Fecal Transplant

What is Fecal Transplant

Fecal transplant (fecal microbiota transplantation, or FMT) is a procedure to replace helpful bacteria in your gastrointestinal (GI) tract. The procedure may be done if the bacteria in your GI tract have gotten out of balance.

This can occur after you take antibiotic medicine because this medicine may destroy helpful bacteria as well as the harmful bacteria that cause infection. This imbalance can allow the harmful bacteria to overgrow.

Putting helpful bacteria into your body can restore the balance.

You may need this procedure if:

  • You have an infection caused by a type of bacteria called Clostridium difficile(C. difficile) and other treatments have not helped.
  • You have a C. difficileinfection that occurs repeatedly.

For this procedure, your health care provider uses a solution made from the stool sample (fecal matter) of a healthy donor. Donors are thoroughly screened and tested before providing a sample to be used in a fecal transplant. The sample is mixed with saline or another type of solution (infusion) before it is put into your body. During the procedure, the sample may be placed in:

  • The last part of your lower intestine (colon). This may be done using a thin, flexible tube inserted into your anus (colonoscopeor sigmoidoscope) or using a bulb syringe (enema).
  • Your upper GI tract. This may be done using a thin, flexible tube (nasogastric tubeor endoscope) inserted through your nose or mouth. It can sometimes be done by having you swallow specially designed capsules.

Tell a health care provider about:

  • Any bowel problems you have had.
  • Any allergies you have.
  • All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
  • Any problems you or family members have had with anesthetic medicines.
  • Any blood disorders you have.
  • Any surgeries you have had.
  • Any medical conditions you have.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

  • Infection.
  • Bleeding in the GI tract.
  • Allergic reactions to medicines.
  • Abdominal pain.
  • Gas or bloating.
  • Nausea or vomiting.
  • Sore throat from a nasogastric (NG) tube or endoscope.

What happens before the procedure?

  • Ask your health care provider about:
    • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
    • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood.Do nottake these medicines before your procedure if your health care provider instructs you not to.
  • Follow instructions from your health care provider about eating or drinking restrictions.
  • You may be asked to take a laxative or use an enema before the procedure (bowel prep).
  • Plan to have someone take you home from the hospital or clinic.
  • If you will be going home right after the procedure, plan to have someone with you for 24 hours.

What happens during the procedure?

This procedure may vary among health care providers and hospitals. You may be given a medicine to help you relax (sedative). The fecal solution can be placed using any of the following methods.

Colonoscopy or sigmoidoscopy

Your health care provider will insert the colonoscope or sigmoidoscope into your anus and advance it into your colon to place the solution. The scope may be flushed with saline solution. This may be repeated until enough of the solution is properly placed in your colon.

NG tube insertion or endoscopy

  • Your health care provider will insert the NG tube through your nose or insert the endoscope through your mouth. The tube or scope will be advanced down through your stomach to your small intestines. If an NG tube is being used, an X-ray may be done to confirm that the tube is in the right place.
  • The solution will be given through the NG tube or endoscope.
  • The tube or scope may be flushed with saline solution.

Enema

Your health care provider will insert a syringe into your rectum to deliver the fecal solution.

What happens after the procedure?

  • Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored often until the medicines you were given have worn off.
  • Do not drive for 24 hours if you received a sedative.

Fecal Transplant, Care After

These instructions provide you with information about caring for yourself after your procedure. Your health care provider may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.

What can I expect after the procedure?

After the procedure, it is common to have:

  • Abdominal pain or cramping.
  • Gas or bloating.
  • Sore throat if your procedure involved a tube being placed in your throat.

Follow these instructions at home:

Medicines

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Avoid taking antibiotic medicines for as long as possible after the procedure.

General instructions

  • If told by your health care provider, try to not have a bowel movement for as long as possible after the procedure.
  • Follow instructions from your health care provider about eating or drinking restrictions.
    • Eat soft, easy-to-digest foods for the first 24 hours.
  • Do notdrive for 24 hours if you received a medicine to help you relax (sedative).
  • Rest as told by your health care provider.
  • Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
  • Clean surfaces at home with bleach to remove spores that can cause another infection.
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

  • Your symptoms do not improve after several hours.
  • Your symptoms get worse.
  • You have a fever.
  • You feel dizzy or weak.

Get help right away if:

  • You cannot eat or drink without vomiting.
  • You have bloody stool or you are bleeding from your anus.
  • You have severe abdominal pain.
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