What Is a Fecal Transplant?
A fecal transplant is a procedure in which the doctor places the processed stool from a healthy donor into the digestive system of an ill person. This procedure is also known as bacteriotherapy, intestinal microbiota transplant, stool transplant, or fecal microbiota transplantation (FMT). A fecal transplant is done to restore the normal balance of bacteria in the digestive system.
Here is how it works:
-
First, the stool of the healthy donor (often a close relative) is screened for any infections or chronic diseases that could be transmitted.
-
Second, it's mixed with a saline solution and filtered so it becomes a liquid suspension.
-
Finally, the prepared stool sample is transferred into the gastrointestinal tract through methods such as colonoscopy, upper endoscopy, a nasogastric tube, enema, or capsules.
-
This helps fill the gastrointestinal (GI) tract with numerous beneficial bacteria that outcompete the bad ones, restoring gut health.
What Is C. Diff?
C. difficile (short for Clostridioides difficile) is a type of bacteria that causes colon infection. This can cause symptoms like diarrhea and pain. It occurs in people who have recently taken antibiotics, which kill other bacteria except C. diff. This infection can range from mild to severe, and in some cases, it can be life-threatening.
In cases of recurrent C.diff, stool transplantation is a highly effective treatment. This helps in
-
Restoring colonization resistance, in which the beneficial bacteria compete with the C. diff bacteria and prevent the infection from returning.
-
FMT reintroduces a variety of good bacteria and restores healthy gut balance.
What Are the Types of Fecal Transplantation?
The types of fecal transplantation are categorized based on delivery method, which are:
1. Lower GI tract:
-
Colonoscopy: In most cases, a fecal transplant is performed by colonoscopy (a type of endoscopy that helps examine the inside of the large intestine, including the colon, anus, and rectum). The healthcare provider guides the colonoscope through the entire length of the colon and then withdraws it. While withdrawing, a solution that contains donor feces is deposited in the colon. The patient is given Loperamide to prevent diarrhea, allowing the donor stool to be retained and making it more effective. A proton pump inhibitor is given to prevent the good bacteria from being killed by the stomach acids. The patient should be followed up for a total of at least eight weeks.
-
Enema: This method introduces the fecal transplant directly into the large intestine through the rectum using a tube. The patient is asked to lie on the side with the lower body elevated. The transplant is inserted into an enema bag and allowed to flow into the rectum. A fecal transplant administered by enema is less invasive and less costly than a colonoscopy.
2. Upper GI tract:
-
Upper endoscopy: If a fecal transplant cannot be done through colonoscopy, it is done via upper endoscopy. The patient is given a sedative, and an endoscope is inserted into the mouth. Air is then used to open the esophagus, stomach, and intestine fully. The stool is placed into the small intestine.
-
Nasogastric tube: A nasogastric tube runs from the nose to the stomach. This procedure delivers liquid stool preparation to the stomach, which then travels to the intestines. A syringe is used to flush the stool preparation into the stomach through the tube.
3. Oral capsules:
-
This is a newer type of fecal transplant that comes in capsule form. Oral fecal transplant is not widely used. The doctor places the capsule containing the screened donor poop in the gut. The patient receives 15 capsules over a period of two days. It is the least invasive and can even be done at home.
What Are the Benefits of Fecal Microbiota Transplantation?
The benefits of fecal microbiota transplantation are
-
It replenishes the gut with beneficial bacteria to restore gut health.
-
It helps treat recurrent Clostridioides difficile infections, which often do not respond to standard medication.
-
It also helps in treating inflammatory bowel diseases and functional gastrointestinal disorders.
-
It helps in balancing gut microbiota related to obesity and insulin resistance.
-
Sometimes, FMT works even better than antibiotics for certain types of infections.
-
It can help reduce swelling (inflammation) and make digestion smoother.
-
It helps the immune system stay strong and healthy.
-
Scientists are also studying how it might help address other issues, such as metabolic disorders, brain diseases (like Parkinson’s), fatigue, pain, and certain cancers that are linked to microbial dysbiosis.
-
It may help with weight control, but further research is needed.
-
Some studies suggest that FMT may help individuals maintain their health as they age, particularly when the beneficial bacteria are sourced from younger individuals. However, scientists still need to conduct further studies to confirm this.
How Is a Fecal Transplant Done?
It has four steps; let’s have a look:
1. Donor selection:
The donor is carefully selected to ensure their digestive system and feces are healthy. Without proper screening, a donor may transmit serious diseases. A potential donor should be between 18 and 60 years of age.
A potential donor also needs to undergo the following tests:
-
Blood tests: Hepatitis A, B, and C, and human immunodeficiency virus (HIV).
-
Stool cultures: Stool tests and cultures are used to check for parasites and other underlying conditions.
Additionally, donors should not:
-
Be immunocompromised.
-
Had any antibiotic exposure in the past six months.
-
Have a recent travel history to endemic areas.
-
Have inflammatory bowel disease.
-
Have a history of drug use.
-
Had tattooing or body piercing in the past six months.
2. Stool preparation:
After collecting the healthy stool, doctors mix it with a saline solution (a salty water solution). Then they strain it carefully until it becomes a smooth, brown liquid full of beneficial bacteria. The fecal transplant is 100% liquid.
3. Getting the patient ready:
-
Before the transplant, the patient should tell the doctor about all their medicines, supplements, and allergies.
-
The patient should avoid high-fiber foods for a few days.
-
The patient should drink only liquids the day before.
-
Antibiotics are prescribed for two days before the transplant.
-
The bowel is cleansed with the help of laxatives or enemas the night before the procedure.
-
The patient is given a sedative for procedures like a colonoscopy or an upper endoscopy.
4. Doing the transplant:
-
Several methods, including colonoscopy, oral capsules, enema, and nasogastric tube, are available for administering a fecal transplant.
-
After the procedure, the person may experience side effects such as gas, bloating, or diarrhea for a few days, but this is normal.
-
Most people experience relief from gastrointestinal symptoms within 48 hours, but it may take one to two weeks for complete symptom relief.
-
It may take up to three months for the gut bacteria to return to normal.
-
The success rate is lowest with the capsule method and highest with the colonoscopy method.
Conclusion:
A fecal transplant is a safe way to restore the health of your gastrointestinal tract when the stool comes from a healthy person. It’s one of the most effective ways to treat C. diff infections that keep recurring. It offers numerous benefits and can help alleviate many gastrointestinal tract disorders. Overall, it’s a safe procedure and might cause only mild side effects.
Key Takeaways From iCliniq:
-
A fecal transplant is a procedure in which doctors transfer healthy gut bacteria from a donor into a patient’s gastrointestinal tract to restore a healthy gut microbiome.
-
FMT treatment is highly effective for individuals with recurring C. diff infections, achieving success rates of up to 95%.
If you have stomach problems or recurrent C. diff, this could be a great option. You can also talk to a medical gastroenterologist at our iCliniq to learn more.
