The poo pill

This post is also available in Dutch.

In an increasingly sterile world, bacteria have more and more opportunity to do damage. Luckily, a solution for the consequences of our hygienic lifestyle is near: the poo pill.

poopillImage by Roselyne

Bacteria are everywhere. They are impossible to avoid. There are good and bad ones, and they multiply in our bodies. When certain bacteria start getting the upper hand, this misbalance can damage our immune system and make us sick. In such a case, antibiotics can help – but it’s possible to target bad bacteria much more effectively, using poo.

Cleaner life, more disease
It turns out that our tendency to scrub our houses with soap and sterilize our bodies with antibiotics can have nasty side-effects. For example, not having been exposed to pathogens in your childhood can lead to immune system deficiencies later in life. This is why, in the Netherlands, there are more people with asthma, allergies and auto-immune disease than before we committed to such a hygienic lifestyle.

Bad antibiotics
Antibiotics are particularly disastrous for our intestines, as they kill good bacteria alongside the bad ones. The use of antibiotics can leave ‘empty’ regions of the intestinal wall, where new bacteria can easily settle (like the bacteria we ingest by eating).

But bacteria that are already present in our intestines, like Clostridium difficile, also get the chance to multiply on an underpopulated patch. C. difficile produces poisonous substances when it multiplies. Too much of these substances can trigger diarrhea, sometimes even leading to death.

Often, doctors’ first solution to this problem is to administer more antibiotics. These do kill most of the bacterium, but also leave yet more empty patches on the intestinal wall. This is even more serious than before, as traces of the bacterium that have become resistant to the antibiotics can now settle on these empty regions and multiply at will. Thus, attempting to treat a condition can trigger new issues.

Transplanting good bacteria
This is why doctors came up with the idea of transplanting a healthy person’s poo, containing a proper bacterial mix, into the intestinal system of a sick person. Thanks to the good bacteria present in healthy poo, this trick can help people with bacterial infections to win the battle in their belly.

The first poo transplantations were performed by delivering healthy poo through a tube directly into the colon, or via the mouth into the stomach. Both these methods turned out to be quite uncomfortable. That is why doctors have now developed the poo pill. About as big as a vitamin pill, the poo pill can easily be taken at home.

By now, several patients have been successfully treated with poo pills. There were, of course, some initial hurdles to overcome. The pill must be acid-resistant in order to survive the stomach, and it is transparent, which is not a pretty sight. The number of pills a patient has to take in a day, a whopping 15, is also not something to look forward to. That’s why it’s still better to take good care of yourself, so pathogens get little chance to multiply in your intestines.

More information
The foundation of stomach, liver and intestine on Clostridium difficile (Dutch)
Article on the use of poo pills in curing infections
Article on the life-saving qualities of poo pills (Dutch)

This blog was written by Sarita Dam. Sarita is a PhD student at the Donders Institute, where she studies the influence intestinal bacteria have on brain and behavior in autism and ADHD. Another blog on this topic can be found here.

Edited by Lieneke. Translation by Jeroen.

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