What is Fecal Microbiota Transplant?
Our body is composed by 10% of our own cells and 90% of cells from bacteria, viruses and fungus that live in and on our body. Without these symbiotic organisms, we would be sick and unable to perform most of our basic functions. Most of these bacteria live in our gastrointestinal (GI) tract, mainly in the terminal portion of the gut: the colon.
Fecal transplant involves processing and ultra-filtering stool from a healthy person, and transferring this concentration of pure bacteria into a person suffering from conditions caused by deranged microbial compositions in great need of the necessary “good” bacteria. The bacteria from the healthy donor then begins to displace and replace the previous population in the patient’s colon, bringing balance to the universe that lives there.
What causes microbiome imbalance?
Our GI tract contains thousands of different bacteria and other microorganisms which are essential to our health. Antibiotics, poor diet, radiation, chemotherapy, and other environmental toxins can disrupt the microbiome balance and allow various diseases to flourish.
What conditions are treated with FMT?
The conditions below are the primary ailments for which patients seek treatment with FMT. Additionally, there are many more that are being researched by the world’s most prestigious medical organizations. Research is constantly uncovering new areas where a balanced microbiome plays an important role in our health.
Our main objective is to treat diseases with a strong inflammatory component in the digestive system, but often IBD cases come hand-in-hand with other diseases such as gluten sensitivity, uveitis, rheumatoid arthritis, spondylitis, food intolerance, multiple sclerosis, autism, and many more.
We also work with a group of consultants in areas such as pediatrics, ophthalmology, ORL, surgery, infectious disease, and neurology who actively intervene whenever they are needed.
- Uncontrolled overgrowth of bacteria called Clostridium difficile infection (C. diff.)
- Diabetes Type 2
- Crohn´s disease
- Ulcerative colitis
- Irritable bowel syndrome
- Celiac disease
- Food intolerance/allergy
- Chronic diarrheas of different origins
- Chronic constipation
- Psoriasis and other dermal diseases
- Multiple sclerosis
Am I a candidate for the fecal transplant procedure?
Every potential patient at Newbery Medicine receives personal consultation from members of the Medical Team. Although we have treated patients of all ages and would consider many conditions, we thoroughly evaluate each patient to ensure that our treatment will benefit their illness. This protects the best interests of our patients since our mission is to manage their expectations and optimize their health.
How is the transplant performed?
Healthy stool is mixed with saline solution and then ultra-filtered to extract everything except the microorganisms. The transplant is administered by our trained team of professionals via enema with a special syringe and catheter. The enema is then retained for minimum of 20 minutes while the patient relaxes in their private procedure room.
We use carefully screened and handled fresh or frozen stool specimens for treatments at Newbery Medicine to produce the best results. We have a supply of frozen specimens which we use for patients in maintenance, for back up or at-home treatment.
Newbery Medicine firmly believes in the lower intestine approach and does not use the “top down” (nasogastric implants) as in our experience this might convey serious risks to the recipient.
How are Newbery Medicine’s donors screened?
Newbery Medicine uses a select few donors who have been rigorously tested and whose bacteria have been shown successful in treating patients. Donors are regularly re-screened and checked to help insure the quality of the samples.
The typical donor profile is someone in good health who has not taken antibiotics for at least 90 days. The donor is usually a young person, physically active, slim, with normal bowel functions and without any history of inflammatory ailments. Newbery Medicine has strong relationships with its donors who are committed to the health of our patients.
Donors complete a screening questionnaire similar to that which is done at blood banks and for organ or tissue transplants. Prospective donors with risk factors for HIV and viral hepatitis are excluded from donating. Persons with gastrointestinal or autoimmune disease or a history of malignancy are not acceptable donors. Donors who meet the criteria undergo blood work testing for HIV, hepatitis A, B and C, and syphilis. They are also tested for bad bacteria such as salmonella, parasites, and clostridium difficile, and also for parasites in their stool.
How safe is FMT?
To date, there have not been any documented cases of infection transmitted through fecal transplant. That being said, fecal matter is a “bodily fluid” and proper donor screening and testing is essential.
Donors undergo a thorough screening (as described above) to best insure the quality of the samples. Any donor failing any part of our rigorous requirements is rejected.
While we work to insure quality and safety, no level of screening is perfect, so patients are asked to sign a consent form acknowledging the risks of undergoing the procedure as well as theoretical risks related to the fecal transplant itself (infection, allergic or immune reaction, or other disease transmissions).
