Vowst - Formerly SER-109, FMT in Pill

[Avalon18]

I have just finished Vowst. It is (12) fecal microbiota pills, taken over a 3 day period (4 pills per day, taken in AM before 1st meal of the day). Prior to raking the Vowst, one must finish all antibiotic therapies, such is Dificid and vancomycin. Magnesium citrate must be taken the day before beginning Vowst. The purpose is to clean out any traces of antibiotics. The worst part was the magnesium citrate prep, which caused D for nearly 24 hours.

It is difficult to know well it will work yet, but I'm hopeful.

[NanciT]

Let us know how you do. We had another member who also has tried this, waiting for an update.

Can you tell us the cost involved??

Wishing you the best!

NanciT

[Avalon18]

Vowst is very expensive, running from $15,400 to over $17,000. My insurance turned my doctor down twice, but I believe an insistent and clear description of my 4 relapses resulted in approval. Once it was approved, my copay was only $80. Between the Vowst, vancomycin, several prescriptions for Dificid and Zinplava (twice), c. diff has been very expensive to treat.

I think it takes at least 8 weeks for the new microbiota in the Vowst to be established, and possibly much longer to displace c. diff.

[Avalon18]

So far, no recurrence of c. diff. However, each time I've had a relapse it has been about 10-12 months between cases. I finished the Vowst at the beginning of October, so I don't know whether I'll eventually have a relapse. I still have some PI-IBS. As far as as PI-IBS triggers are concerned, I seem to have some additional unexpected food triggers.

In my case, I have severe GERD and have been taking pantoprazole for a long time. I have been unable to eliminate using pantoprazole, although I've tried to taper it off and use famotidine instead. I understand that PPIs like pantoprazole may increase vulnerability to c. diff, but there's nothing I can do.

I will be having an endoscopy to check my hiatal hernia and to check for Barrett's esophagus, among other things. Hopefully no surgery, although if it's warranted it can eliminate GERD from what I've been told.

I hope that I won't have a relapse again, and that the Vowst will prevent yet another case of c. diff.

[beth22]

Thanks for keeping us updated. Good news that there is no relapse and hopefully it will stay like that. My mother had c diff a couple of times and she also had GERD and was on a PPI until the end of her life at 98, but did not relapse with c diff because of it. Hopefully, you won't either.

[Avalon18]

So far, no relapse. In February 2024, I went to a local restaurant with what must have been a problem kitchen, and got food poisoning. I got dehydrated and went to a hospital. In mid-March I had a stool test, after getting D for a couple of days in the previous week. The food poisoning must have been salmonella, as I still tested positive for it after having no symptoms since the previous month. I hope it doesn't have a lasting effect on my gut microbiome.

The good news, if it can be called that, is that the stool test was negative for C. diff and toxins - GDH and PCR tests were negative 6 months after Vowst. Hopefully, it will stay that way.

I still have IBS, though. I take Florastor, and I think it helps some, but the IBS lingers.

[beth22]

Thanks for the update. I got campylobacter from bad food after c difficile and it took a while to go away too and it set me back with IBS symptoms, but I did not relapse with c diff either. Sounds like the treatment worked for you. I hope you feel better soon. Salmonella is hard on the GI tract too!