Poop doesn’t get enough credit. Sure, it’s gross and the last thing you’d want to bring up during a dinner conversation. But from nourishing crops to possibly offering a solution to Africa’s water problem, poop is due some credit. Now, how about a pill of poop for good health? It might sound weird, but it could be the answer to potentially deadly gut infections.
Clostridium difficile or C. diff is a spore-forming bacterium that can lead to infection in the colon and infect people after an antibiotic destroys existing bacteria. People over 65 are especially prone.
Medications such as probiotics are often administered to fight C. diff, but don’t get to the root of the problem as well as microbiome therapy. Microbiome therapy is the process that entails transferring healthy human gut microbes from one person to another, to maintain the gut’s delicate balance of healthy bacteria. How the microbiome therapy is administered can range from enema to colonoscopy, or orally taken pills full of freeze-dried stool.
Seres Therapeutics was the king of the poop pill and was valued at $133.7 million when it went public in 2015. But last year, half the patients who were taking Seres’s pill had their C. diff infections return. Not good for Seres Therapeutics or those suffering from C. diff, but all hope for the controversial pill wasn’t lost either. Seres Therapeutics’s main competitor, a stool bank called OpenBiome, is focusing on poop that’s been barely processed to fight C. diff. Since opening in 2012, the company has over 15,000 successful cases under its belt. Of course, administering raw poop is a regulation nightmare. Stool donations are screened for harmful pathogens, but there is no 100% guarantee on poop testing.
Not ready to be flushed just yet, Seres aimed to develop a more bacteria-tailored and regulation-friendly pill that would kill the C. diff while preventing pathogens with ethanol. C. diff lives on certain bile acids in the intestines and eating only gives the bacteria more nourishment. Of course, there are good bacteria in your gut too, and when introduced in a large enough number they can starve the C. diff out. That’s the goal of Seres’ new pill: focus on those good bacteria.
Treating C. diff might be the primary purpose of the poop pill, but for gastroenterologists like Colleen Kelly, that’s not where the benefits end. Kelly has been treating patients with fecal microbiota transplants since 2008, and found that the side effects were particularly beneficial to patients with alopecia universalis, a condition characterized by the complete loss of hair. One of Kelly’s patients hadn’t been able to grow hair anywhere on his body since he was 16, but after receiving the treatment with stool, started growing fresh patches of hair. The ability to fire up hair follicles hasn’t been the only positive side effect to come from microbiota transplants. Some patients have shown weight loss, while others have reported that their depression faded away.
It’s these kind of side effects that help to further the development of microbiome therapies – and make the idea of a pill filled with freeze-dried poop a little easier to swallow.