Fecal matter transplant

A fecal matter transplant or fecal microbiota transplant (FMT) is a therapy that involves the transfer of fecal waste from a healthy donor to the colon of a patient. At present, in the U.S., fecal matter transplant is regulated by the FDA and is only approved for use in severe or reoccurring c. difficile infections. In the UK, some clinics, such as the Taymount Clinic offer FMT for a wide range of GI and chronic illnesses.

The FDA regulation hasn't stopped people with other illnesses, especially GI illnesses, such as ulcerative colitis or irritable bowel syndrome, from experimenting on their own with FMT. Recipes for do-it-yourself FMT are abundant online, including Dr. Sarah Myhill's protocol, Probiotic Therapy Home Infusion Protocol.

Methods
Fecal matter from a person with healthy gut flora is mixed with saline, strained, inserted into the patient with Clostridium difficile colitis via a colonoscopy, endoscopy, sigmoidoscopy, or enema in order to recolonize the ill person's bowels. It is recommended that the donor be someone close to the patient, with the first choice being a spouse or significant other, but other close friends, relatives, or a “universal donor” source may be warranted. The physician should ensure that the “universal donor” source employs rigorous screening and testing standards. Testing includes screening the donors’ blood for diseases like HIV and hepatitis and testing their stool for bacterial pathogens, giardia and cryptosporidium, parasites, and C. difficile.

Chronic fatigue syndrome
Much discussion has been on the topic of microbiome health and its relationship to ME/CFS. This discussion has included FMT.

In 2012, in Australia, a study using a combination of fecal matter transplants and an oral course of cultured bacteria reported a high rate of CFS improvement: "Bacteriotherapy achieves initial success rate of 70% in CFS and a 58% sustained response. Given that manipulation of the colonic microbiota improved CFS symptoms, bacteriotherapy for CFS warrants further investigation and may provide further insight into a possible etiology of CFS."Journal of the Australasian College of Nutritional and Environmental Medicine, Vol. 31, No. 3, Dec 2012: 3-8. This study has not been replicated.

Though the topic is reported sporadically on ME/CFS forums, no other studies for FMT and ME/CFS have been cited except the 2012 one cited above.

Learn more

 * 2012, The GI Microbiome and its Role in Chronic Fatigue Syndrome: A Summary of Bacteriotherapy (Thomas J. Borody, Anna Nowak, Sarah Finalayson)