Frequently Asked Questions
Click below to learn the answers to common questions about FMT
What is FMT?
FMT stands for Fecal Microbiota Transplant. It’s a microbial therapy that delivers stool from a healthy person into the colon of a sick person. This procedure creates a healthy balance of bacteria within the sick person’s colon, allowing for them to get better.
For more detailed information, check out our What is FMT page.
What is C.diff?
C.diff, or Clostridium difficile, is an opportunistic infectious bacteria that causes severe diarrhea. Other symptoms include abdominal pain or discomfort and fever. This infection can result in dehydration, toxic megacolon, septicemia, and death. Current treatment requires antibiotic therapy, but antibiotic-resistant strains of C.diff are on the rise.
For more detailed information, check out our page about C.diff.
How do you know you have c.diff?
Symptoms of C.diff include 3-30 severely watery stools a day, as well as abdominal pain or discomfort, and fever.
You need to have a physician run tests to diagnose that you have C.diff.
How safe is FMT?
FMT is an incredibly safe therapy. The short-term safety studies have reported extremely low rates of serious adverse events. Most adverse events that have been reported are minor, for example bloating, diarrhea and nausea. There have been a few studies that have followed patients over 3 years and those also show good safety outcomes, in fact they show better outcomes compared to patients who were effectively treated with antibiotics. The biggest risk with FMT is potential infection. This risk is largely mitigated through extensive donor screening, but like many things, we don't know what we don't know.
Interested in learning more about our safe practices for FMT? Check out our Quality and Safety page.
How effective is FMT?
According to recent studies, oral FMT capsules have been shown to be just as effective as colonoscopic delivery, with a cure rate of 96.2% in treating C.diff. And, when compared to treatment with Vancomycin, FMT is more effective.
How do I know fmt treatment is right for me?
If you have C.diff and you've failed at least one round of antibiotic treatment, then FMT may be right for you!
Current guidelines from the AMA and IDSA strongly recommend the use of FMT after the second recurrence of C.diff. So, if you've been treated, but still haven't found resolution of symptoms, come talk with us. FMT is a safe, effective option to address recurrent/antibiotic-resistant C.diff infections.
If you are feeling uncertain about FMT and have more questions, feel free to Contact Us and we’ll be happy to discuss your concerns.
What are the different kinds of FMT?
There are several methods of FMT treatment, these include:
What kinds of fmt do you offer?
We offer Frozen Oral FMT Capsules and FMT via Retention Enema.
Can I do FMT if I don't have C.diff?
Unfortunately, we cannot treat any patients that do not have C.diff infections not responding to standard therapies. If you are interested in the research and resources about clinical trials and our expertise in fecal transplant we are happy to talk to you and do our best to point you in the right direction.
what are the FDA requirements for FMT treatment?
Currently, under the FDA Guidelines, we are allowed to use FMT to treat patients with C.diff not responding to standard therapies.
To learn more, check out our FDA Guidelines page.
I don’t want to take antibiotics, can I start with FMT to treat my C.diff?
Unfortunately, no. Due to current FDA guidelines, we are only able to provide FMT treatment to patients with antibiotic-resistant or recurrent C.diff. For more information, check out our FDA Guidelines page.
Where does the stool come from?
Our stool comes from healthy pre-screened donors in the local Portland, OR area.
How do you screen your donors?
We screen our donors in three phases.
The first phase is a medical history questionnaire that is extremely thorough. Our donors do not have any significant health issues, are not on any pharmaceutical medications and have a history that supports a healthy microbiome. For example, our donors were all born vaginally and breastfed. They have had less than 5 rounds of antibiotics in their life and none in the past several years. They have a whole foods organic diet that is high in fiber and low in processed foods. And most importantly, they are happy healthy humans.
The second phase of screening is an in-person intake to clarify their questionnaire responses followed by a comprehensive physical exam.
