Capsule Fecal Transplant As Effective as By Colonoscopy for C. Diff Infections Interview with:

Clostridium difficile CDC image

Clostridium difficile
CDC image

Dina Kao, MD, FRCPC
Division of Gastroenterology, Department of Medicine
University of Alberta
Edmonton, Alberta, Canada What is the background for this study? What are the main findings?

Response: We wanted to see what would be the best way to deliver fecal microbiota transplantation (FMT.)

There were many controlled studies of FMT delivered by various methods, showing different success rates. Not only were the route of delivery different, but the amount of donor stools also varied greatly from study to study. It appeared that most of the studies delivered by the upper routes gave a smaller amount of donor stool compared to the studies delivering FMT by colonoscopy.

Our hypothesis was that given the same amount of donor stool, the effectiveness would be similar by capsules and by colonsocopy.

Dina Kao, MD, FRCPC Division of Gastroenterology, Department of Medicine University of Alberta Edmonton, Alberta, Canada

Dr. Kao What should readers take away from your report?

Response:That fecal microbiota transplantation by capsules is a very effective, safer, cheaper and better accepted alternative for mild to moderate RCDI. The microbial engraftment also appeared similar between the two different routes of delivery. What recommendations do you have for future research as a result of this study?

Response: There are many studies exploring the therapeutic potential of microbiome in various conditions. C diff is the most straight forward condition to treat. We need to move beyond just looking at the stool microbial composition analysis, and perhaps start to think about how we can study the host immune response. Is there anything else you would like to add?

Response: Our current understanding of diseases is incomplete and our treatment imperfect. It is only through a partnership between the medical community and patients can we develop better understanding of diseases and improve patient care. Thank you for your contribution to the community.


Dina Kao, Brandi Roach, Marisela Silva, Paul Beck, Kevin Rioux, Gilaad G. Kaplan, Hsiu-Ju Chang, Stephanie Coward, Karen J. Goodman, Huiping Xu, Karen Madsen, Andrew Mason, Gane Ka-Shu Wong, Juan Jovel, Jordan Patterson, Thomas Louie. Effect of Oral Capsule– vs Colonoscopy-Delivered Fecal Microbiota Transplantation on Recurrent Clostridium difficile InfectionA Randomized Clinical Trial. JAMA.2017;318(20):1985–1993. doi:10.1001/jama.2017.17077

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.


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