Fecal Microbiota Transplantation (FMT)

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Introduction to Fecal Microbiota Transplantation (FMT)
Fecal Microbiota Transplantation (FMT) is a well‑established clinical microecological therapy instead of conventional drug treatment. Viable gut microbiota obtained from rigorously‑screened and standardized‑processed healthy donors are delivered into the patient’s intestine via endoscopy or other modalities. This reconstructs the patient’s damaged gut microecosystem, repairs the intestinal barrier, regulates local and systemic immunity, and treats various diseases caused by gut microbiota dysbiosis.
The complete workflow consists of strict donor screening, microbiota preparation, pre‑transplant bowel preparation, endoscopic microbiota infusion, and systematic post‑procedural follow‑up. Transplantation can be performed by colonoscopy, in which the prepared microbial solution is directly delivered to colonic lesions to achieve microbiota engraftment. Alternative administration routes can be adopted according to clinical conditions. Physicians will select individualized regimens based on patient tolerance and lesion location.
Main Indications and Corresponding Symptoms
Recurrent Clostridioides difficile infection (Pseudomembranous colitis)
Recurrent watery diarrhea, abdominal pain and fever, frequent relapse after antibiotic treatment and poor response to conventional medications. It is the classic indication for FMT with high clinical remission rates.
Inflammatory Bowel Disease: Ulcerative Colitis, Crohn’s Disease
Repeated abdominal pain, muco‑bloody stools and diarrhea with a persistent and relapsing course and unsatisfactory drug control. FMT can alleviate intestinal inflammation, reduce flare‑up frequency and aim for long‑term disease remission.
Functional Gastrointestinal Disorders: Irritable Bowel Syndrome, refractory chronic constipation, chronic diarrhea
Chronic abdominal distension and pain, defecation disorder with alternating diarrhea and constipation. No significant organic lesions are found in examinations, and improvement from multiple pharmacological interventions is limited.
Other diseases associated with gut microbiota dysbiosis (individualized assessment required)
Cirrhosis complicated by hepatic encephalopathy, non‑alcoholic fatty liver disease; certain metabolic disorders including obesity and insulin resistance; anxiety and insomnia accompanied by intestinal symptoms; refractory intestinal injury following chemoradiotherapy, gut colonization of multidrug‑resistant bacteria, etc. FMT can be used as part of comprehensive treatment.
Note: FMT is not a universal cure. Complete pre‑treatment assessment is required. Contraindications such as gastrointestinal perforation, active massive gastrointestinal hemorrhage and severe immunosuppression must be excluded before confirming treatment suitability.

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