What is the success rate?
FMT is on the cutting edge of medical treatment and as such there have not been many controlled clinical studies on FMT. Therefore the medical community is still awaiting final results. However, in the experience of the centers that are using this treatment, most patients treated improve their quality of life and most symptoms tend to meliorate. In the experience of Newbery Medicine, which has been performing FMTs for over three years, we have seen an approximate 70% rate of patients achieving significant improvement.
What is the process for booking a Medical/FMT treatment at Newbery Medicine?
Initially, we arrange a medical consultation to review your particular case. Our philosophy is to consider every case from an individual perspective to offer you the best treatment options. Although FMT treatments are very safe, we understand there are specific indications for FMTs, so we want to make sure your case will benefit from this advanced treatment.
Consultations are done by Skyp. To arrange your consultation, please get in touch with our Coordinator at email@example.com and you will receive a prompt response to your questions.
After considering your particular situation we will proceed to send you a treatment plan along with a definite budget.
How long has Newbery been performing FMTs? What is the medical background of the staff?
Newbery Medicine’s team of medical professionals collectively have decades of experience in FMT, bacteriology, and infectious disease control. The team formally started doing FMTs at Newbery Medical in January 2014. Our team has extended experience in Internal Medicine, a bacteriologist with an advanced degree and an Infection Control specialist that supervises the overall treatment program.
What is the Newbery Medicine clinic like?
It is a very modern facility, entirely designed to accomplish all the necessary processes to administer FMTs.
What is the treatment cost?
The treatment cost is based on the individual needs of every patient. We do not offer a standard treatment as we understand every case is different and need to be tailored to every particular situation. After learning about the case through an individual interview with one of our physicians, we would offer the patient a treatment plan along with a tentative budget.
How is your treatment center different than others who do FMT?
We are a science based group with a background of decades of medical experience. We discovered that FMT can be a very powerful and successful therapy after developing an effective preparatory protocol prior to implantation. Without proper preparation, FMT practitioners saw serious reactions to implantation including the reactivation of the underlying disease. For that reason, we follow a strict protocol with every patient receiving FMTs.
We have developed a highly sophisticated bacteria bank carefully supervised by our bacteriologist and our director whose has decades of experience in infectious diseases. Fecal bacteria are very delicate to manipulate as they come from a dark, humid and non-oxygenated environment to a richly oxygenated, dry and light-filled world. For that reason every step in the process should be highly studied and controlled to get the best results.
What kind of preparation do you recommend before proceeding with FMTs? Should I use antibiotics, purge, cleansing?
We see the gut environment as a very complex and delicate ecosystem which can’t be violently disrupted without the risk of serious consequences. When we receive a patient with inflammatory issues, we know they have an abnormal microbiota composition, that their “organ” is deeply unbalanced. We believe that, although the patient´s gut is not perfect, we should not make it worse by “cleaning” it with antibiotics, enemas or any other disturbance of the original atmosphere. By using any of the mentioned “cleaning” methods we create a harsh environment for the new bacteria making the proliferation of life almost impossible.
The new microbiota which will arrive via FMT need the best conditions to engraft and survive. This means food, humidity and temperature. We may plant the best seed in the world but if the soil is not the proper one, no plant will grow from it.
For those who cannot travel to your location, do you ship fecal implants for self administration?
Initially we did advise some patients from a distance, but we quickly discovered that nothing can replace a face-to-face consultation or physical examination. An initial Skype interview is required for us to start learning about a person and for you to learn about us.
We do not provide the bacteria specimens to people who have not been previously treat at Newbery Medicine in-person.
Are there things that patients can do to increase their success?
We are immersed in an ocean of threats to our health every day. In theory, we should avoid potential contamination as much as posible. This includes WiFi, nuclear radiation, processed food, vaccines, useless medications, nonsense vitamins and supplements, fluoride in the water and in toothpaste, mercury, asbestos, etc.
Eat food—real food—locally produced without chemical interventions, properly cooked or fermented. This is the best source of nutrients and energy for our general health.
We have to understand that FMT is a long-term therapy used to treat chronic conditions; it needs to be maintained without interruption just as an IBD case that responds to a medication like Remicade needs a maintenance dose for a long period of time. It’s the same situation for a UC patient who responds to FMT; they will require a maintenance dose every two to four weeks. Under these conditions, we have seen patients who have been in remission for almost three years and are able to control the inflammation and return to a normal life.