Fecal microbiota transplantation (FMT), also known as stool transplantation, is a procedure in which stool from a healthy donor is placed into the gut of a patient in order to treat a certain disease. FMT is not a new concept, but in the last six years it has become a standard-of-care therapy for the treatment of recurrent Clostridium difficile infection (CDI).
Treating infection with C. difficile
Clostridium difficile (C. diff) is a bacterium that is ever-present in our environment. Many people have C. diff in their bodies without issue; it is not the bacteria itself that makes you sick. However, under certain conditions, the bacteria release toxins, and it is the toxin that causes disease. A person with a CDI may experience watery diarrhea and abdominal cramping. In severe cases, infection can cause dehydration, require hospitalization, and be life-threatening.
The main risk factor for CDI is taking antibiotics, which is why doctors discourage unnecessary antibiotic use. Ironically, first-line treatment for CDI is also antibiotics. About 20% of people treated with antibiotics will develop recurrent infections, and the best way of clearing recurrent CDI is with FMT. This is supported by several guidelines. The reason why FMT works so well is largely unknown, but generally speaking it restores important helpful bacteria that help protect against CDI.
But while supported by guidelines, FMT is still considered investigational and is not currently FDA-approved. However, FMT can be performed for clinical care to treat recurrent CDI (typically defined as three or more confirmed episodes), or CDI that does not respond to other treatments. An FMT for any other indication can only be performed in the setting of a clinical trial.
How is FMT performed?
FMT can be delivered in many ways, the most common being via a colonoscopy. This procedure is very safe overall. Mild discomforts, like bloating, gas, and low-grade fevers have been reported.
The donor stool is typically provided by a stool bank. Hospitals can have their own stool banks, or they can partner with an external stool bank, the largest of which is OpenBiome. OpenBiome is a nonprofit stool bank that is able to provide prescreened donor stool, similar to the Red Cross for blood donation. The donor stool is screened for potentially disease-causing organisms; the donor’s blood undergoes routine laboratory testing and is screened for infectious diseases; and the donor’s medical history is evaluated.
How well does FMT work?
FMT has a cure rate of 80% to 90%, meaning the vast majority of patients will be cured of recurrent CDI with a single treatment. However, there are some patients who will need more than one FMT treatment.
The window of recurrence is typically eight weeks; if a patient makes it to eight weeks post-FMT without any issues or recurrence of diarrhea, we deem them cured. We don’t have a good way of predicting who might fail their first FMT. But we do know that antibiotics within the first eight weeks post-procedure should be avoided if possible.
Overall, FMT is a safe, well tolerated, and possibly lifesaving procedure for recurrent CDI. FMT should not be attempted at home, but rather should only be performed by a trained clinician using thoroughly screened material.
There is exciting research underway exploring the use of FMT to treat other diseases as well.
Below are spiritual recipe for health and wellness: Matthew E. McLaren
2 Chronicles 7:14 NKJV if My people who are called by My name will humble themselves, and pray and seek My face, and turn from their wicked ways, then I will hear from heaven, and will forgive their sin and heal their land.
Psalm 4:1 ESV Answer me when I call, O God of my righteousness! You have given me relief when I was in distress. Be gracious to me and hear my prayer!
Psalm 5:1-3 NKJV Give ear to my words, O Lord, Consider my meditation. 2 Give heed to the voice of my cry, My King and my God, For to You I will pray. 3 My voice You shall hear in the morning, O Lord; In the morning I will direct it to You, And I will look up.
Psalm 6:9 NKJV The Lord has heard my supplication; The Lord will receive my prayer.
Psalm 17:1 NKJV Hear a just cause, O Lord, Attend to my cry; Give ear to my prayer which is not from deceitful lips.
Psalm 42:8 NKJV The Lord will command His lovingkindness in the daytime, And in the night His song shall be with me— A prayer to the God of my life.
Psalm 54:2 NKJV Hear my prayer, O God; Give ear to the words of my mouth.
Psalm 55:1 NKJV Give ear to my prayer, O God, And do not hide Yourself from my supplication.
Psalm 55:17 NKJV Evening and morning and at noon I will pray, and cry aloud, And He shall hear my voice.
Psalm 61:1 NKJV Hear my cry, O God; Attend to my prayer.
Psalm 66:19-20 NKJV But certainly God has heard me; He has attended to the voice of my prayer. 20 Blessed be God, Who has not turned away my prayer, Nor His mercy from me!
Psalm 69:13 NKJV But as for me, my prayer is to You, O Lord, in the acceptable time; O God, in the multitude of Your mercy, Hear me in the truth of Your salvation.
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