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Updated: Mar 24, 2026
Fecal Microbiota Transplantation via Colonoscopy for Recurrent C. difficile Infection
Published on: December 8, 2014
Fecal microbiota transplantation for recurrent Clostridium difficile infection: The patient experience
Amy L Pakyz1, Leticia R Moczygemba1, Lynn M VanderWielen2
1Department of Pharmacotherapy and Outcomes Science, Virginia Commonwealth University School of Pharmacy, Richmond, VA.
Background:
Although effectiveness of fecal microbiota transplantation (FMT) has been adequately documented, the patient experience of undergoing FMT has not.
Methods:
We carried out a qualitative interview study using semistructured questions relating to aspects of health pre-FMT, during FMT, and post-FMT periods with 17 participants. Inductive coding was used to identify core themes during the periods.
Results:
Pre-FMT themes included physical (continuous diarrhea and weight loss), mental (depression, wanting to die, and fear), quality of life (unable to perform normal activities), social support, and financial (medication costs) factors. Provider resistance/limited awareness were barriers to FMT. Participants reached a tipping point, experiencing feelings of hopelessness, which led them to pursue FMT. During FMT, participants commented on lack of a so-called ick factor. During the posttreatment period, participants experienced symptom relief, but had residual fears. Patient activation was present during all phases, including information seeking and empowerment.
Conclusions:
During the pre-FMT period, participants experienced extreme discomfort and encountered FMT barriers. Undergoing FMT was reported as easy but residual fear remained. There were displays of patient activation at all FMT time periods, including the seeking of FMT. Participants could have benefited from having undergone FMT sooner, demonstrating a need for improvement in provider education and health system barriers regarding FMT.
Insights
Patients undergoing fecal microbiota transplantation (FMT) experienced significant pre-procedure distress and barriers, but found the procedure itself easy. Post-FMT, symptom relief was noted, alongside residual fears and a desire for earlier intervention.
Area of Science:
- Gastroenterology
- Microbiome research
- Patient-centered care
Background:
- Fecal microbiota transplantation (FMT) effectiveness is documented, but patient experiences remain under-explored.
- Understanding the patient journey is crucial for improving FMT accessibility and care.
Purpose of the Study:
- To explore the patient experience of undergoing fecal microbiota transplantation (FMT).
- To identify themes related to health, barriers, and patient activation across pre-FMT, during FMT, and post-FMT periods.
Main Methods:
- Qualitative interview study with 17 participants.
- Semistructured interviews explored health aspects across three FMT periods.
- Inductive coding identified core themes.
Main Results:
- Pre-FMT: Participants faced physical (diarrhea, weight loss), mental (depression, fear), quality of life, social, and financial challenges.
- Barriers included provider resistance; participants felt hopeless before pursuing FMT.
- During FMT, the "ick factor" was minimal; post-FMT, symptom relief occurred with residual fears. Patient activation was evident throughout.
Conclusions:
- Patients endure significant pre-FMT discomfort and barriers, with provider education and system changes needed.
- FMT procedures were perceived as easy, though residual fears persisted.
- Earlier FMT access could benefit patients, highlighting the need to address provider and health system barriers.
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