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Updated: Mar 9, 2026
Fecal Microbiota Transplantation via Colonoscopy for Recurrent C. difficile Infection
Published on: December 8, 2014
Perceptions of fecal microbiota transplantation for Clostridium difficile infection: factors that predict acceptance
Leslie Park1, Anjali Mone1, Jennifer C Price2
1Division of Gastroenterology, NYU Langone Medical Center, New York City, NY (Leslie Park, Anjali Mone, Demetrios Tzimas, Jacqueline Hirsh, Michael A. Poles, Lisa Malter, Lea Ann Chen).
Background:
Despite the effectiveness of fecal microbiota transplantation (FMT) for treating recurrent Clostridium difficile (C. difficile) infection, some patients are reluctant to accept this therapy. Our study examined attitudes towards FMT and factors that contribute to patients' acceptance of this treatment.
Methods:
We distributed patient surveys at a Veterans Affairs hospital, a public hospital, and an academic faculty practice. Multivariable logistic regression was performed, adjusting for factors associated with FMT acceptance on univariate analysis and prior experience with C. difficile infection.
Results:
Of 267 patients, only 12% knew of FMT prior to the survey, but 77% would undergo the procedure if medically indicated. On multivariable analysis, those with children and with college degrees or higher were more likely to agree to FMT (odds ratio [OR] 2.11, 95% confidence interval [CI] 1.02-4.35; OR 2.27, 95% CI 1.11-4.60 respectively). Sixty-five respondents (71%) chose colonoscopy as the preferred vehicle for FMT, while nasogastric tube was least preferred. Disease transmission was the most common concern (30%, n=242), and FMT success rate was the least selected concern (9.1%).
Conclusions:
Most patients in a diverse sample of gastroenterology clinics had no prior knowledge of FMT, but were receptive to the procedure. Having children and higher education levels were predictors for FMT acceptance. Our findings suggest that barriers to FMT utilization may be overcome with counseling about safety concerns. More data on the risk of transmitting diseases or clinical characteristics, such as obesity, through FMT are needed and will be important for the acceptance of this procedure.
Insights
Most patients are open to fecal microbiota transplantation (FMT) for recurrent Clostridium difficile infection, even without prior knowledge. Acceptance is higher among those with children and college degrees, suggesting education can overcome barriers.
Area of Science:
- Gastroenterology
- Microbiome Research
- Infectious Diseases
Background:
- Fecal microbiota transplantation (FMT) is effective for recurrent Clostridium difficile infection.
- Patient reluctance exists despite FMT's efficacy.
- Understanding patient attitudes toward FMT is crucial for its wider adoption.
Purpose of the Study:
- To examine patient attitudes towards fecal microbiota transplantation (FMT).
- To identify factors influencing patient acceptance of FMT for recurrent C. difficile infection.
Main Methods:
- Patient surveys were distributed across diverse healthcare settings (VA, public, academic).
- Multivariable logistic regression analyzed factors associated with FMT acceptance.
- Adjustments were made for univariate findings and prior C. difficile infection history.
Main Results:
- Only 12% of 267 patients knew of FMT pre-survey, yet 77% would accept it if indicated.
- Having children (OR 2.11) and college degrees (OR 2.27) predicted higher FMT acceptance.
- Colonoscopy was the preferred delivery method (71%); disease transmission was the primary concern (30%).
Conclusions:
- A majority of patients are receptive to FMT, despite limited prior awareness.
- Patient education on safety concerns may reduce barriers to FMT utilization.
- Further research on disease transmission risks and clinical characteristics is needed to enhance FMT acceptance.
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