Considering FMT? Here’s Everything You Need to Know

Fecal Microbiota Transplantation (FMT) is used to restore gut bacteria back to their normal density and diversity to aid optimal gut functionality. The Taymount Clinic in the UK started performing FMT treatments in 2009 using a very specific methodology and a minimally invasive procedure. Over the past eight years, they’ve conducted 20,000 procedures and patients have experienced remarkable results.

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Fecal Microbiota Transplantation (FMT) is used to restore gut bacteria back to their normal density and diversity to aid optimal gut functionality. It is the process of implanting beneficial intestinal bacteria and yeasts from a healthy donor into the colon of a person who is lacking the essential gut microflora they need for their digestive system to function properly.

What is a Fecal/Faecal Microbiota Transplant used for?

There are two areas where FMT may be of interest:

  • Recurrent Clostridium difficile infection
  • Non-responsive or managed-gastrointestinal or neurological conditions

FMT has been shown to be over 90% effective in treating the C.difficile infection in patients who had failed to respond to antibiotic treatment. In addition, academic and medical research indicates that gut bacteria may play a significant part in alleviating the symptoms of:

  • Inflammatory Bowel Diseases (Crohn’s Disease & Ulcerative Colitis)
  • Constipation
  • Chronic Diarrhea
  • Irritable Bowel Syndrome – IBS (Post-Infectious, Post-Antibiotic)
  • Neurological conditions such as:
    • ME (Myalgic Encephalopathy)
    • CFS (Chronic Fatigue Syndrome)
    • MS (Multiple Sclerosis)
    • Parkinson’s Disease

Clinical studies supporting FMT in specific conditions:

  • IBD (inflammatory bowel disease) – study showed 45% remission rate from FMT

A study was published recently including 406 cases broken down by disease type. Results showed the following:

  • diff – 85% cure rate, 95% improvement rate; excellent results
  • Constipation – 40% cure rate, 67% improvement rate
  • UC – 34% cure rate, 68% improvement rate
  • Crohn’s – 30% cure rate, 60% improvement rate
  • IBS – 46% cure rate, 73% improvement rate

This study did not find a significant difference between the three routes of administration, which were naso-intestinal tube, FMT capsule, or colonoscopy.

The Taymount Clinic in the UK started performing FMT treatments in 2009 using a very specific methodology and a minimally invasive procedure. Over the past eight years, they’ve conducted 20,000 procedures and patients have experienced remarkable results.
Patients treated at Taymount for C. diff have 100% cure rate, and this is due to Taymount’s special methodology. Patients with C. diff are treated with five implants on five different days using samples from five different donors. It’s been shown that the more diverse your gut microbiome is, the less likely you will succumb to C. diff. Therefore, diversity from different donors is key.

In conditions such as IBD, about 1/3 of Taymount patients experience rapid resolution, 1/3 experience partial, satisfactory resolution, and 1/3 experience resistance (no improvement).

FMT Methodology

Non-C. diff patients undergo 10 different treatments, on 10 different days, using samples from 10 different donors.

Providing the best possible implants is a big part of the work at the Taymount Clinic. The process starts with a healthy donor. Taymount tests their donors thoroughly and screens for a wide range of diseases.

They advise them on diet and monitor it closely to ensure that their gut contains the optimum range of microbiota. Many of the microbiota important to good gut health have a limited lifespan when exposed to oxygen or other environmental factors, so they collect the donor material under deoxygenated conditions and transport it back to the lab in an insulated container along with a sterile saline solution.

Once back in the lab, the stool sample is processed at a controlled temperature and nitrogen-rich environment to separate the microbiota from the food waste element. All food particles, hormones, and toxins are removed.

Then they make up the implants, which are placed into fast-freeze under lab conditions for later use. The samples are stored until they have re-tested the donors to ensure the continuing safety and quality of the implants.

When the patient is ready to receive the implant, they deliver the sample via a small rectal catheter. This is much safer and less invasive than colonoscopy or naso-gastric tube. They allow 1 hour for each transplant.

It’s important to consider the type to donor implant being used. Some methodologies use fresh stool, which can have some negative effects. Even asymptomatic donors could be carrying something very pathogenic that would be harmful to an immuno-comprised patient.

Taymount quarantines their implants for at least 3 months in ultra-deep-freeze to make sure the donors clear two tests done three months apart to ensure nothing is incubating that may later appear.

Patient safety

Taymount does not use fresh FMT donor material. There are some pathogens and conditions that are not detectable by test at an early stage of their infection, for example Hepatitis. It is therefore vitally important to quarantine under deep freeze conditions all material for a minimum of three months to allow any latent disease to reveal itself.

Implants

Taymount does not deliver implants of whole stool; they use only the vital preserved microbial content of the donor stool, not the donor’s food (which the recipient may be allergic too), epithelial cells, hormones, or excreted toxins. They take a safety aliquot (a sample) from every single implant and store it in their deep freezers at -80ºC for a period of time, which allows for subsequent testing should the need arise.

Donor Testing Process

Taymount banks implants taken from regularly screened donors who have undergone a full detailed list of laboratory tests every 3 months. All donors are required to follow a high-nutrient, probiotic, and pre-biotic rich diet. All are non-smokers, with a slim body disposition, free from mental illness, have a well-functioning digestive system, and with no antibiotics in their recent history.

In addition to screening for diseases and undesirable pathogens, their stool testing by DNA PCR reveals the gut flora profile, so they can see if the required microbiota is ideal or needs optimizing. This ensures that the implant is of the highest quality and most beneficial to the recipient.

To learn more about FMT at the Taymount Clinic, check out our podcast with the founder, Glenn Taylor, here.


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What do you think? I would like to hear your thoughts or experience with this.

Dr. Ruscio is your leading functional and integrative doctor specializing in gut related disorders such as SIBO, leaky gut, Celiac, IBS and in thyroid disorders such as hypothyroid and hyperthyroid. For more information on how to become a patient, please contact our office. Serving the San Francisco bay area and distance patients via phone and Skype.

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