What is an FMT?

The birth of FMTs precedes knowledge of microbes, much less the gut microbiota. The first records date back to fourth century China, where “yellow soup” (i.e., human fecal slurry) was used to treat patients with severe diarrhea and food poisoning. Though quite possibly the worst soup ever, it was reported to have "brought patients back from the brink of death.”

Fast forward to 1958, when the first “modern” FMT was performed. In this case, fecal enemas were used to cure 4 patients with pseudomembranous colitis, likely caused by C. difficile. Normally, the gut microbiota resists colonization by C. difficile. However, if the microbiota is disrupted, typically following antibiotic treatment for another infection, the pathogen can survive and thrive—secreting toxins, causing diarrhea and damaging the intestine.

The researchers in the 1958 study knew that antibiotics presumably killed off gut microbes and hypothesized that reintroducing “normal” bacteria into the gut via the fecal enemas would “re-establish the balance of nature.” The practice wasn’t deliberately used for C. difficile infection (CDI) until the 1980s, with some success.

Edit this but talk about history of FMT