HF 7878

Fecal Microbiota Transplantation (FMT)

Fecal microbiota transplantation (FMT) treats clostridium difficile (C. diff.) infection. C. diff. is often caused by antibiotics that change the bacteria in the colon. Antibiotics kill off good bacteria and this allows the C. diff. bacteria to thrive. This causes severe diarrhea and may cause death if not treated. FMT transfers healthy stool and bacteria into your colon to help treat the infection.

Getting Ready

  • No antibiotics 2 days before FMT (vancomycin, metronidazole, or Flagyl®)

  • Clean bathrooms with bleach the morning of the FMT. This reduces risk of reinfection.

  • You will need a responsible adult to drive you home if your FMT is by colonoscopy, endoscopy, or sigmoidoscopy due to sedation medicines that are used. If you are not able to arrange this, we can reschedule your FMT.

  • If you are getting capsules or enemas, you do not need a driver.

  • A few days before the FMT buy your supplies. Only refer to instructions your doctor has chosen for you.

FMT by Enema Instructions

Supplies

1-Sodium phosphate enema (can be purchased at local drugstore)

Diet

No special diet needed.

Giving Yourself the Enema

Lay a towel on your bed to protect it. Lie on your bed on your left side, knees bent. Gently insert lubricated enema tip into your anal canal. It may go in easier if you bear down, like you are having a bowel movement. This helps relax the muscles. Squeeze the enema bottle to get the liquid into your rectum. Gently remove enema tip from your body. Hold the liquid in for 3-5 minutes. Use the bathroom. It is normal to have mild cramping or burning, it will go away with rest.

Day of FMT

Complete the bowel prep. Give yourself the enema 1-2 hours before you leave home.

Your Visit

It will take 2-3 hours. You may resume your normal routine and diet afterwards.

FMT by Capsule Instructions

Supplies

Stomach acid blocker medicine will be prescribed by your doctor. You will pick it up at the pharmacy and take as directed for 2 days before your FMT.

Please note: The FMT capsules are the size of a large vitamin. Let us know if you have problems swallowing.

Diet

The day before your FMT, no solid foods after midnight. You may have clear liquids only.

Day of FMT

Stop drinking liquids 2 hours before scheduled time to arrive.

Your Visit

It will take 30-90 minutes. You will not be able to eat or drink anything for one hour after your FMT. You may resume your normal routine.

FMT by Colonoscopy, Endoscopy or Sigmoidoscopy

Supplies

Bowel prep-as directed by your doctor (you will pick up supplies from pharmacy).

Going Home

You will need to arrange for a responsible adult to take you to and from the Digestive Health Center because of sedation medicines used.

Bowel Prep

Follow pharmacy mixing directions. Start drinking bowel prep at 6:00 pm the evening before your FMT. Prep will take 3-4 hours. Drink one 8-ounce glass every 15-20 minutes. Finish drinking the entire bottle of bowel prep before you go to sleep.

Diet

After you start your bowel prep eat no solid foods. You may have clear liquids.

Day of FMT

Stop drinking liquids 4 hours before scheduled arrival.

Your Visit

It will take about 3 hours. Diet and activity are restricted for 24 hours if you get sedation medicine.

After FMT

Side Effects

Recovery of fecal microbiota in your gut may cause symptoms such as (but not limited to)

  • Diarrhea

  • Abdominal pain

  • Bloating

  • Cramping and an urge to have a bowel movement

These symptoms are very common in the first several weeks after treatment and slowly resolve over 1-2 months.

Medicines

No antibiotics, unless ordered by your doctor.

Diet

Eat a bland diet at first. Avoid dairy, besides probiotic yogurt or kefir. Slowly begin your normal diet as you feel better.

Follow-up

We will call you to follow-up and see how you are feeling. Please contact us if you are having problems or have questions before hearing from us.

When to Call

  • Fever over 100.4°F, for 2 readings taken 4 hours apart

  • New or worse abdominal pain or cramping

  • Chills

  • New weakness or fatigue

  • Extreme bowel movement urgency and/or loose bowel movements

Who to Call

Less than 2 days after FMT:

UW Health Digestive Health Center
750 University Row
Madison, WI 53792
(608) 890-5010 or (855) 342-9900

More than 2 days after FMT:

UW Health Infectious Disease Clinic
600 Highland Ave.
Madison, WI 53792
(608) 263-0946 or (800) 323-8942