Fecal Microbiota Transplant (FMT): Bigger than you think

Fecal Microbiota Transplant (FMT) is a unique procedure in which stool from a healthy donor, containing a “good” microbiome, is placed in a patient - by colonoscopy, endoscopy, sigmoidoscopy, or enema. The success rate of this non-canonical and unique medical treatment for C. difficile is >90% with a single administration! In September 2013 the FDA began permitting its use as an experimental drug in cases where C. difficile infection fails to respond to antibiotic therapy. Today, there are multiple organizations routinely performing FMT to treat C. difficile infections, and there is a Fecal Transplant Foundation that is raising awareness of and supporting FMT in many ways, including continuous process optimization and standardization. There is a non-profit stool bank, OpenBiome, that collects fecal samples, screens them for parasites and pathogens, stores them at –80°C, and ships to hospitals on demand. Several companies are developing next-generation solutions – capsules loaded with bacteria derived from human stool, or mass produced in fermenters – that are intended to make the FMT technology more appealing and standardized. A number of ongoing clinical trials are using FMT to treat chronic diseases that may have their basis in microbiome imbalances and the body’s responses to them, such as ulcerative colitis, Crohn’s disease, obesity, metabolic syndrome, and type 2 diabetes mellitus. The use of FMT should be seen as a first iteration of therapeutic approaches aimed at adjusting the balance of gut microbiomes. The progress so far is truly impressive, and this technology – maybe in more “civilized” form – has tremendous potential. It makes sense to freeze a few stool samples, while you are still young, for the remote future. Just in case. As a backup, children can donate poop samples to their obese, or old and sick parents – to “reset” their microbiome and provide instant cure.