Fecal Microbial Transplants (FMTs)
Intestinal Microbiota Transplants (IMTs)

By Ross Pelton, RPh, PhD, CCN
Scientific Director, Essential Formulas

Fecal microbiota transplants (FMTs), also referred to as intestinal microbiota transplants (IMTs), have recently gained a great deal of interest. Some experts emphasize that “fecal transplant” is an inappropriate term for this procedure because it is the microbiota that is being transferred. Therefore, Intestinal Microbiota Transplants (IMTs) are correct, although FMT is still more commonly used.

The history of FMT was traced back to Chinese medical literature in the 4th century. In the United States, fecal microbial transplants were approved by the Food and Drug Administration (FDA) in 2013 for the treatment of resistant Clostridium difficile infections (RCDIs). Currently, treating patients with resistant Clostridium difficile (also known as C. diff) infections is the only FDA-approved use for FMTs.

Fecal microbiota transplantation is the administration of fecal matter from a donor into the intestinal tract of a recipient, which quickly changes the recipient’s gut microbial composition, resulting in a health benefit to the recipient. Preparation for the procedure involves mixing a stool sample with saline or water and then filtering it through gauze or a coffee filter. The solution is then administered into the colon as a rectal enema, or through a nasogastric tube. The solution can also be freeze-dried and then encapsulated and administered orally.

Many videos, blogs, articles, and discussions on Do-It-Yourself (DIY) fecal microbial transplants have been posted on the internet. However, DIY microbial transplants carry some risks such as infections and the transmission of drug-resistant organisms. Approved hospitals and clinics have strict guidelines for screening donors, consisting of an extensive questionnaire, a personal interview, and running laboratory tests on the prospective donor’s blood and stool sample.

What’s In Your Poop?
Human feces is about 75% water and 25% solids, but this can vary substantially from person to person. Fiber holds a substantial amount of water. Thus, the amount of dietary fiber is one variable that affects the water content of an individual’s stools.ⁱ An individual’s hydration level also affects the water content in their stools.

Studies have shown that about 50% of the solid content in stools consists of bacteria expelled from the colon.ⁱⁱ The remaining solid content in stools is a mixture of proteins, undigested fibers, fats, and hundreds of postbiotic metabolites produced during colonic fermentation.ⁱⁱⁱ

Effectiveness of Intestinal Microbiota Transplants for C. diff Infections
Intestinal microbiota transplants (IMTs) are very effective in treating recurrent Clostridium difficile infections. A study published in the highly respected New England Journal of Medicine reported that 13 of 16 patients (81%) were cured after a single transplant of donor feces. Several weeks later, 2 of the remaining three patients were cured after receiving a second infusion with feces from a different donor. Overall, FMT cured 15 of 16 patients (91%) in this clinical trial.^iv By comparison, resolution of C. difficile infection occurred in only 4 of 13 patients (31%) who were treated with the antibiotic vancomycin.

Dietary Causes of Dysbiosis
When probiotic bacteria are not fed well, they cannot grow and proliferate. This enables harmful bacteria to develop, which results in dysbiosis. There are two main “food groups” for your probiotic bacteria; dietary fibers and polyphenols. Unprocessed plant-based foods are the richest source of these compounds. However, data from the National Health and Nutrition Examination Survey (NHANES) revealed that 95% of American children and adults DO NOT consume the recommended daily fiber.^v Studies also report that Americans consume low levels of dietary polyphenols.^vi

There are currently over 204,000 fast-food restaurants in the United States, compared to the fact that there are only about 20,000 natural food grocery stores in the U.S. Also, sales of organically grown foods account for about 4% of total U.S. food sales. These statistics show how heavily Americans rely on processed foods that are low in fiber and polyphenol content, which contributes to dysbiosis.

Prevention of Clostridium difficile Infections
Clostridium difficile infections arise due to dysbiosis. Intestinal dysbiosis is now being recognized as the triggering factor of C. difficile infections.^vii We now understand that postbiotic metabolites play a critical role in regulating the microbiome ecosystem. Some of their essential functions include maintaining the optimal level of acidity, reducing inflammation, and directly killing pathogens.

Diet & Dr. Ohhira’s Probiotics
A plant-based diet provides the fibers and polyphenols that enable your probiotic bacteria to produce postbiotic metabolites, which are the compounds that regulate the microbiome ecosystem.

Each dose of Dr. Ohhira’s Probiotics directly delivers over 500 postbiotics into the intestinal microbiome. Hence, Dr. Ohhira’s Probiotics is like a powerful nutritional supplement for your microbiome because it supplies the postbiotic metabolites that help create and maintain a healthy microbiome.

NOTE: Essential Formulas, Incorporated does not recommend or promote the use of Fecal Microbial Transplants (FMTs). This article is for educational purposes only.