Fecal Microbiota Transplant: Science & do-it-yourself Instructions for Chronic Disease (DIY FMT) by Anna Maria S ..... Fecal Transplant Therapy Do-It-Yourself Forum
Date: 8/2/2017 1:29:36 AM ( 6 years ago ago)
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Fecal Microbiota Transplant: Science & do-it-yourself Instructions for Chronic Disease (DIY FMT)
In this video I present: - The idea behind Fecal Microbiota Transplantation (FMT) - Science based considerations that help to plan and implement do-it-yourself FMT - A demo of the actual implementation Important Points: FMT, Fecal microbiota transplant. FMT is a therapy, where we take the stool of a healthy donor and transplant it into the GI tract of a patient. Goal of FMT is to correct a microbial dysbiosis in the GI tract. The acronym FMT is used for fecal microbiota transp/transplantation, for fecal microbiome transplant or for fecal matter transplant. Fresh fecal matter is composed of approx 75% water, 15-20% of food residues and toxins and 5-10% live microbial mass. It is the ultimate probiotic formula, by no of strains as well as by no of microbes per strain. Stool also contains SCFA, these molecules are the main source of energy for colonic cells. In current medical practice FMT is only employed for recurrent CDI. An infection that usually results from a generous use of ABX. FMT works by correcting bacterial dysbiosis. In research literature we find quite strong evidence (many studies) suggesting FMT can drastically improve and even resolve UC. Otherwise there are some pieces of evidence suggesting efficacy for other pathologies, documented mostly in case studies, case reports. Theoretically all conditions linked with a GI dysbiosis could benefit from FMT. As with most medical therapies there are desired and undesired effects with FMT as well. FMT is considered a low risk intervention, both in scientific literature and by todays medical practice. The majority of adverse events appear to be mild and of gastrointestinal nature. I have included a list here with the most commonly reported adverse events. More serious side effects have been reported but are rare, as examples I have listed weight gain and neuropathies. FMT can also trigger disease flares. Modalities: How long should your treatment last? The duration of an FMT therapy for other disease varies and depends on many factors. It is a good idea to start with what has worked for other patients. Experience with different autoimmune disease has shown how periodic top ups can help maintain a healthier microbiosis. Regarding route of administration if we look at data from C Diff, thus far we can say endoscopically performed FMT and self admin enemas have pretty much the same efficacy and are superior to nasogastric delivery. Comparing clinics performing FMT via enema and DIY applications at home I think we can say that clinics likely have an edge when it comes to experience as well as to donor selection, which makes them a better solution on the short term. If periodic top ups are necessary DIY is probably the better solution to adopt from the start. Comparing single vs multiple donors. In theory diversity in the GI microbial composition has found to be associated with a better disease resistance Comparing fresh with frozen stool: Same efficacy in C.Diff treatment. If used fresh than then the fresher the better, if used frozen freeze as soon and as cold as possible (-70/80° C) Regarding patient preparation: in theory a clean colon with a low bacterial load are advantageous to improve the chances of colonisation by the new microbes. Regarding donor preparation: A more diverse diet leads to a biodiverse microbiota, which we want. If the patient has strong intolerances, it makes sense to have the donor avoid or considerably reduce these foods (min 4d before treatment). FMT Steps: 1. Define/design the protocol: a. Prepare patient-donor agreement, questionnaire, test criteria 2. Find a suitable donor: . Questionnaire a. Sign agreement b. Blood and stool testing 3. Prepare for the therapy according to protocol: . Patient equipment, clean colon, reduce intestinal permeability, a. Donor equipment, diet b. Patient-donor logistics 4. Implement therapy 5. Maintenance phase
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