FMT stands for Fecal Microbiota Transplant, which is ‘the process of restoring the bacteria commonly found in a healthy human gut’ (according to the Taymount clinic).
Or, to put it in plain English: implanting a healthy person’s stool (+ microbiome) into a sick person’s gut.
Although the idea has been around for a long time (there’s evidence of similar procedures in ancient India and China) and the procedure can even be observed in nature (for example animals eating poo) it has only recently been implemented in a clinical context and has made headlines as the new wonder cure for c.difficile, an antibiotic-resistant bacterial infection that can lead to a lot of suffering and death. Only 2-5 transplants are usually needed to cure c.diff in most cases.
It has also been used for many other chronic health conditions such as IBS, IBD, ME, MS and more, and is being tested for conditions like Autism, Parkinson’s and Alzheimer’s.
The results for these conditions don’t appear to be as straight forward as c.diff and vary individually.
Sometimes it takes longer for symptoms to resolve and transplants have to be repeated over a longer period of time in order to see lasting results.
However, according to Thomas Borody, one of the pioneers in this field, even the most stubborn cases resolve after two years of intermittent treatment.
Since all these conditions have a dysbiosis of the gut microbiome in common, the idea is to restore the microbiome to a healthy state.
As the science on the microbiome is fairly new, we don’t have enough information yet to replicate the full microbiota in a lab.
Therefore currently the only way to transfer the complex gut microbiome into a sick person’s gut is to take it from a healthy person.
In a clinical context the donors are carefully selected and screened for all sorts of diseases and their fitness, mental state, medication history and BMI. Because many of the microbes in our gut are anaerobes, an anaerobic environment is maintained when collecting and preparing the transplants. Any waste material is then filtered so that the Fecal Microbiota Transplant mainly contains the microbes.
The transplant is usually administered by colonoscopy, endoscopy, sigmoidoscopy or enema.There is also talk about developing ‘poop pills’ which would make the procedure more accessible.
Unfortunately there are only four dedicated FMT clinics in the world: the Taymount Clinic in England, the Centre for Digestive Diseases and Melbourne FMT in Australia, and the Newbery Clinic in Argentina. These clinics treat all kinds of conditions, not only c.diff, but always at the patient’s risk.
There are a few more doctors around the world who are known to treat c.diff with FMT as this is now well backed by research but it is still not very accessible for most.
No wonder that many desperate people are resorting to desperate measures: DIY stool transplants. This is understandable, especially in the case of c.diff where it could be a matter of life and death. I considered it when I first came across FMT and decided I couldn’t afford treatment at the clinic. I decided against it mainly due to a lack of healthy donors.
The DIY method has many problems though. In a home setting it would be difficult to maintain an anaerobic environment and therefore not many of the anaerobes would actually survive the passage.
There’s also the problem of choosing the right donor and doing adequate testing – someone who appears to be healthy might still carry pathogens or parasites that would cause harm to an already sick person. Then there’s the ick factor… Then again, if it’s a matter of life and death there’s not really much to lose!
FMT can be considered the ultimate probiotic. Commercial probiotics are now thought to stimulate the immune system and to help crowd out pathogens but unfortunately have a poor record of colonization.
There is also no way yet to culture all the anaerobic species in the lab and therefore in probiotics we only end up with a few beneficial strains that fail to mimic the complexity of the full gut microbiome.
Disturbances in the human microbiome are now shown to be the root cause of many chronic diseases and an easy way to restore the balance could help a lot of patients with an array of chronic diseases.
Hopefully this treatment will become more accessible to more people with time, popularity and success. I for one have been part of the experiment…Read all about my journey with FMT here, here and here.
If you or a loved one suffers to a condition that is related to the microbiome and you’d like more information on FMT check out ‘the power of poop’s website:
It has a big database of practitioners and all the information you’d need for DIY FMT. There’s also success stories and you can join their Facebook discussion group.
The Taymount clinic have recently expanded their treatment plan options to make it more accessible and affordable. There’s also tons of information and success stories: http://taymount.com.
If you’re from north- or south-America you can check out the Newbery clinic in Argentina.
Have you received FMT? I would love to hear from you…
- http://www.england.nhs.uk/wp-content/uploads/2015/04/10-cdi-practical-aspects-faecal-microbiota-transplant.pdf http://taymount.com/faecal-microbiota-transplant-fmt