Fecal Transplant: A Breakthrough Treatment for IBS?

I remember when I first heard about fecal transplants. I was driving home from work and listening to a segment on NPR about them. An older woman who got very sick with some sort of infection that she had to treat with really strong antibiotics, had long-term adverse effects on her GI tract as a result. She had constant diarrhea and lost weight. She decided to enroll in a trial to get a fecal transplant. Afterward, she noticed an immediate improvement in her gut issues, to the point where she deemed it a full-scale reversal of her symptoms.

I remember listening to the segment with rapt attention, equal parts appalled and envious. Admittedly, it sounded gross. Why would I ever want someone else's fecal matter implanted in me? The ick factor of the idea was very high. But I had to admit when I considered what it was like for me in the days when my IBS was at its absolute worst, wreaking utter havoc on my life. I would have tried almost anything to get it under control, including something like this.

What is fecal microbiota transplant?

A fecal transplant, or to be more exact, a fecal microbiota transplant (FMT) is more or less what it sounds like. It's when the stool of a healthy donor is distilled and then transferred into the colon and intestines of another patient often suffering from a GI-related disorder like IBS. The premise of it is that IBS and other gut-related problems often stem from a (sometimes severe) disruption in the microbiome of the gut. This is why many IBS patients, including myself, do well on a high-quality probiotic regimen. In my case, I need to take probiotics daily to deter regular IBS outbreaks.

But for some IBS patients, probiotics do not go far enough to restore the balance of the flora in their gut and they continue to suffer from symptoms. This is where a fecal transplant may be helpful instead because the natural healthy flora composition of someone else's gut is being transferred directly into the gut of a sick patient.

But does the science support it as a viable alternative for alleviating IBS symptoms in patients with severe cases? Well, there have been some studies with promising results, but with some major caveats.

Research on fecal microbiota transplant and IBS

For instance, a study published in 2017 in the World Journal of Gastroenterology was a meta-analysis that reviewed existing papers and cases. Of the 48 patients evaluated in these works, treatment revealed an improvement in more than half (58 percent) of them.¹

Another study from The Lancet: Gastroenterology and Hepatology was conducted to determine whether FMT is effective in patients with moderate-to-severe IBS. The good news? The patients who had FMT experienced a significant improvement in IBS symptoms up to and after 3 months subsequent to the procedure. The bad news? These improvements didn't last more than a year (and many even fell short of a year).² So in other words, the improvements – while significant – were short-term. It's been suggested longer-term improvements will be more likely when the implantation process is upgraded in a way that lets the patient retain the benefits of it.

The future of fecal microbiota transplant

So, it seems that FMT – while promising for treating IBS – may still have some kinks to be worked out to have enduring benefits. In the meantime, most IBS patients will have to do their best to work with the options offered to them elsewhere through modalities like diet, prescription medication, and holistic treatments.

I've been fortunate that through diet, supplementation (especially of probiotics and soluble fiber), and some other methods, I mostly have my IBS under control nowadays. But others have not been so fortunate. I hope that treatments such as FMT become viable options one day for those where other treatments and management options they tried have failed or fallen short.