Safely Combat C. difficile Infections with Frozen Fecal Pills

Researchers are looking for the next best non-invasive and safe alternatives to fight infections. Although unconventional, a preliminary study published in the Journal of the American Medical Association revealed the successful strides researchers have made to cure patients suffering from recurrent C. Difficile infection (CDI) using oral frozen fecal matter treatment.

Ilan Youngster, MD, MMSc, of Massachusetts General Hospital, Boston, MA, and colleagues reported the frozen fecal pill treatment stopped 90% of the incidences of diarrhea. Studying 20 patients who had experienced a minimum of 3 episodes of mild to moderate CDI who previously failed 6-8 weeks treatment with oral vancomycin, or at least 2 episodes of severe CDI requiring hospitalization, the researchers’ primary goal was to assess the safety and efficacy as well as the rate of diarrhea resolution associated with oral frozen fecal treatment.

After being given 15 tablets on 2 consecutive days, the patients were carefully monitored for symptom resolution and adverse events for up to 6 months. The study found that among the 20 participants, 14 patients (70%) experienced clinical resolution of diarrhea following the first administration of treatment and remained symptom-free at 8 weeks. The remaining 6 non­responders were treated a second time at an average 7 days following first procedure, 4 of whom achieved resolution of diarrhea, producing an overall 90% rate of clinical resolution of diarrhea.

To make the treatment, stools are initially mixed with saline and filtered through a sieve before being piped into capsules that are stored in deep freezers for a minimum of 4 weeks at -80 degrees Celsius. As these pills require unique acid resistance to safely navigate the gastrointestinal tract, the outer shell of the pill remains an unpleasant shade of brown.

Although a myriad of procedures ranging from colonoscopies to nasogastric tubes, and even enemas, have been traditionally used for most gastrointestinal conditions, they all have potential discomforts and risks for patients attached. Commenting on the potential danger of patients gagging and vomiting from the tubes initially used, Elizabeth Hohmann, MD, staff physician in infectious diseases at Massachusetts General Hospital, said, “Just getting the tube down is a problem. That’s pretty scary.”

Looking ahead to the future of gastrointestinal treatments, Youngster stated,“The use of capsules simplifies the procedure immensely, potentially making it accessible to a greater population.”