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Fecal Microbiota Transplant

Recurrent C. difficile infection can be treated with fecal microbiota transplant, or FMTFecal microbiota transplant, or FMT, takes stool from a healthy donor and transplants it into the digestive tract of a patient suffering from recurrent Clostridium difficile infection, or RCDI. Patients who have had three or more relapses of mild to moderate RCDI that have not responded to antibiotics are eligible to receive FMT at Drexel Gastroenterology.

How Does FMT Work?

Patients with RCDI have too much of a bad bacteria (C. diff) in their digestive tracts, in particular in the large intestine. This often results from taking antibiotics that are strong enough to kill the good bacteria but not the C. diff. With no competition, the C. diff takes over, causing RCDI, which is characterized by:

  • Diarrhea
  • Abdominal pain
  • Bloating
  • Fatigue
  • Fever

Taking stool that has an appropriate bacterial population (or microbiome) from a healthy donor and introducing it to the sick person’s digestive tract restores the balance, and frequently resolves the C. diff infection within days, or even hours.

What to Expect During the FMT Procedure

First, a donor is identified. At this time, patients receiving FMT at Drexel Gastroenterology have the option to choose their donor from among family and friends, or they have the option of using an unrelated prescreened anonymous donor.

Friends and family who are prospective donors will be screened for a number of infectious diseases, parasites, and general overall good health. Once a suitable donor is found and the stool is acquired, it is mixed with saline and transplanted to the RCDI patient via colonoscopy, enema, or a tube inserted through the nose and extending into the small intestine.

Transplantation via enema and nasal tube can be done while the patient is awake. Colonoscopy is usually done under twilight sedation. Patients are typically able to return home the same day.

Does FMT Really Work?

Most studies of FMT for RCDI have shown a 90 percent or greater cure rate with one or more fecal transplantations.

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What Else Does FMT Treat?

At this time, FMT is only recommended as a treatment option for RCDI. However, there is reason to believe that it could be used to treat a host of other digestive conditions, such as:

  • Inflammatory bowel disease
  • Irritable bowel syndrome
  • Crohn’s disease
  • Ulcerative colitis.

There is also some suggestion that FMT could be helpful in the treatment of non-digestive conditions, including neurologic, rheumatologic and even cardiovascular diseases. If you are interested in learning about existing clinical trials, you may view a list of fecal transplant studies at clinicaltrials.gov.

To learn more about FMT at Drexel Gastroenterology, please schedule an appointment at one of our many convenient locations in Philadelphia.

Additional FMT Resources

American Gastroenterological Assocation’s FMT Site

FDA’s “Guidance for Industry” policy on the use of FMT to treat RCDI

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