Finally, we do extensive blood and stool screening for any infectious diseases that might be transferred through the stool to the recipient.
Where can I learn more about this?
Feel free to Contact Us if you have any questions! You can also check out these helpful links:
New Documentary about FMT: https://designershitdocumentary.com/
Peggy Lillis Foundation: https://peggyfoundation.org/
Mark Davis Ted Talk: https://youtu.be/C9bYKd_Ffgc
Where is your stool bank located?
How much does FMT cost?
We charge $600 for a single dose of FMT capsules (30 capsules).
We charge $250 for an FMT enema.
For every patient being treated by Flora Medicine physicians, we require an initial $200 office visit.
Is FMT covered by insurance?
FMT can be billed to insurance including Medicare if an outside physician is the administering physician. We do not currently bill insurance.
How long does FMT treatment take?
Our FMT capsule treatment involves swallowing ten capsules daily for three days. But most of our patients report relief of symptoms within 24 hours of initiating therapy.
How long does it take for FMT to work?
We generally see improvement in symptoms within 24 hours, often patients will experience their first formed stool within this time period.
Can another physician treat me with your FMT?
What do I need to do to prepare for FMT treatment?
In order to prepare for FMT treatment, we ask patients to avoid the use of antibiotics and proton-pump inhibitors (PPIs) at least 24 hours before your first dose. Ideally, we would have you take the capsules on an empty stomach and allow at least a couple of hours before your next meal.
Do I need to go to the hospital for FMT treatment?
No. We can treat you at our office in Portland, or make a home visit if you live in or around Portland. We also offer a program for physicians to contract with us so that they can use our FMT capsules with their own patients outside of Portland.
Can I be treated at home?
Yes! We offer in-home treatment for patients in and around Portland. We also offer a program for physicians to contract with us so that they can use our FMT capsules with their own patients.
How likely will my condition return with fmt treatment?
Recurrence is dependent on various factors, what your exposures may be (antibiotic use, spores remaining from your first infection, hospitalization, etc), your age and your living situation.
That being said, FMT is more than 90% effective at treating and curing C.diff infection, that number increases to greater than 95% if the person receiving treatment has to undergo two FMT treatments. Many of the studies follow participants, or those who have received FMT for their C.diff infection, for 8 weeks, sometimes even longer. And in these studies, researchers are finding that individuals treated with FMT sustain cure.
If I am on antibiotics, can I be treated with FMT?
If you are on an antibiotic and wish to be treated with FMT, we can do it. However, we ask you stop taking your antibiotic 24-48 hours before you ingest the FMT product. This is done in order to protect the healthy microbial diversity delivered in the FMT to the recipient which is how it cures C.diff for good.
How will fmt treatment affect my diet?
After receiving FMT, we ask you don't eat one hour after treatment. Aside from that, you can continue to eat your normal diet, with a few caveats.
Many of the foods available in fast food restaurants or even at your local market contain antibiotics. Avoiding these foods is essentially to maintaining the newly transplanted microbiome you've just spent previous time and money on. We recommend a whole foods based diet to not only support your body, but the microbes we just introduced into your system, they like to eat too! If you need guidance concerning nutrition, we are happy to help.
I live on the other side of the country, can you treat me with FMT?
We offer a program for physicians to contract with us so that they can use our FMT capsules with patients outside of Portland. We are able to ship our FMT capsules across the United States. For patients wanting their physician to administer our FMT, you must either Contact Us or have them fill out the form on our Physician Accounts page.
Our physicians are only able to treat you in our office or if you live in the surrounding areas of Portland, OR.
I live outside the US, are you able to treat me?
We can treat any patients we meet and establish care with in-person. If you can come see us here in Portland, OR we are happy to work with you. If you live outside the U.S. we are happy to set up a remote education consultation to discuss what resources you have in your area and help point you in the right direction.
I have more questions, who can I speak with?
We are more than happy to speak with you further about FMT.
Please Contact Us for more information.