Fake feces shows promise as treatment for C. difficile
Published Sunday, January 20, 2013 10:30PM EST
Last Updated Sunday, January 20, 2013 11:28PM EST
On the heels of new research that found fecal transplants are extremely effective at curing patients infected with C. difficile, a Canadian invention could help diminish the treatment’s gross-out factor: artificial feces.
The synthetic poop was developed and tested by researchers at the University of Guelph, University of Western Ontario and Kingston General Hospital. Only two people in the world have been treated -- and cured -- of their C. difficile infections with the fake feces, including Cynthia Morgan-Robson.
The 75-year-old woman contracted C. difficile at her nursing home, and standard treatments failed to work.
“I couldn’t stand, I couldn’t think, I couldn’t talk,” Morgan-Robson told CTV News. “I felt so sick and I was isolated for a long time. I had a horrible time.”
While her daughter, Linda, qualified as a donor for a fecal transplant, doctors at Kingston General asked if they wanted to test the potential new treatment.
They agreed, and the synthetic feces was transplanted into Morgan-Robson’s bowel via a colonoscopy. Her daughter said the treatment began working almost immediately.
“All of a sudden she started to know who I was, and she would smile and she would attempt to try to sit up and she wanted to start doing things on her own,” she told CTV.
“It was like a cloud, it just lifted.”
Added Morgan-Robson: “I feel like a new person.”
Research into the synthetic stool was published in the new science journal Microbiome.
Thousands of Canadians every year contract C. difficile, which attacks the digestive system after antibiotics have killed off the good gut bacteria that protects against the bug.
A C. difficile infection can cause an array of gastrointestinal problems, including severe diarrhea.
A study published last week in the New England Journal of Medicine found that fecal transplants can cure most cases of C. difficile that have resisted treatment. While other research had also established the treatment’s efficacy, the latest study was a randomized controlled trial, which is considered the most reliable type of research.
The procedure involves transplanting the feces of a healthy patient into a patient infected with C. difficile to restore the healthy bacteria.
While patients who have been ill for some time and experienced little relief from other treatments have been eager to receive the transplant, the idea of a fecal transplant makes some people uncomfortable.
So Guelph microbiologist Emma Allen-Vercoe invented what she has dubbed “RePOOPulate,” a so-called “super-probiotic” from 33 strains of bacteria found in healthy intestines. The fake feces was grown in a “Robo-gut,” equipment at the University of Guelph that mimics the environment of the large intestine.
“It’s several bugs put together than can perform as an ecosystem like the bugs in your gut,” Allen-Vercoe told CTV.
Dr. Elaine Petrof, an infectious disease specialist with the gastrointestinal diseases research unit at Kingston General, said the two patients so far treated with synthetic feces were nearly back to normal after two or three days. And by their six-month follow-up appointments, they had not relapsed.
The treatment also has other benefits, she said.
“The patients and also the medical personnel doing the procedure find it much more, how shall we say, much more palatable than the real deal,” Petrof told CTV.
Dr. Lawrence Hookey, medical director of the endoscopy unit at Hotel Dieu Hospital and Kingston General, has performed both traditional fecal transplants and the two synthetic procedures.
“The new synthetic stool or synthetic material is amazing,” Hookey told CTV. “When we do the colonoscopy and infuse it, it’s like infusing cloudy water. There’s no particular smell, and the procedure doesn’t feel or look any different than most other colonoscopies we do.”
While the results of the first two transplants are promising, further research is needed to confirm the treatment’s effectiveness and safety. Next week, doctors will meet with officials at Health Canada to discuss the possibility of setting up larger studies.
The researchers also hope that one day RePOOPulate will be used to treat other gastrointestinal conditions, such as inflammatory bowel disease and obesity.
With a report by CTV’s medical specialist Avis Favaro and producer Elizabeth St. Philip