Fecal Microbiota Transplantation (FMT)

The Ertan Digestive Disease Center at Memorial Hermann-Texas Medical Center offers fecal microbiota transplantation (FMT) for patients with recurrent C. difficile (clostridium difficile bacterium) infection.

Offered in cooperation with the School of Public Health at The University of Texas Health Science Center at Houston (UTHealth), the FMT program is part of an Institutional Review Board (IRB)-approved protocol for treatment of C. difficile infection. It is the only one in Texas.

To be eligible for FMT, patients must have three documented episodes where stool tests positive for C. difficile. FMT has been shown to be approximately 90 percent effective in treating cases of C. difficile that have not responded to other treatments.

What Is C. Difficile?

C. difficile is one of the nearly 1,000 species of micro-organisms that inhabit the gastro-intestinal (GI) tract. Most are harmless; many are necessary for good gastrointestinal (GI) health. An infection occurs when beneficial bacteria are outnumbered by C. difficile, causing serious intestinal problems, including chronic diarrhea and colitis. Symptoms can include:

• Watery diarrhea
• Fever
• Appetite loss
• Nausea

Patients can develop a C. difficile infection in one of several ways, most often:

• When they have been treated with antibiotics, which eliminate beneficial bacteria in the GI tract.
• In a setting, such as a hospital or long-term care facility, where broad-spectrum antibiotics are commonly administered for extended periods of time.

A patient who is approved for FMT is screened for and must be clear of these infections:

• Hepatitis A, B and C
• HIV 1 and 2
• HTLV 1 and 2
• Syphilis

Then, the recipient is scheduled for a colonoscopy to be performed after he or she has been off of antibiotics for one week. Preparation for the outpatient procedure is the same as for a standard colonoscopy. During the FMT, the recipient is given up to 500cc of a fluid carefully prepared from stool collected from a healthy donor.

Transplant donors are usually volunteers at UTHealth who have been pre-screened for the diseases listed above, as well as C. difficile, parasites and bacteria (including E. coli O157:H7) in the stool. A recipient may select his or her own donor; however, the cost of testing for an outside donor is the responsibility of the recipient.

Recipients are tested at one-week and one-month intervals after the procedure. The FMT can be repeated if the transplant has not been successful in restoring the bacteria to the intestine.