'Poop pills' may be cure for C. diff infection, says researcher

Swallowing pills derived from human poop could prove to be the non-antibiotic answer to a ferociously infectious disease that federal scientists have declared an urgent national threat.

C. difficile -- C. diff for short -- is a debilitating bacterial infection of the intestinal tract that occurs when antibiotics wipe out health-promoting "good" bacteria. Once that happens, diarrhea-causing C. diff flourishes.

On Long Island, as elsewhere, C. diff is a formidable foe, spreading mostly in health care settings.

The experimental "poop pill" was developed by Canadian researchers, who designed it to prevent recurrent C. diff, which can prove fatal.

Lead investigator, Dr. Thomas Louie, discussed his pill research Thursday during a telephone news briefing from the annual meeting of the Infectious Diseases Society of America in San Francisco.

He reported a 100 percent cure rate in 27 patients who took between 24 and 34 pills crafted from donated feces, mostly from family members.

Louie said he hopes the public understands why the pill was developed and can get beyond being queasy about its contents.

"I think in some ways the ick factor is something we got out of the schoolyard," Louie said of the natural tendency to find a discussion of fecal matter off-putting.

Dr. Bruce Hirsch of North Shore University Hospital in Manhasset said he has been providing local patients with fecal-based pills for nearly a year, based largely on Louie's pioneering research.

"This is a remarkably effective therapy," Hirsch said.

"The ability to give bacteria through a capsule provides a restoration of the good bacteria in a person's lower gastrointestinal tract," Hirsch said Thursday.

He underscored that fecal-based pills are far more effective in treating recurrent C. diff than standard therapy, which involves prescribing highly potent antibiotics.

Federal health officials recently declared C. diff's growing prevalence a major health care crisis. An estimated 500,000 people -- many of them elderly -- are stricken annually. One of Louie's patients was only 6. Every year about 14,000 people die of C. diff nationwide. The bacteria are highly drug-resistant.

Hirsch said he and his colleagues custom-produce the pills in the laboratory and give them a citrus flavoring.

Poop pills are a new twist on infusions of diluted feces either through a colonoscopy or through a nasal-gastric tube.

As with Hirsch, Louie of the University of Calgary, said his pills are custom-made in a lab.

The fecal matter is processed, Louie said, until it contains only bacteria, which then is put in a triple-layered gel capsule.

Dr. Vincent Yang, who chairs the department of medicine at Stony Brook University School of Medicine, said the pill sounds promising. "There is a lot of potential in this method to treat C. diff," he said.

When asked if Stony Brook might consider it, Yang said: "Definitely. Absolutely."

Yang said C. diff triggers more than diarrhea. The infection, he said, can cause colitis, which is an inflammation of the intestinal tract. C. diff also can cause intestinal perforation, added Yang, a gastroenterologist.

The Food and Drug Administration earlier this year withdrew its requirement that human feces be considered a drug when treating relapsing C. diff.

"The FDA actually said that stool was a drug, which was bizarre and kind of funny," Hirsch said, adding the agency "requires that we inform our patients that it is experimental."