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Questions on FMT research and procedures

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Questions on FMT research and procedures



My questions arise from past topics on this forum which are related to the procedure and the donor selection:

  1. The procedure. From the FMT articles I've read two steps are essential for the procedure to be really effective.
    1. Avoid mixing the transplant with gastric juices since benefficial bacteria can't survive the clorhidric acid in the stomach.
    2. Insertion of the transplant to the duodenum or jejunum to allow the spread of the bacteria to all sections of the small and large intestine.
  • In light of this information procedures involving transplants through colonoscopies or enemas will be lacking.
  • The best procedure I've seen in this section of the forums is Dr. Thomas Louie's, from Calgary Foothills Hospital who successfully has developed a triple layered pill which manages to resist gastric juices and release the transplant to the mid gut. I've read in another message that there's already people making their own pills at home so my questions are:
  • How can I do it myself? Is enough to avoid gastric juices to buy three different calibers of gelatin capsules and insert them one into another? How can I know the pill will disintegrate just in the mid gut, not before, not later? Is a centrifugation and testing method needed to separate the beneficial bacteria from the pathogenic microorganisms that can be present in a donor's stool? Is there any way to do it at home? Thinking about a method to kill pathogens and leave the beneficial flora unharmed I remember dioxine chloride, a very soft bleach, which has been used for many years to produce drinkable water and disinfect stored foods. FDA studies show that it has enough potency to kill anaerobic organisms (which are mostly pathogens) but not enough potency to kill aerobic bacteria. Do you think this could be an option to ensure the safety of a donor's sample?
  • If pills are not an option how can I find some doctor or gastroenterologist willing to do a gastroduodenal tube FMT? Is a procedure that can be learned so it can be applied at home if no professional in my country considers FMT a valid therapy and opposes to do such procedure?
  1. My second question is related to donor selection. Another message on this forum tells how gut microbiota never recovers from antibiotic damage so an adult who has received 10-20 courses of antibiotics will have a poorer flora than a child who has received none.
    • For a donor I'm thinking about my older brother who although he has received many courses of antibiotics in his life (today doctors prescribe antibiotics like candies) has an outstanding gut health. I can remember he's got gut issues once or twice in his life and just a short diarrhea. He always, time after time, kept normal and healthy when the rest of the family got stomach sick when we all ate some food that got us sick or caught an intestinal virus.
    • His drawbacks as a donor are, by what he manages to remember, (wish I could see his medical file) as his doctors diagnosed it, a constitutional candidiasis,  since he was 15 y.o., now he's 37. "Constitutional" I imagine must be another word to avoid saying "idiopathic". This candida has occasional flares in summer in his mouth, hands and feet but as he has grown older the flares have gradually decreased in intensity and frequency. Another drawback is the contraction of a virus when he was a teen which affected his facial nerves paralizing half his face for a period of time. He was treated with what he remembers as a white "powder" and "tablets" which I guess were antibiotics and he recovered in a month or so.

Thanks in advance to all those who take the time and effort to share some knowledge and answers to my questions.


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