Fecal transplant, also called fecal microbiota transplant (FMT), is used to treat an infection in the large bowel (colon) caused by bacteria called Clostridioides difficile. You may also hear this infection called C. diff. Older people who are in the hospital have a higher risk of getting C. diff. That’s because their ability to fight off germs is lower. But people who haven’t been in the hospital can sometimes get it, too. This is called community-acquired C. diff. A fecal transplant may be used when this infection happens over and over again and is severe.
Normally, your large bowel has bacteria living in it. These bacteria are both good and bad.
So what happens? When you get medicines (antibiotics) for another infection, the medicine helps kill the bacteria causing the infection. But the medicines also kill some of the good bacteria. This changes the balance of the bacteria in your large bowel. With less good bacteria, the bad bacteria grow and take over.
A fecal transplant is done to get the good bacteria in your large bowel back in balance. A bowel movement (stool) from a healthy donor has the right balance of good and bad bacteria. This means that there are more good bacteria than bad. This donor stool is then given to the person with the infection. As a result, there are more good bacteria to offset the bad. This gets the balance back to what it should be.
Before a fecal transplant can be done, the bowel movement from a donor is tested to make sure that it’s free of infection. The sample is then made into a form to be used for treatment. Before you start the fecal transplant procedure, you must sign an informed consent. Signing this document means you understand the risks and benefits of the transplant, other available treatments, and your questions were answered. Be certain to get answers to all your questions before you sign.
The fecal transplant can be swallowed as capsules or given in a colonoscopy or special enema. The sample can also be given through a tube placed in the nose and into the small intestine. You and your healthcare provider will talk about the transplant and decide which method will work best for you.
Here’s a general look at what happens with a fecal transplant. Follow your healthcare provider’s specific instructions. Your healthcare provider may do the following:
Once the procedure is done, you can go home. You may need to have more than 1 treatment as an enema or through the tube over several days.
The risks of fecal transplant are most often mild and last only a short time. These may include:
Other more serious risks may happen. These are often linked to how the transplant was done, such as a colonoscopy. The risks may include:
After the procedure, call your healthcare provider if you have: