Faecal Microbiota Transplantation (also known as ‘FMT’ or a stool transplant) is a treatment used to restore a healthy balance of bacteria into the gut of a person suffering from a disease or infection associated with bacterial imbalances.
The healthy bacteria contained within the transferred faecal material repopulates the bowel of the recipient and restores the imbalance. This can be carried out using a number of methods such as capsule, rectal enema, colonoscopy, nasogastric tube and nasoduodenal tube.
FMT is only licensed for use in the UK in patients suffering from an infection of the bowel caused by a bacterium called C.difficile (C.diff). The mainstay of treatment for C.diff infection involves rehydration therapy and antibiotics. In the majority of patients this is effective, however, the infection recurs in 25-30% of patients and further antibiotic therapy gives diminishing rates of cure.
FMT has been shown to be the most successful treatment for recurrent C.diff infection, with primary cure rates of between 81-94% reported in the medical and scientific literature.
There are trials investigating the use of FMT in patients with other conditions such as Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Disease (IBD) however, further research is needed before FMT becomes a licensed treatment option in these patients.
While the exact mechanism is still unclear, FMT is thought to work by re-populating the gut of the recipient with healthy bacteria from the donated faecal sample.
FMT is thought to be a safe, effective treatment for patients with rCDI. At present, there have been no reports of the transmission of infection through FMT. The donor providing the stool sample undergoes extensive screening in order to assess their suitability.
One difficulty is that because there is no national donor registry, it can be hard to source suitable donors to donate samples for the treatment. A further difficulty is that doctors often have to process the samples themselves, which is time consuming and inconvenient. Ultimately, the costs and logistical factors associated with doctor sourced donors critically limits access to FMT for patients.