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Enter the Poop Pills...

by Bruno Van de Casteele

February 28, 2016

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Donate Just over three years ago I reported on a very promising scientific result battlingC difficileinfections. This infection has the debilitating effect of chronic (think years on end) diarrhea. The proposed but experimental way to cure it was doing fecal transplants, basically taking stool from a healthy person and, after treatment, inserting it directly into the intestines of the patient. The results were stunning: people got better really quickly.

There is, apart from the icky nature of the transplant, another issue: the stool is delivered by a tube through the nose all the way into the intestines. It'snot veryeasy. At the end of my previous article I mentioned that work is ongoing to identify the bacteria present in the stool and deliver them to patients in pill form. At that time, this was called "pseudo poop" (because it’s only the identified bacteria, not an actual sample). Not the best choice of words, marketing-wise.

Just last month, I read about a clinical trial that will start next month in Boston by a team in the Massachusetts General Hospital, lead by Dr. Eliane Yu. People will either receive a tiny amount of stool in a pill, or a placebo (the study I reported on in 2013 wasn’t double blind). And yeah, even though the official term is “fecal microbiota transplant capsules,” aWashington Post articlereported on it the treatment as “poop pills.”

Because it still is poop.Apparently it’s easier to very critically select a donor than it is to identify the needed bacteria. There is another article on the Washington Post'swebsite detailing what the process is. Do note that these donors are now strangers; in initial trials they were relatives of the patient.

So, what is the goal of this clinical trial? Treatment for some other debilitating disease? Well, this time it’s a test to see if taking these pills can reduce weight. The article headline put it more succinctly: “Eating poop pills could make you thin. Seriously." The test here is to find donor “samples” from lean persons, give them to other people and track their weight. That seems more like speculation, but there appears to be some ground for this. According to this line of thought, bacteria in our intestines might predispose us toward obesityor not. Apart from a less perfect observational study (measuring gut fauna and correlating it to weight), double blind studies like the one here might make the matter clearer. Though I would like to caution for having too much optimism: a pill alone will not solve the obesity problem.

by Bruno Van de Casteele

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