Fecal Transplant (FMT)

What Is A Fecal Transplant?

A fecal transplant, also known as a Fecal Microbiota Transplant (FMT) as well as bacteriotherapy, is a method of helping to repopulate the patients gut with normal and healthy bacteria and microbes that come from the donor’s gut. FMT has been found to be particularly good at treating the antibiotic resistant Clostridium difficile (C. diff) with research (1) (2) proving this therapy shows considerable benefits. Aside from treating C. diff studies have recently looked into treating IBS (3) as well as other conditions such as ulcerative colitis and psoriatic arthritis (4). The studies with patients who have moderate to severe IBS (diarrhea predominant IBS as well as constipation predominant IBS) have shown positive results and more lengthier studies are underway to confirm the effectiveness of FMT for IBS.

The fecal transplant is performed by mixing a saline solution with a healthy donor’s fecal matter and delivered by enema. Recently other methods such as using endoscopy and colonoscopy have proven to be as effective as well as fecal matter preparation such as freeze-dried FMT pills and frozen preparations of donor feces have also proven to be effective.

What Is C. Diff?

Clostridium difficile, known also as C. difficile is a bacteria infection that affects the colon. The bacteria produces toxins that can damage the lining of the gut and it can cause symptoms such as fever and abdominal pain with frequent watery diarrhea. It can also cause severe dehydration which can cause drowsiness, fainting and confusion. The infection can progress to a stage where it is possible that the colon can rupture or spread to the abdomen causing a life threatening inflammation.

C. difficile can cause illness when the patient has been undergoing a treatment of antibiotics for an infection from different part of the body. The antibiotic treats the intended infection but C. difficile is not affected by this type of antibiotic and then the bacteria is allowed to multiply without other bacteria in the gut to prevent its growth. This increase overwhelms the gut with C. diff bacteria which can then lead to illness.

C. diff presents many symptoms similar to IBS which is why it is important your doctor investigates your symptoms and eliminates the conditions such as C. diff before a diagnosis of irritable bowel syndrome is made. Be sure to contact your doctor if you still have diarrhea after a recent round of antibiotics or bloody diarrhea.

Fecal Transplant for IBS

Stool transplants begun as finding a way to treat C. diff infections but recently it has been found that FMT is helpful for treating IBS-D and IBS-C. A study showed that FMT has the same response rate as the low-FODMAP diet which makes it a suitable option to try if the person is finding the low-FODMAP diet difficult to follow. Another small study at Montefiore Medical Center treated patients with fecal microbiota transplantation after other interventions such as dietary modification, antibiotics and anti-depressants had failed. Their results are encouraging as FMT resolved or improved the symptoms of 70 percent of the patients with abdominal pain, bowel habit, bloating and flatulence having all improved. Half of the patients trialled say the FMT resulted in an improved quality of life.

These studies show us that FMT for IBS may well be a great method to help resolve their IBS symptoms but longer and larger studies need to be assessed to give us a better picture of this treatment. There are such studies currently in progress and hopefully they will confirm FMT for treating IBS is beneficial.