News / Edmonton

'They don’t find it gross': Fecal bacteria capsules helpful for patients, study finds

Study finds that fecal bacteria capsules are just as effective as a colonoscopy for treating clostridium difficile, which can be fatal

The University of Alberta's Dr. Dina Kao and her patient Karen Shandro. Kao led a clinical trial that proved stool transplants via capsule are just as effective as when done by colonoscopy.

Sharman Hnatiuk / AHS

The University of Alberta's Dr. Dina Kao and her patient Karen Shandro. Kao led a clinical trial that proved stool transplants via capsule are just as effective as when done by colonoscopy.

Edmonton researchers are hopeful that a small dose of healthy poop—ingested in capsule form—will help more patients with a specific type of bacterial infection, by providing a boost of healthy bacteria.

The University of Alberta published the results of a clinical trial in the Journal of the American Medical Association on Tuesday, showing that Fecal Microbiota Transplants (also known as a stool transplant) via capsules are 96 per cent effective, the same as when done by a colonoscopy.

The innovative treatment was pioneered in Alberta, and provides a less invasive option for patients suffering from the bacterial infection clostridium difficile.

A stool transplant transplants healthy fecal bacteria into a recipient’s body to restore the healthy balance of gut bacteria. It’s usually done either by colonoscopy, an enema procedure, or having a tube inserted into the nose to feed into the large intestine.

Dr. Dina Kao, the lead author of the clinical trial and an associate professor with Faculty of Medicine and Dentistry, said based on the strength of the research results, she expects capsule stool transplants to become more common in medicine.

She said the capsules save the healthcare system about $1,000 per patient.

“We are hoping that there’s going to be a wider adoption of (this method of) delivering transplants. It’s safer, it’s cheaper and it’s better for the patients,” she added.

Colonoscopies come with risks such as over-sedation or possibly causing a tear in the large intestine. The capsule treatment could also be useful to rural and isolated communities where there is no opportunity for more advanced operations such as colonoscopies.

The capsules were invented by the University of Calgary’s Dr. Thomas Louie, who started using the treatment in July 2010.

Part of the study was to measure patient preference, and while swallowing fecal bacteria may not sound appetizing, patients typically preferred it over an invasive operation.

“They don’t find it gross or repulsive,” Kao said.

Karen Shandro, from Ardrossan, was diagnosed with clostridium difficile multiple times in 2015 after experiencing what she thought was a routine sinus infection. Before taking part in the clinical trial, she was fatigued, lethargic and had no appetite.

After taking the pills, she was back to normal after about 48 hours.

“They were somewhat larger than I anticipated. But they were very easy – they taste neutral and they have no aftertaste,” she said, noting she had to swallow about 40 pills.

Kao hopes her research will encourage more people to be proactive about their health as well as consider taking part in clinical trials. She also wanted to thank the pool of stool donors who made the trial possible.

“They are truly the unsung heroes here. Many of them wanted to remain nameless. Somehow being a blood donor is noble, but not so much for a stool donor.”

The trial was funded with $500,000 from Alberta Health Services and $357,000 from community donors through the University Hospital Foundation.

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