FMT (fecal microbiota transplantation) is a procedure used to treat Clostridium Difficile (C. Diff). C. Diff is a bacterium that can cause serious and debilitating inflammation of the colon. Patients can experience chronic diarrhea, dehydration, abdominal pain, and weight loss. It is estimated that over 30,000 Americans die every year as a result of this disease. This infection can come back even after one treats it successfully.

We know that an altered intestinal microbiota is the main factor that causes recurrent C. Diff colitis and that the intestinal bacteria probably play a role in a number of other gastrointestinal and metabolic diseases.

Fecal Microbiota Transplant (FMT) is the term used when stool is taken from a healthy person and put into a sick person to cure a certain disease. We believe that reintroduction of normal flora via donor feces corrects the imbalance and enables recovery of normal bowel function. This contrasts with the chronic use of antibiotics, which perpetuates the very condition that lead to the initial episode of CDI, namely an altered intestinal microbiome.

This procedure is highly effective, with cure rates approaching 90-95%. The selection of a fecal transplant donor is very important to ensure both the effectiveness and safety of the transplant. I require the potential donors have an extensive screening to prevent transmission of infections, and I interview them to ensure they have excellent health. 

The specimen (a fecal suspension prepared at our surgical center) is administered through colonoscopy. From the point of view of the patient, this is very much like having a regular colonoscopy: the prep (everybody’s least favorite aspect of a colonoscopy) is the same. For the procedure you are fully asleep: you receive deep sedation and an anesthesiologist monitors you while I infuse the suspension in the colon.

Following the procedure I ask patients to follow a special diet for the first couple of weeks after the transplant.

Caterina Oneto, MD

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