Swapping Poop: Fecal Microbial Transplantation (FMT)

Swapping poop sounds really gross, but it has helped so many people and is actually a medical treatment. Fecal microbial transplantation (FMT for short) is what we will be talking about in this article.

You will learn:

What is fecal microbial transplantation (FMT)?
How was fecal microbial transplantation developed?
Why is fecal microbial transplantation used?
Challenges with FMT
How do you know if fecal microbial transplantation is the right treatment for you?

So first things first!

What is fecal microbial transplantation (FMT)?

Fecal microbial transplant (FMT) is a therapy where a solution of fecal matter is taken from a donor and placed into the intestinal tract of a recipient. This procedure is also called bacteriotherapy, fecal transplant, stool transplant, or intestinal microbiota transplant.

The fecal matter solution can be delivered through several methods. The most common delivery methods include:

Colonoscopy
Enema
Nasogastric (NG) tube
Capsules (sometimes referred to “poop pills”)

The goal of this therapy is to take microbes from a healthy person’s microbiome and deliver them to someone whose microbiome is unhealthy in hopes of improving their condition. It’s essentially the opposite of using antibiotics. Antibiotics are used to treat by killing off bacteria, while FMT is used for treating with bacteria.

This isn’t a new practice and has been used for thousands of years, but it is new to Western medicine. Many studies are going on to understand the best methods to use this treatment.

History of FMT

Records of the use of FMT date back to ancient 4th century China. A doctor used what he called “yellow soup” to treat patients who were suffering from food poisoning and diarrhea. The yellow soup is believed to be a mixture of broth mixed with dried and fermented stool from healthy people. The doctor would give this to his patients to help treat their digestive problems.

The Bedouin groups were known to practice something similar. If anyone in the group was to begin suffering from dysentery they would eat the camel dung to improve their condition. This practice is still used today.

Animals have always done this. They eat the droppings of other animals and it gives them a more diverse microbiome. Veterinarians of years past have used this method to help improve their patient’s conditions — referring to it as “transfaunation”.

These practices were a sort of precursor to what doctors are trying to replicate in a healthier, more controlled way.

Why is FMT used?

FMT is used to increase the microdiversity of someone’s microbiome. Microdiversity is so important because it is what keeps your gut health and thus your immune and bodily health at its peak. When something happens to throw off the balance of your microbiome, it alters all of the bacteria living there and can change how your body reacts to everything.

Much like taking probiotic-rich foods or supplements, FMT is introducing different strains to your microbiome.

Since FMT is still quite new to Western medicine, it hasn’t been approved by the FDA for the treatment of all diseases. Though there have been studies proving its efficiency as a treatment it still isn’t a commonly practiced treatment.

Some of the diseases that FMT is typically used for include:

C. diff infection (CDI)
Parkinson’s disease
Fibromyalgia
Chronic fatigue syndrome
Myoclonus dystopia
Multiple sclerosis (MS)
Obesity
Insulin resistance
Metabolic syndrome
Autism
Alzheimer’s disease
IBD and other functional GI disorders
Cancer

Research is ongoing and more and more conditions are being recognized as having a dysbiosis link. Any condition with an altered gut microbial flora can very likely be considered for treatment via FMT.

Challenges with FMT

Since each person’s microbiome is as unique to them as their fingerprint, it can be challenging to isolate and figure out exactly what species of bacteria is needed to alter their gut in a positive manner. Dr. Sabine Hazan and her team have developed a company that is looking deeper into the world of bacteria inhabiting our stool.

Progenabiome isn’t just looking at the surface of the bacterial communities within our guts. Many companies that are studying stool stop at phylum or class. Dr. Hazan and her team are getting all the way down to the species level and associating different bacterial species with either health or specific diseases.

While Progenabiome is making huge bounds in this research, it is still so novel that there isn’t a lot of information to go based on. But some of the common side effects of FMT that have been recorded are:

Fever
Abdominal discomfort
Bloating and flatulence
Diarrhea and/or constipation
Vomiting

There are still complications when doctors begin to consider FMT as a treatment plan for their patients. Some of the problems that need to be considered and studied include:

Not knowing the exact microbial fingerprint for each disease
Patients have adverse reactions to treatment:
- Do they need another dose or do they need less dosage
- Was a specific strain not compatible with the patient
- What was their microbial distribution prior to treatment and did that affect how they responded to the FMT
Restrictions on when/where FMT can be used
Some patients end up contracting a different disease from the FMT since certain microbes can be ignited when in a specific kind of environment — research is still being developed on this topic

With all of these considerations in mind, sometimes the potential benefits will outweigh the risks at hand. So doctors will move forward with treatment as the research shows just how incredible the improvements among patients have been.

Is FMT right for you?

Now, after reading the last segment you might be thinking that FMT is too new and potentially dangerous for you to ever consider using it as a treatment. (Or you might just think it’s too gross — which is understandable) But, don’t lose hope quite yet.

Success rates with FMT for different conditions have been quite high. Rates do vary depending on gender, race, and where you live, among other things that alter the beginning state of your microbiome. However, many people are seeing huge improvements in their health. So here is some of that research to consider if FMT is right for you.

Mild to moderate cases of CDI had an 87.4% success rate when using FMT treatment. This study had shown that severe cases of CDI were less likely to respond to FMT.

Parkinson’s patients saw an improvement in both motor and non-motor skills that had been previously declining due to disease progression.

FMT was shown to improve cognitive function and reduce plaques on the brain in Alzheimer’s patients.

Cancer patients showed a reduction in side effects from their treatment and an improvement of the effectiveness of treatments after doing FMT.

We cannot give you a yes or no that FMT will be right for your exact situation. If you feel as though it might be a method of treatment to explore, consult with your physician and see if the benefits outweigh the risks and if you’d be a good candidate for FMT.

Want to learn more about FMT from one of the doctors making huge breakthroughs in the industry? Check out Dr. Browns podcast with Dr. Sabine Hazam for more information!

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