What is it?
A fecal transplant, also called fecal microbiota transplantation (FMT), is a procedure to restore healthy bacteria in the large intestine (colon). Healthy bacteria from a donor's stool is prepared and then put into your colon.
Why is it done?
Currently, FMT is only done to treat people with severe or recurrent Clostridioides difficile (C. diff) infection.
The colon normally contains a mix of bacteria. Some of the mix is good bacteria that keep the colon healthy. They don't cause disease. But when you take an antibiotic to kill bad bacteria, the medicine may also kill the good bacteria. Without the good bacteria, bad bacteria like Clostridioides difficile (also called C. diff) can cause serious illness. C. diff can cause diarrhea, fever, and belly cramps.
The healthy donor stool used for FMT contains good bacteria which repopulate the colon and help to fight off C. diff. FMT is very successful in treating recurrent C. diff infection. With a single transplant, about 8 out of 10 people are cured of their C. diff infection. 1 or 2 out of 10 people may need to have a second transplant.
How is it done?
You will meet with a specialist to make sure you meet the criteria to get FMT. If you meet the criteria, stool from a donor will be saved and then processed for the transplant. FMT donors go through the same screening process as blood donors. All donors must be healthy and meet criteria from Health Canada. Donor’s stool is also screened to make sure they do not have any harmful bacteria or viruses that could spread to an FMT recipient.
Before the transplant, your doctor may ask you to do some things to prepare. You may need to go on a liquid diet. You may be asked to stop taking certain medicines. Your doctor may also have you take a laxative or other medicine to empty your colon.
There are several ways to get the donor stool into the colon. The most common is with a colonoscopy. But it may also be done by taking capsules, by having an enema, or through a nasal tube. Sometimes more than one method is used.
The transplant is done in a clinic or a hospital. If the FMT is given by capsules, it is done in a clinic.
In a colonoscopy, the doctor moves a thin, lighted tube through the colon. As the tube is removed, the stool is put in the colon. You may get medicine to help you relax during this procedure.
If the stool is put in the colon with an enema, you will continue lying down for several minutes.
After the transplant, you may have some discomfort, such as gas, cramping, or bloating. These symptoms should go away on their own. Let your doctor know if they last or get worse. There's also a small chance of getting a new infection from the donor stool. To decrease this risk, donors and donor stool are screened for infections.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
