Roosevelt Institute | Cornell University

Massachusetts General Hospital Develops New Capsule as an Alternative to Fecal Transplants

By Adrian JonesPublished October 21, 2014

Due to the extensive and costly process of a fecal transplant, patients have been in search for alternatives to the surgery. One alternative includes a do-it-yourself (DIY) transplantation method taught via Youtube videos. Researchers from the Massachusetts General Hospital wanted to develop a cheaper alternative to the fecal transplant surgery and also a safer alternative to the DIY transplants. The frozen capsule alternative they developed was tested in a small study and proves to be just as effective as a fecal transplant. Further studies must be done on the fecal capsule, and the capsule is still awaiting FDA approval.

By Adrian Jones, 10/21/2014

Fecal transplants are an expensive surgery primarily done to replace a deficit in good bacteria. When the good bacteria is killed off or suppressed, it can cause bad bacteria to over-populate in the colon, leading to fatal diarrhea. Just four months ago, the Massachusetts General Hospital concluded their study of frozen fecal microbiota transplantation capsules (FMT) as a safer alternative to surgical fecal transplants. Additionally, Mass General Hospital researchers conducted this study to discourage the rising interest in do-it-yourself home fecal transplants, demonstrated in <span "font-family:="" tahoma"="" style="">YouTube videos.

 The FMT capsule is composed of stool or human feces from screened donors. The stool is mixed with a saline solution, and then mixed with glycerol to preserve the "healthy" bacteria. And finally it becomes piped intro capsules that then get stored in a regular freezer before the patient swallows it. Researchers hypothesized that because helpful bacteria in stool from healthy donors are used to treat and restore healthy bacteria in order to prevent various illnesses like C. difficile in traditional fecal transplants, fecal bacteria in capsules should achieve the same effectiveness at a much cheaper cost. Surprisingly, the researchers were correct in their assumption. The Journal of the American Medical Association published their results: within two days, 19 out of the 20 patients in the study cohort were cured of diarrhea and related symptoms.

 The FMT capsule would be cheaper than surgical fecal transplant, and would save patients from enduring a labor-intensive process involving a long tube, a process similar to that of a colonoscopy. The clinical trial participants have found that the pills are easier to take because they felt like "small ice cubes."

Although the FMT capsule provides faster improvements at a lower cost, the study was very small and only preliminary. Also, the capsule has not yet met Federal Food and Drug Administration (FDA) drug licensing requirements. With a sample size of only 20 individuals, a larger study with more extensive research must be conducted in order to confirm its positive implications. The Mass General Hospital results demonstrate the potential of the FMT capsule but further research is necessary to determine the long-term effectiveness as well as the safety of the pill with FDA approval.