June 6, 2023
Fecal Microbiota Transplants (FMT) are a medical therapy in which stool is taken from a healthy donor and inserted into the colon of a sick patient. The treatment is used for illnesses associated with the dysbiosis of the gut microbiome. Many illnesses are found to be associated with the microbiome, including a lot of chronic illnesses that have no known cures.
Dysbiosis is, by definition, the imbalance of the bacterial components of the body. When imbalance in the microbiome occurs, the many functions that the microbiome regulates can be thrown out of whack and effect the health of the host. Autism, IBD and obesity all have known links to a microbiome in dysbiosis.
Fecal transplants are now being administered and carefully studied for the treatment of these microbiome-related conditions. The following sections will outline how and by whom FMT is administered, and what it can be used to treat.
For a full list of current illnesses fecal transplants are being used to treat, check out these articles on FMT treatments. If you want to learn more about the basics of stool treatment, read on!
Fecal microbiota transplants can be administered by three different methods. The most common form of delivery is by colonoscopy or enema, a second common method is by nasoenteric tube, and lastly, FMT capsules. Choice of method is dependent on location of the issue in the colon and personal comfort.
Generally colonoscopy is used for upper GI tract delivery, while enema is ideal for lower tract delivery. Nasoenteric tube, which is a tube fed through the nose and into the gut, is ideal for upper tract delivery as well. FMT capsules, which are relatively new and are fecal treatments in pill form are best for upper tract delivery. There have been no indications that any fecal transplant method is superior to another only that certain ones may be better at reaching certain affected areas of the colon.
Stool transplants are mainly used for Clostridium Difficile infections, but are being studied for many chronic conditions. Below we provide an overview of each of those conditions and how they are treated by fecal transplants.
Fecal transplants have proven to be an incredibly safe and effective treatment for Clostridium Difficile infections. C Diff is a bacterial infection of the gut. It affects your gut microbiome and 90% of cases are curable by manipulating the gut microbiome through FMT.
Ulcerative Colitis sufferers have an altered microbiome composition, compared to those in a healthy state. Dysbiosis of the gut microbiome is thought to be manageable by use of fecal transplants, to provide it with the good bacteria it needs to repopulate and rebalance. According to studies up to 41% of patients are able to reach a symptom-free state through use of fecal therapy.
Those with Crohn’s Disease have been found to have microbial differences from those without the condition. Microbial dysbiosis may be at the care of may of the symptoms of Crohn’s and early studies have shown that FMT for the treatment of Crohn’s can be effective in up 61% of cases.
A distinct microbial difference has been reported in those who are obese and have difficulty losing weight. According to research, there is an increased amount of bacterial enzymes associated with the processing of carbohydrates. Scientists are now studying how manipulating the microbiome through use of FMTs can affect weight loss in obese individuals.
Fecal Transplants have been found to have a positive impact on both behavioral and GI symptoms associated with Autism Spectrum Disorder in 60% of cases, due to the connection between autism and the gut microbiome. The method of treatment seems to be effective due to what is known as the gut brain axis. However, the results are early and there will need to be much more study to fully assess the efficacy of FMT for Autism.
Irritable Bowel Syndrome is an incredibly common affliction and the best treatment for each sufferer of IBS can be hard to assess, but FMT therapy might be the IBS treatment that works for many. It is too soon to tell definitively but researchers believe that a connection between the microbiome and IBS symptoms are a good indication that FMT will work for the condition.
FMT is currently available mainly for the treatment of C Diff, and though it is available for the treatment of other conditions in certain regions, it is not widely available everywhere. Many of the conditions it is used for are still in the research phase and will need further data and follow up in order to be properly assessed by regulatory bodies.
Here are the statuses of regulation in select regions globally:
Despite regulation certain specialists will perform FMT, case dependent in many regions. Check out our resource list of FMT practicing clinics and doctors.
FMT is an exciting area of medicine and there is plenty more to know about it. Check out some other online resources on stool therapy.
A slideshow outlining the regulatory policies and decisions by select global regions on FMT for the treatment of C Diff and other conditions. This is a great resource if you are interested in learning more about the regulatory bodies in charge of the rules around FMT.
FMT and microbiome research is quickly developing, check out this list of resources for everything you need to know about the field.