Fecal Microbiota Transplantation (FMT), Bacteriotherapy

Fecal Transplant Guide: How They Work and What They Can Cure

Fecal microbiota transplant, otherwise known as “FMT,” is a medical procedure involving the transplantation of stool from a healthy donor into gut of an ill person. Stool is a rich source of microbiota – that is, bacteria, fungi, protozoa and viruses. When poop is transplanted, the healthy microbiota from the donor is able to assist the weakened microbiome health of the patient, returning their microbiome to a more balanced and healthy state.

Fecal Transplants may or may not be something you already know a bit about, but if you don’t, this article will help you understand what is sure to be the next frontier in medicine. We’ll break down the following topics:

What is a fecal transplant?

A fecal transplant, otherwise called bacteriotherapy or a fecal microbiota transplant (FMT), is a medical therapy where stool is taken from a healthy donor, and is transplanted into the gut of a sick patient. FMT is used to treat illnesses attributed to a connection with an unhealthy or gut microbiome.

How does a fecal transplant work?

FMT treats patients through the insertion of stool from a healthy individual into the gut of an ill patient. This delivers healthy microbes to their gut, and replaces bad bacteria. The purpose is for the healthy bacteria to stave off the bad bacteria living in the guts of someone who is sick.

In Clostridium Difficile, for example, the therapy works by reculturing healthy bacteria in the gut to fight off the invasive Clostridium Difficile bacteria. A C Diff infection is the most common illness fecal microbiota transplantation is used as a cure for, but there are plenty of other microbiome-related diseases being studied as potential candidates for the use FMT.

Wait, what’s the microbiome?

The microbiome is the whole of the communities of bacteria, fungi,protozoa and viruses that live inside our bodies. We contain millions of microbiota, more than human cells, and they play an important role in key functions such as digestion, immune response and brain health (more specifically, the gut brain axis).

The microbiome is broken up into different sections in the body. There are unique microbiome communities in our noses, ears, eyes, mouths, skins and guts. Each community has its own functions, and is affected by many factors including stress level, diet, geography, and even ancestral background.

FMT treatment: how is it administered?

After a fecal sample is collected from a donor, it is carefully screened for diseases and irregularities. If the sample is safe, it is turned into a slurry by mixing in water or saline to the stool. The slurry is either frozen for later use, or used immediately, in which case it is transplanted into the gut of the patient using one of three methods:

• Colonoscopy or Enema: This is the simplest method of delivery. The stool is inserted directly into the colon. Enema is used for a lower tract delivery and colonoscopy for an upper tract delivery.
• Nasoenteric tube: A tube is inserted in the nose and fed down into the stomach or small bowel for delivery.
• Poop capsule (a “crapsule”): A fecal-filled capsule designed to break down in the gut is swallowed. As many as 8 capsules have to be ingested to receive the equivalent amount of material as is distributed through the other two methods.

Enema or colonoscopy are the more commonly used methods. Nasoenteric tube delivery and poop capsules are available for those who prefer a less invasive procedure.

Is FMT safe? What are the risks involved?

FMT, performed in a clinical setting, is a safe treatment with very few associated risks and reported side effects. Though it is a low-risk therapy when done properly and with a carefully screened donor, the same level of safety is not guaranteed when done at home with a DIYfecal transplant procedure.

Risks of an FMT:

There have been very few reported FMT side effects and/or complications associated with it. Some minor symptoms may occur, including abdominal pain, cramps, changes in bowel movements, and very rarely – Intestine Perforation, but these symptoms are also common symptoms of the diseases FMT is used to treat.

The long-term effects have yet to be studied because its use in clinical settings of study has been relatively recent. There are have been reports of anecdotal symptoms, but none are seen as broad safety risks of a stool transplant.

What symptoms and diseases can FMT cure?

FMT is mainly used to treat C. Diff, but it has the potential to treat a whole host of conditions – Ulcerative, Colitis, Crohn’s, IBS, and more. These, along with other chronic diseases, are thought to be linked to the gut microbiome. Fecal transplants alter the gut bacteria that causes inflammation.

