Intestinal Microbiota Transplant (IMT), sometimes called Faecal Microbiota Transplant (FMT) treatment that transfers healthy gut bacteria from a screened donor to a patient, helping to restore balance in the gut microbiome and treat certain conditions.

What on earth is IMT?

Imagine if your gut had a reset button—a way to restore balance when things go haywire. That's essentially what IMT offers. By transferring stool from a healthy donor into the gut of someone struggling with certain intestinal issues, IMT aims to reintroduce beneficial microbes and set things right.

How is IMT created?

The process of making IMT is more high-tech than you might think and involves a lot of consideration and testing to ensure it is safe.• Donor selection – Not just anyone can be a stool donor. Potential donors undergo rigorous screening—including health questionnaires and blood and stool tests—to ensure they are free from infections and other health concerns.• Sample processing – Once a donor is cleared, their stool sample is processed in a lab. This involves filtering out unwanted material and isolating the beneficial microbiome. The sample is then prepared according to how it is administered (given) to the patient (see below).

How is IMT administered?

How IMT is given to a patient isn’t a one-size-fits-all procedure, there are different ways to introduce the healthy microbes into the recipient’s gut. This route of administration will depend on the patient and what is the best fit for them. Recipients are closely monitored during and after the procedure to promptly address any adverse reactions.

IMT can be given from the upper part or the lower part of the gastrointestinal route.

Each method has its own advantages, and the choice depends on factors like the patient’s condition and doctor’s recommendation.

When is IMT the go-to solution?

IMT has gained prominence primarily for treating a recurrent version of a bacterial gut infection called C. difficile — a condition causing severe diarrhoea and colitis (inflammation of the colon). It is now standard care for patients with this infection and is approved in national and NICE guidelines for this purpose. When standard antibiotic treatments fail, IMT has shown remarkable success in restoring gut health for these patients.

While IMT's efficacy in treating C. difficile infections is well-established, researchers are exploring its potential for other conditions:

• Inflammatory Bowel Diseases (IBD): Preliminary studies are investigating IMT's role in managing conditions like ulcerative colitis and Crohn's disease.
• Metabolic disorders: There's ongoing research into how IMT might influence conditions such as obesity and diabetes by altering the gut microbiome.
• Liver diseases: There is growing interest in using IMT for liver diseases, where gut microbiome imbalances may contribute to conditions like cirrhosis and primary sclerosing cholangitis.
• Restoring gut health: Researchers are exploring whether IMT could help restore gut health after treatments that severely impact the gut microbiome such as chemotherapy, cancer immunotherapy or intensive and extended use of antibiotics.

However, these applications are still under investigation, and more research is needed to determine IMT's effectiveness beyond C. difficile infections. As research continues, IMT may become a valuable tool for a wider range of conditions, offering new possibilities for gut-related and systemic health issues.

Don't try this at home!

With all the buzz around IMT in the media and online, it’s no surprise that some people have tried to take matters into their own hands. However, DIY IMT is risky and not recommended. While finding a donor might seem easy (a friend or family member, perhaps), there's no way to properly test the stool at home for harmful bacteria, viruses, or parasites. That means you could be putting yourself in serious danger or infection.

Beyond the donor risks, the method of delivering the sample without medical supervision can also lead to serious complications. Without proper screening, hygiene, and administration, a self-administered IMT could do more harm than good. If you’re considering this treatment, always seek advice from a qualified medical professional—your gut (and your health) will thank you!

The future of IMT

IMT represents a fascinating intersection of ancient practices and modern science. By harnessing the power of a healthy gut microbiome, IMT offers hope for patients battling persistent intestinal infections. As research advances, who knows what other gut-related ailments might be tackled with this innovative approach?

Links/resources

IMT patient information leaflet (Guts UK! website)
British Society of Gastroenterology (BSG) and Healthcare Infection Society (HIS) IMT/ FMT guidelines(BMJ Gut Journals)