not convinced I've fixed things longterm since I pretty much did the dumbest of things immediately post ingestion.

Usually I live on raw fruit and vegetables to control any bowel inflammation. I, in my infinite wisdom, decided to go and eat a very low fiber diet straight after taking the pills. This included- a dozen sausages over two days, two litres (half a gallon) of Ginger beer and other sodas (!), pizza, honey-soy crisps, potato crisps and a ton of guacamole.

I kinda had a blow out because we had people over for BBQs two days in a row. Now all these foods usually cause me massive problems. And on their own they have all previously triggered flare ups, not to mention the usual allergies that fire up due to my over-active immune system.

But...

After eating 30 of the fecal pills the day before the BBQs, I found I had zero reaction to any of the bad food.

Like nothing. No inflammation, no migraines, no sinus rhinitis. I'm not even an angry SOB. All's calm. Well, apart from some constipation and sore lower back due to the huge amount of zero fibre food I ate.

I'm actually going to make another batch of pills next week but this time I'm going to stick to my usual high-fibre, low-inflammation diet. Plus I'm going to do a pre-pill enema to ensure I give the bacteria the best hope of recolonizing instead of killing them with hind-gut fermentation thanks to, well... sausages, crisps and ginger beer!!

Post Edited (CoastalChris) : 6/1/2014 10:48:26 PM (GMT-6)

Anyone knows if there's any progress in research on fecal transplant pill? I keep googling it but it seems to have ended on year 2014

thanks DB, that's what i actually expected, remicade generates such enormous profits so no reason doing research on anything else (:

CoastalChris:
I read the paper; do you work at a lab where you made the pills and did everything they did?

("Patients with >3 rCDI episodes were referred for FMT. rCDI was controlled with oral vancomycin. On the day of the procedure, related donors, previously screened for transmissible pathogens, provided ~100 grams of freshly passed feces. The fecal sample was suspended in 600-800 ml of prereduced PBS. Over 2.6 h, serial centrifugation at 400xg, 1000xg and 6000xg with interspersed decanting of the supernatant layer recovered pelleted fecal microbes in the sediment of the last centrifugation step. The sediment was resuspended in a minimal amount of PBS to allow micropipetting into #1 gelatin capsules (0.47 ml), and overcapsulated further with #0 and #00 capsules. The recipient stopped vancomycin on the day prior to the procedure and at 05:00 h on the procedure day underwent a colonic cleansing with picosalix. At 13:00 h, without antacid premedication, the recipient ingested freshly assembled capsules (n=24-34) over 5-15 minutes on an empty stomach. Prior testing of capsules showed that capsules remained intact for over 2 h at RT and ~1 h at 35o C in stirred liquid. qPCR testing of the sediment of donor and serial recipient fecal samples, prior to and a week, 1, 3 and 6 months post FMT, was performed")

In other words did you have access to centrifuges and resuspended the sediment in PBS into gelatin capsules and also #0 and #00 capsules? Did you do it on an empty stomach, do the colonic cleansing with picosalix and the donor was screened? Also wondering what you symptoms were precisely as in the extent of ulcers

Did you know the extent of inflammation visually or other or were you using symptoms as a measure or guide of how well this helped you. I'm very curious as to how long you've had UC, what other medications you're taking, if you stopped them before doing this - just as much information you could tell me please. Do you ever go into complete remission? What are your worst symptoms and the extent of your inflammation (bleeding, mucous, fever, anemia or more mild such as less pain and blood or no blood? Also how many bm's/day and what do they consist of prior to and after this treatment

It seems in making something like this at it would be safer to administer a home made version via enema and how were you certain you would not cause further infection from a problem donor?

Others who tried also respond please

Thanks