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Fecal Microbiota Transplant (FMT)

Fecal Microbiota Transplant (FMT)

FMT is also known as a stool transplant. A doctor transplants feces from a healthy donor into the gut of another person to restore their balance of bacteria. This is experimental therapy used to treat a repeated infection from the bacteria C. difficile (CDI).

Will FMT help me?

According to recent studies, patients who have FMT for repeated CDI have noticeable improvements in their symptoms. However, we cannot promise you these same results.

How is FMT delivered?

Doctors use a tube called a colonoscope. The tube delivers the donor’s fecal matter through the patient’s rectum into the large intestine.

Why does Stanford Health Care offer FMT?

More people are being hospitalized for conditions linked to CDI.CDI is one of the top 3 infections acquired in US hospitals, leading to 14,000 deaths each year.  CDI is often caused by overusing antibiotics. The antibiotics can disrupt a patient’s microbiome (the community of bacteria, viruses and other microbes that live in our bodies). That disruption allows C. difficile to grow rapidly. Studies have shown FMT is nearly 3 times more effective than standard treatment for CDI.

Will I need to pay for tests and treatment?

This is not a research study, so no research funding is available to pay for it. Treatment will be billed to your insurance company.
Check with your insurance company to see if it will pay for this.

Donor screening will also be billed to the donor’s insurance company. We cannot guarantee that insurance will cover the cost for the donor or the patient.

What if I’m injured during the transplant or become sick later?

FMT has not been approved by the FDA. It is still an experimental treatment. No funding is available in the case of injury or sickness. Any patients getting injured or ill from this treatment will receive medical care. However, this care will not be free of charge.

 

Could FMT be bad for me?

Donor screening
All donors get extensive screening before they can donate their stool. This prevents you from being exposed to known infections or illness.

Still, the donor may have an unknown disease or an infection. You may be exposed to this from the transplant. Although this is extremely rare, such a risk cannot be eliminated.

Infection with bacteria that resist drug treatment.
There is a growing problem in our general population with bacteria that resist antibiotics. Even healthy donors can carry them.

There have been patients who were infected with antibiotic-resistant bacteria from the donor stool. The patients often have weakened immune systems.

These types of infections are extremely rare.  Still, they are dangerous because they are difficult to treat.

We test donor material for these bacteria, but there is a chance they can be missed.
 

Symptoms after FMT

Symptoms are common after the transplant and may last for 1 to 2 months. Symptoms include:

  • Diarrhea
  • Gut pain
  • Bloating
  • Cramping
  • An urge to have a bowel movement

The cause of these symptoms is a condition called irritable bowel syndrome, or IBS. This develops in many patients from the intestinal trauma linked to CDI. It can occur whether they are treated with FMT.

In some cases, we can provide early treatment for this condition. Usually we like to wait for at least 2 months because of the changes in your body during this time.

It is important to decide if these symptoms are from returning CDI. That is often linked to extremely urgent bowel movements and loose bowel movements.

The risk that CDI will return is highest around 1 to 2 weeks after treatment. If you suspect a relapse of CDI, it is important to let your doctor know. You may need have your stool tested as soon as possible.
 

Colonoscopy

This procedure uses colonoscope, which is a tube with a tiny camera. The tube is inserted through the rectum into the large intestine.

Patients receive a separate consent form that describes the risks of this part of the procedure.
 

Unknown risks

In addition to the risks explained above, FMT may hurt you in ways that are still unknown.  Complications may include (but are not limited to):

  • Missing the presence of polyps, cancer, or other problems because donor stool interferes with views of the colon
  • Allergic reaction to donor stool
  • Colon inflammation in patients who have inflammatory bowel disease
  • Higher risk of developing conditions that may be related to donor gut bacteria.  These conditions include autoimmune, allergic, or neurologic disorders, obesity, and cancer.

Pregnancy and birth control

Women who can become pregnant must have a negative pregnancy test before treatment begins. If you think you are pregnant or if you become pregnant during treatment, you must tell the doctor right away.

Who can I talk to if I have more questions?

If you have questions or think the treatment has hurt you, talk to any member of your health care team. We can be reached at Stanford Health Care’s Division of Gastroenterology at:  650-736-5555.

INTERESTED IN AN ONLINE SECOND OPINION?

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Visit our online second opinion page to learn more.

Clinics for Fecal Microbiota Transplant (FMT)