It might sound revolting, but doctors could one day prescribe poo pills. Sometimes, when antibiotics have eliminated ‘friendly’ bacteria, the gut’s microbial community is overrun with a bacterium called Clostridium difficile (falsely coloured orange) that causes chronic diarrhoea and can sometimes be fatal. In the past couple of years, an unusual treatment has proven highly effective: faecal transplants – in which a liquid stool sample from a healthy gut is squirted into a patient’s colon – eradicate C. difficile by restoring the normal bacterial balance. But medical regulations and squeamishness prevent many doctors from performing the procedure. As an easier alternative, researchers are testing tablets containing concentrated faecal bacteria from healthy donors. In one trial, the tablets cured all 27 of the patients on which they were tested, raising the possibility that poo pills – which have no smell or taste – could become a more palatable option for patients with severe gut infections.
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