Faecal Microbiota Transplant (FMT) is the process of transferring gut bacteria from a healthy donor into the gastrointestinal tract of a recipient with an imbalanced or compromised microbiome. This procedure is gaining increasing recognition as an effective treatment for certain gastrointestinal conditions, particularly those related to gut dysbiosis. Although FMT has only recently gained widespread medical acceptance, the concept of using healthy stool to restore gut function dates back centuries.

The gut microbiome is now understood to be as vital as other major organs in the body, influencing not only digestion but also immune function, metabolism, and even mental health. Much like traditional organ transplants, FMT involves the transfer of living, beneficial microorganisms to restore balance and improve overall health.

The most common use of FMT – Treating Clostridium Difficile infection (C. Diff)

FMT is most commonly used to treat Clostridium Difficile Infection (CDI), a serious bacterial infection that causes severe diarrhoea, inflammation of the colon, and life-threatening complications if left untreated. CDI is often linked to the overuse of antibiotics, which disrupt the natural balance of gut bacteria and allow C. Diff to thrive.

What makes C. Diff particularly dangerous is its resistance to many antibiotics. In fact, many patients experience recurrent infections even after multiple rounds of antibiotic treatment. FMT offers an alternative solution with a remarkable 98% success rate in curing recurrent CDI, far surpassing the efficacy of standard antibiotic therapy. By reintroducing healthy bacteria into the gut, FMT helps restore the natural microbiome, outcompeting harmful bacteria and reducing the likelihood of reinfection.

Other conditions where FMT shows promise

While the primary application of FMT is for CDI, emerging research suggests that it may be beneficial for other gastrointestinal and systemic conditions linked to gut microbiome imbalances. Some of these include:

1. Post-Infectious Irritable Bowel Syndrome (PI-IBS)

• Post-Infectious IBS occurs after a severe bout of food poisoning, gastroenteritis, or other infections that disrupt the gut microbiota.

• Symptoms include chronic diarrhoea, bloating, abdominal pain, and changes in bowel habits.

• FMT has shown promising results in restoring gut bacteria and alleviating persistent IBS symptoms.

2. Inflammatory Bowel Disease (IBD)

• Conditions like Ulcerative Colitis (UC) and Crohn’s Disease are thought to be influenced by an imbalanced microbiome.

• While research is still ongoing, FMT has shown potential in reducing inflammation and achieving remission in some patients with UC.

3. Antibiotic-Associated Diarrhoea (AAD)

• The overuse of antibiotics can deplete beneficial gut bacteria, leading to prolonged diarrhoea.

• FMT helps restore a diverse microbiome, promoting healthy digestion and recovery.

4. Other emerging uses

• Research is ongoing into the potential of FMT for conditions such as Metabolic Syndrome, Obesity, Autism Spectrum Disorder (ASD), and even certain Neurological Disorders, as scientists continue to explore the profound connection between gut bacteria and overall health.

How FMT is performed

FMT can be administered in several ways, depending on the patient’s condition and the physician’s recommendation. The most common methods include:

• Colonoscopy – The most effective and widely used method, where the transplant is delivered directly into the colon.

• Enema – A less invasive approach, though typically requiring multiple applications.

• Capsules – Frozen or freeze-dried faecal material in pill form, allowing for a non-invasive oral route.

• Nasogastric/Nasoduodenal Tube – A tube inserted through the nose into the digestive tract to deliver the transplant, though this method is less commonly used.

Regardless of the method, strict screening protocols ensure that only healthy, pathogen-free stool is used to minimise any risks to the recipient.

The future of FMT

With its high success rate in treating recurrent C. Diff infections and its growing potential for other gut-related conditions, FMT is proving to be a groundbreaking therapy in modern medicine. As more clinical trials emerge, we may see FMT becoming a mainstream treatment for a broader range of diseases. Scientists are also working on refining FMT into more standardised, commercially available microbiome therapies, including synthetic microbiota-based treatments that could offer the benefits of FMT without the need for human donors.

While FMT is not yet a first-line treatment for all gut conditions, its effectiveness and growing research make it an exciting area of medicine that holds the potential to revolutionise the way we approach gut health and chronic illnesses.

If you are experiencing persistent gut issues and would like to explore whether FMT is a suitable option for you, it is best to consult a specialist who can guide you through the process and discuss potential benefits and risks.

Experience and expertise in Faecal Microbiota Transplant (FMT)

Preparation for a procedure is key, as some preparation can start up to 7 days prior. In your consultation, Dr. Suhirdan will explain what preparation you require for your procedure and also advise you about your medication (if you take any). For full details and downloads, please refer to: