Fecal Transplant: What You Should Know

Medically Reviewed by Minesh Khatri, MD on May 28, 2023
4 min read

It may sound gross, but a poop transplant is a powerful treatment for serious diseases.

A fecal transplant is a procedure that places the stool of a healthy person into the colon of someone who’s ill. Your doctor may call it bacteriotherapy.

Who needs a fecal transplant?

Fecal transplant is used to treat a severe bacterial infection called C. difficile, or C. diff.

Like most infections, C. diff is usually treated with antibiotics. But in some people, the infection can come back again and again. It won’t respond to more antibiotics.

A fecal transplant is a more successful treatment for recurrent C. diff than antibiotics. It often clears up the infection quickly.

How does a fecal transplant work?

A fecal transplant puts stool full of healthy bacteria into your colon. When you have enough good bacteria in your gut, the bad bacteria that cause disease are held in check.

Antibiotics can wipe out the bacteria that make you sick. But they may also clear out the bacteria that keep your body healthy. Without that balance, the bad bacteria can take over. They produce toxins that make you sick with diarrhea and colitis.

A fecal transplant can restore your gut’s healthy bacteria balance. This will help you fight the infection and feel better quickly. It may also help your body resist C. diff in the future.

Could a fecal transplant treat other diseases?

Unbalanced gut bacteria may play a role in other health problems too. Doctors have begun to test fecal transplants on people who have:

Fecal transplants show a lot of promise as treatments for ulcerative colitis. One reason may be that people with UC often have an unhealthy mix of gut bacteria that makes it hard for them to fight off stomach infections.

In one study, people with UC received a fecal transplant that used poop from two donors mixed together. Some saw improved symptoms and lower inflammation only a month later, and 15% of patients went into remission. That means they had no UC symptoms at all.

There is some evidence that donor “matching” can improve the chance of success for people with ulcerative colitis. A donor in good health is important, and it may help if they are close to you in age. In addition, it seems that family members often make better donors than those chosen at random. Sibling donors seem to do better than parent or child donors -- possibly because they tend to be closer in age.

More research is needed to learn why fecal transplants work for some people with UC but not for others.

How is a fecal transplant done?

Doctors collect a donor’s bowel movement and mix it with saline solution, then strain it through a coffee filter. The result is a brown liquid that contains the good bacteria. The doctor injects it deep into your colon using a long, flexible tube called a colonoscope.

This procedure usually takes place in a hospital. You’ll get medicine that will make you sleep through the whole thing.

Before you get a transplant, you won’t take any antibiotics for 2 days. The day before, you’ll have a liquid diet and use laxatives or an enema as your doctor tells you to.

On the day of your transplant, you’ll get loperamide (Imodium) to keep you from having diarrhea. This helps you hold in the donated stool so it’s more effective.

Poop capsules

It isn’t as widely used, but there is a newer type of fecal transplant that comes in capsule form called VOWST. The doctor places it in your gut through a long tube that goes up your nose and down into your belly. Donated poop is screened, prepared, and frozen, then placed inside little capsules. You’ll get 15 capsules over 2 days. It doesn’t sound pleasant, but it works well to clear up diarrhea from recurrent C. diff.

Another approved fecal transplant that is given rectally one time is called Rebyota.

Who can donate stool?

Most stool donors are family members or friends, but they don’t have to be. You can also get frozen, screened poop transplants from stool banks.

Stool donors and their poop are carefully screened. Donors get blood and stool tests to check for infections or drugs that could be passed along in their poop. Stool donors can’t take antibiotics for at least a month before the transplant.

To qualify as a stool donor, you can’t have:

Can you do fecal transplant on your own?

Should you try a do-it-yourself fecal transplant to save time or money? No.

Donated stool needs to be screened to check for traces of any bad bacteria, infections, or drugs. A do-it-yourself fecal transplant could harm the person who gets the donation. You could get a serious infection even if the stool comes from someone who doesn’t appear to be sick.

Side effects

There are some possible side effects with fecal transplants. The antibiotics used with the procedure can cause diarrhea, a rash, and nausea. The transplant can cause bowel issues and nausea. But, so far, research shows the effects are not typically serious and usually go away with time.