Although these illnesses affect the human body in different ways, the belief that the gut microbiome is at a core of them is why fecal matter transplants are thought to be so effective. Below are all the diseases Fecal Microbiota Transplants are currently being used or studied to treat:

• Arthritis
• Asthma
• Autism
• Chronic Fatigue Syndrome
• Clostridium Difficile Infection
• Colitis
• Crohn’s Disease
• Eczema
• Fibromyalgia
• IBS (Irritable Bowel Syndrome)
• Insulin Resistance
• Metabolic Syndrome
• Mood Disorders
• Multiple Sclerosis
• Obesity
• Parkinson’s Disease
• Psoriasis

The history of fecal microbiota transplants

There are references to Fecal Transplants going back 2000 years in Chinese literature. In more recent history, it has been used since the 1950s, principally for the treatment of Clostridium Difficile. But the therapy didn’t really pick up steam until the early 2000s when C Diff prevalence started rising, and a rise in mortality rates were observed.

Clinicians took notice of the treatment and started applying it more readily for the treatment of C Diff. Now studies are underway around the world to examine the application of the FMT procedure as a treatment for other diseases, mainly those classified as chronic illnesses that have been found to have associations with the gut microbiome.

There are studies underway at the University of Arizona, looking at the effectiveness of FMT on Autism and its associated GI symptoms. In New Zealand, a study led by Wayne Cutfield, investigates the effect of FMT on weight loss in obese individuals. In Ontario, Canada, a series of studies have been performed on FMT as a potential treatment for Colitis. There are even studies recruiting right now for FMT-associated cures for Bipolar Disorder, Crohn’s Disease, Parkinson’s, Disease, MS, and more! You can check out our list of recruiting studies right here.

The future of poop transplants

In many senses, the future of FMT is now. Around the globe, physicians are studying its effectiveness in treating some of our most misunderstood diseases. FMT is approved for wide use, at the discretion of the practitioner, in many countries. But in others, like Canada and the United States, it is only approved for use in C Diff infections.

The how and why of stool transplant curative powers largely remains a mystery. Its effects have been reported to cure/reduce symptoms in conditions from Colitis to Autism to Parkinson’s Disease. Though not always effective, it’s potential is promising and needs to be studied further. The future of FMT lies in uncovering what aspects of the treatment are working to treat these illnesses, and isolating them to create more specialized and effective treatments.

Where can I get a stool transplant?

As mentioned above, FMT is only approved for wide-ranging therapeutic use in certain countries, where the regulations are country-specific. But if you live in a country where it is not approved for use, with the rise in interest in fecal transplants, you can be sure there will be more studies popping up.

Check out a nearby University or research institute to see if they have any studies you can participate in.

Should I try a fecal transplant at home?

Though we understand that the limited access to FMT can be frustrating, you should never attempt a DIY fecal transplant. There isn’t yet enough research to ensure the absolute safety of the procedure, and it is very difficult to ensure a safe donor without testing, which can only be done in a clinical setting.

Yes, there is some promising research and anecdotal evidence to support FMT, but we don’t yet know the true effectiveness of the treatment. If you do not live in a country where fecal implant is approved as a general therapy and you are not currently living with a C Diff infection, but you want to try it, look into the trials that may be happening in your area.

If you found this article helpful make sure to subscribe to our newsletter, or like us on Facebook for updates on everything FMT and the microbiome. If you want to learn more about the specifics of this process, check out these resources:

Fecal Transplant Guide: 40+ Best FMT Articles and Resources

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I Had a Fecal Transplant and It Saved My Life

FMT can be a life saving treatment. Read one woman’s story about how a fecal implant saved her from a deadly C Diff infection.

Everything You Need To Know About Becoming a Fecal Transplant Donor

Stool donors are in high demand for stool transplant therapies. Learn what it takes, and how you can become a donor.

Oral Capsules vs Colonoscopy-Delivered FMT

Scientists study and break down which is more effective to improve gut microbiome related disease – FMT by way of colonoscopy or the “crapsule.”