FMT, fecal transplants, fecal microbiota transplants are all terms that have been in the news lately across all different types of publications from The Huffington Post to New Scientist. Not only does it present new treatment options and challenge the way we have always thought about bacteria, it is creating some commotion in the US in particular so today we wanted to give you the rundown on the most common questions we get asked about FMT.
What is FMT?
FMT stands for Fecal Microbiota Transplant which sounds a little gross but I can assure you that it’s not and that it’s actually quite amazing.
Fecal or Faecal Microbiota Transplant (FMT) is the process of isolating the beneficial intestinal bacteria and yeasts (The Faecal Microbiome) from the stool of a healthy, disease-free person and implanting it into a gut of a person whose gut has bacteria and yeasts that have been reduced by antibiotics, compromised by pathogenic parasites or “starved out” by poor diet , thus lacking the essential Microflora needed to maintain numerous normal and vital healthy gut functions. It’s important to note that we don’t transplant raw stool as the name might imply, it’s just the bacteria that gets transplanted.
Why is it done?
There are a number of health conditions where recent academic and medical research in the United States and Australia indicates that gut bacteria may be playing a significant role in modifying or treating the symptoms. The research cited in this New Scientist article reports that in a study of patients suffering from C. Diff, “15 out of 16 people given transplants were cured of their infections, compared with 4 of 13 patients receiving standard antibiotics.”. These results are not isolated; at The Taymount Clinic we have treated patients who have tried everything else and have been able to improve them by using FMT.
What can FMT be used for?
Research comes out almost daily showing breakthroughs in new areas where FMT can be applied; in addition, FMT is currently being used to treat these conditions:
Clostridium difficile infection
Inflammatory Bowel Diseases (Crohn’s Disease & Ulcerative Colitis)
Irritable Bowel Syndrome – IBS (Post-Infectious, Post-Antibiotic)
ME (Myalgic Encephalopathy)
CFS (Chronic Fatigue Syndrome)
MS (Multiple Sclerosis)
In a research study by Centre for Digestive Diseases in Australia, the researchers wanted to test their hypothesis that fecal flora played a large role in Ulcerative Colitis. Fecal bacteriotherapy was performed on 6 patients with Ulcerative Colitis. The researchers found that by 4 months after this treatment, a complete reversal of the symptoms had occurred in all of the patients. You can read the full study here: http://www.cdd.com.au/pdf/publications/paper17.pdf
Many studies show a 90% or higher success rate in eradicating C. diff with FMT. One such study published in the American Journal of Gastroenterology found that fecal microbiota transplantation achieved clinical resolution in 245 out of the 273 patients in the study.
In yet another study by the Centre for Digestive Diseases in Australia, researchers found that FMT can reverse MS-like symptoms – suggesting a GI infection underpinning these disorders.
These studies are recent but the idea that our microbiome plays a large role in our overall health is not new.
“The control of man’s diet is readily accomplished, but mastery over his intestinal bacterial flora is not…the innumerable examples of autointoxication that one sees in his daily walks in life is proof thereof. They are the cases that present…malaise, total lack of ambition so that every effort in life is a burden, mental depression often bordering upon melancholia, frequent attacks of indefinite abdominal pains due to flatulency, sudden attacks of acute diarrhea alternating with periods of constipation…A battle royal must be fought and when this first great struggle ends in victory for the Bacillus bulgaricus it must be kept on the field of battle forever at guard…”
Bond Stow, M.D., on autointoxication and Lactobacillus bulgaricus – Medical Record Journal of Medicine and Surgery, 1914
How is FMT done?
A healthy donor is selected for health, lifestyle and diet and is regularly and extensively screened for serious communicable diseases and parasites. Their gut Microflora is assayed by PCR DNA analysis for a profile of the component bacteria and yeasts. By supplementation with a combination of live and active probiotics and diet modification the donor’s microflora maintains large numbers of a broad spectrum of beneficial bacteria.
The donor provides daily stool samples to the laboratory where the stool is processed (see our blog for details) and the microbiome isolated and stored in Ultra Low Temperature conditions at -86ºC.
When they are needed, the samples are slowly brought up to +37ºC and implanted into the Colon of a patient with a compromised gut flora. Our clinical method ensures that the implant is distributed along the whole length of the colon. With immediate effect the patient’s gut profile begins to resemble the microbial construct of the healthy donor and starts the same normal metabolic functions. The effects vary from very rapid (c.diff), to the longer term and it can sometimes take a few weeks or months for long-term immune system responses to the treatment. Treatment response times vary greatly depending on presenting symptoms, individual medical conditions, lifestyle and environment.
What is receiving FMT like?
Here is what Roger Elliott, one of our previous patients, had to say about his experience.
Roger runs a blog called Celiac Travel which helps people with celiac (coeliac) disease find gluten free food at home or away.
Why are fecal transplants and the FDA in the news so much lately?
As of April 2013 the FDA has classified fecal microbiota transplant (FMT) as an “Investigational New Drug”. This means that until FMT is formally approved, its use is restricted to the treatment of Clostridium difficile infection (C Diff). That’s bad news for patient safety because it forces the treatment ‘underground’ into a non-clinical environment where health, safety and quality are compromised, with people trying to do this themselves at home. The FDA is moving very slowly despite demand for greater access to this procedure. We certainly don’t believe that you should be forced to attempt a medical procedure at home.
This article on Wired makes an excellent point that “If we want to honor the intent behind the FDA’s authority, which is to protect the vulnerable, then the process of examining fecal transplants must somehow be accelerated” and hopefully the press coverage that this is now getting will help with that.
Want to find out more about having FMT treatment?
At this moment in time, the Taymount Clinic is the only clinic in Europe, specialising in FMT. Our clinic director, Glenn Taylor, has done over 800 of these procedures for patients from all over the world. If you would like to have a consultation to discuss your diagnosis and whether FMT can help you, then follow this link: To schedule a consultation and take the first step toward getting FMT, click here.