How is a Fecal Transplant Done: FMT Procedure and Protocol

June 7, 2023

Fecal Microbiota Transplants (FMT) are a treatment involving the insertion of stool sample from a healthy donor into the gut of a patient. The procedure is not yet widely available, and is currently under study for the treatment of many microbiome-related illnesses and conditions. If you’re curious how this procedure is done, we provide information on the following topics:

  • How is a fecal transplant done?
  • Who is qualified to perform a fecal transplant?
  • Stool transplant protocol for chronic illness
  • Other resources to learn more about FMT delivery methods

How is a fecal transplant done?

Fecal  transplants can be done with poop pills, an enema, or a nasoentric delivery method (through the nose). The process starts by first collecting a stool sample from a healthy donor, it is tested, turned into a slurry and blended with saline, and then the sample can be used for a fecal transplant.

The stool must go through a rigorous screening process to test for disease and other problems before it is accepted. The sample that is collected can be used immediately, frozen for later use, or turned into a stool capsule.

The three main delivery methods for fecal microbiota transplants are outlined in more detail below.

1. Oral fecal transplant with poop pills: using “crapsules”

Poop capsules or “crapsules” are fecal-filled capsules designed to break down in the gut when swallowed. They are ideal for delivery of FMT to the stomach and the upper tract of the large intestine. These capsules are also great for those who would prefer a less invasive form of FMT.

The amount of fecal matter in the capsules is significantly less than in other delivery methods. As many as 8 capsules have to be ingested to receive the equivalent amount of material as is distributed through the other two methods.

2. Fecal transplant enema: going in the other end

Colonoscopy or enema are another form of FMT delivery, where the stool slurry is transplanted directly into the colon. An enema is used for a lower tract delivery, whereas a colonoscopy is used for an upper tract delivery. Delivery location can depend on what part of the microbiome is most affected.

3. Through your nose: nasoenteric delivery method

The final delivery method is a Nasoenteric tube, which is inserted in the nose and fed down into the stomach or colon for delivery. This method utilizes the stool slurry, and as with colonoscopy and “crapsule” this method is generally best for upper tract delivery.

How do I choose a fecal transplant method?

Colonoscopy is the most common way FMT is administered. Delivery method should be discussed between doctor and patient and is usually based on the location of disease or problem area, and the comfort of the patient. As of now, there is no evidence that any method is more effective than another, though the methods do vary in price.

Who is qualified to perform a fecal transplant?

Fecal Microbiota Transplants are a medical procedure and should only be done in a medical setting by a medical professional.There are many gastroenterologists who will perform FMTs for C Diff and other microbiome-related illnesses, but there are restrictions on the treatment in certain regions.

Though they may seem simple to perform, the process of screening both donor and patient to make sure the treatment is safe is an extensive process, and not something that is possible to do for at-home treatments. We never recommend you attempt to perform a DIY fecal transplant, and always go to an FMT clinic if you’re interested in the procedure.

Those who live in regions with major restrictions who are still looking to have the treatment done should consider studies and trials that are recruiting to test out FMT as a potential medical therapy. These clinical studies are still safe to participate in, as they are performed by qualified medical professionals, and might help you get an FMT treatment – even if it is not approved in your region.

What is the stool transplant protocol for chronic illness?

Fecal transplants are used to treat microbiome associated chronic illnesses and the deadly Clostridium Difficile infection. These illnesses are associated with imbalance or disruption in the gut microbiome. Feeding healthy bacteria into the gut microbiome via FMT can re-balance the microbiome.

The stool that leaves our body carries with it millions of bacteria. Utilizing this stool, FMT takes healthy bacteria from a donor and transfers it to the patient helping balance their gut microbiome.

Other resources to learn more about FMT delivery methods

These articles can help you learn more about the methods for delivering FMT, as well as more in-depth information about the process of stool transplants.

Good News: You Can Take Your Fecal Transplants Orally

A study published has reported that success rates are not altered by delivery method of FMT. Fecal transplant pills are just as good for treating C Diff as are the more traditional delivery methods.

Fecal Transplant Resources Guide: 40+ Articles, Podcasts, and Sites

Peruse a large list of resources on FMT and the microbiome. Learn about the basics of FMT or find out where you nearest FMT performing clinic is.

I Had A Fecal Transplant And It Saved My Life

Read about the first-hand experience of someone who had a fecal transplant that helped cure their severe Clostridium Difficile infection.