Fecal Transplants: What Are They and Do You Need One?

It may sound crazy, but another person’s poop could save your life. Fecal transplants have gained attention in recent years as an innovative and effective treatment for some gastrointestinal disorders, especially those caused by the deadly Clostridium difficile (C. diff.) bacteria.

With a high success rate, a fecal transplant is an excellent option if you have exhausted standard treatments.

Fecal Transplants Explained

To restore the balance of beneficial bacteria in your digestive tract, a fecal transplant — also known as fecal microbiota transplantation (FMT) — may be used to place a small amount of medically processed stool from a healthy donor into your colon. The healthy bacteria move into the gut to hopefully outcompete harmful bacteria, especially C. diff. To do this, your doctor will recommend one of these delivery routes:

• Colonoscopy: The donor stool is placed directly into your colon through a colonoscope
• Enema: Putting the stool into your rectum allows it to reach your lower colon
• Capsules: Healthy fecal matter is processed into capsules that you swallow

Are You a Candidate?

Fecal transplants primarily are used for patients who have experienced recurrent C. diff. infections that do not respond to standard treatments, such as antibiotics. There are no strict age limits for fecal transplants; both children and adults can be candidates if they meet the clinical criteria. A physician will carefully assess your health and history before recommending the procedure.

Understanding C. diff.

C. diff. is a type of bacteria that causes colitis (inflammation of the colon). It typically occurs after a patient has taken antibiotics, which can disrupt the natural balance of bacteria in the gut, allowing C. diff. to flourish. It also is linked to hospital stays, which can occur more frequently in colder months when infections and hospital admissions rise. C. diff. infections can range from mild to life-threatening, with severe cases leading to dehydration, hospitalization or even death if left untreated. Symptoms include:

• Severe diarrhea, often watery and frequent
• Abdominal pain or cramping
• Fever
• Nausea or loss of appetite
• Weight loss and dehydration (in severe cases)

C. diff. Prevention

C. diff. can be prevented, especially by following these important tips:

• Avoid unnecessary antibiotics because they disrupt gut flora and increase the risk of C. diff. Always follow your doctor’s advice and complete the full course of prescribed antibiotics
• Practice good hand washing with soap and water, especially in healthcare settings
• If you or a loved one is in the hospital, ensure healthcare providers follow infection control protocols, including wearing gloves and gowns
• C. diff. spores can survive on surfaces, so it's important to clean commonly touched areas with disinfectants that are effective against C. diff

Success of Fecal Transplants

Fecal transplants have a high success rate, with 85 percent to 90 percent of patients experiencing a full recovery. For those who do not respond initially, a second transplant may increase the success rate to nearly 98 percent. Patients typically experience relief from symptoms within a few days to a few weeks after the procedure. Given its effectiveness, FMT has become the treatment of choice for recurrent C. diff., with many patients achieving long-term remission of symptoms.

Alternatives to FMT

For those who are not candidates for FMT, alternatives include:

• Antibiotics: Standard treatments involve antibiotics like vancomycin or fidaxomicin, although recurrent infections can develop resistance
• Probiotics: These may be used to restore the balance of gut bacteria but are generally less effective than FMT
• Bezlotoxumab: A monoclonal antibody treatment that helps reduce the recurrence of C. diff. by neutralizing its toxins. It usually is used with antibiotics

The Future of Fecal Transplants

Healthcare providers are researching fecal transplants as possible treatments for many conditions, including:

• Inflammatory bowel disease (or IBD, including ulcerative colitis and Crohn’s disease)
• Irritable bowel syndrome (IBS)
• Obesity
• Liver disease
• Diabetes
• Food allergies
• Autism spectrum disorder (ASD)
• Anxiety disorders
• Depression
• Multiple sclerosis (MS)