Faecal Microbiota Transplantation (FMT)

What is faecal microbiota transplantation?

Faecal microbiota transplantation (FMT) is a procedure in which processed stool from a healthy donor is transferred into the bowel of a patient to help restore a healthy balance of gut bacteria.

The donor stool is sourced from BiomeBank or the Australian Red Cross, both of which are registered with the Therapeutic Goods Administration (TGA). Donor selection and screening is a rigorous process to ensure donors are healthy and free of identifiable transmissible infections.

When is FMT used?

FMT is used to treat recurrent or severe Clostridium difficile infection (CDI) that has not responded to standard antibiotic therapy.

Clostridium difficile (also known as C. difficile or C. diff) is a bacterium that can cause severe inflammation of the bowel. It typically occurs after antibiotic use, which can disrupt the normal gut microbiome and allow C. difficile to overgrow and cause infection.

Most people respond well to targeted antibiotic treatment. However, some experience multiple recurrences or more severe illness. In these cases, FMT is highly effective in re-establishing a healthy microbiome and resolving the infection.

How is FMT performed?

In my practice, FMT is delivered during a colonoscopy. While under sedation, the processed donor stool is introduced directly into the large bowel.

What are the risks?

FMT is generally considered safe and well-tolerated. Most side effects are minor and temporary, including:

  • Diarrhoea

  • Abdominal cramping

  • Low-grade fever

  • Bloating or flatulence

  • Constipation

Serious complications are extremely uncommon. Early issues with FMT were primarily related to inadequate donor screening, which is now a highly regulated and thorough process.

Long-term side effects have not been established, but no evidence of harm has been reported to date.