Fecal transplantation

Your digestive tract is home to a complex ecosystem of microorganisms, mostly bacteria, that we are only beginning to understand its large role in our immune system and inflammation. A healthy gut contains a balanced mixture of many organisms. When this ecosystem becomes unbalanced, some bacteria can grow out of control and make you sick.

Fecal transplantation (bacteriotherapy) is a treatment that involves putting another person’s healthy stool into your large intestine (colon). It’s also known as a stool transplant or fecal microbiota transplant (FMT). It’s most often used to treat recurrent Clostridium difficile (C. difficile or C. diff) infection, with a 90% or higher success rate. FMT restores healthy microbial communities in the colon that in turn fights off the C. difficile infection.

C. difficile infection means the environment in your intestine has become unhealthy and resistant to treatment. Fecal transplantation restores health to this environment by placing healthy donor stool in your intestine. Donors are carefully screened to make sure the stool you receive is healthy.

What to expect from fecal transplantation

Fecal transplantation is usually performed with a colonoscopy, and the prep for the procedure is the same as it is for a colonoscopy. You must clean out your colon beforehand, which involves eating no solid food the day before the procedure and only drinking clear liquids. After midnight the night before, you fast completely. You’ll also take a laxative in liquid or pill form the night before and possibly the morning of the exam, or give yourself an enema the night before or the morning of the procedure. This is all to clean out your colon. Your doctor might also recommend that you stop taking certain medications before the procedure.

During the procedure, you’ll be given a sedative via a needle in your arm (IV) to make sure you’re comfortable. Once you’re sedated, your doctor will insert a tube (colonoscope) into your rectum and into your colon. As the tube is withdrawn, the donor stool is inserted through the tube into your colon. You’ll need to recover from the sedation medication before you go home, and you'll need someone to accompany you to the procedure and drive you home as well.