Written By: Prerna Mittra | Published : February 11, 2025 8:58 PM IST
Medically Verified By: Dr Pradeep Mahajan, medical director at Mahajan Hospital and regenerative medicine researcher at StemRx Bioscience Pvt Ltd
Fecal microbiota transplantation (FMT) is a therapy in which the gut microbiome of the patient is 'restored' by transplanting healthy donor microbiota. (Photo: Freepik)
Basics of gut health: Microbiota refers to the community of microorganisms -- including bacteria, viruses, fungi, and others -- that live in the human body and may be considered 'commensal', 'symbiotic', or 'pathogenic'. The concept of 'microbiome' or 'microbiota', when used conversely, can mean the cumulative genetic content of these organisms. As a term, 'microbiota' describes the 'aggregate of microbial cells' associated with the human body, of which the most plentiful and diverse is the intestinal microbiota. It becomes imperative to take care of gut health, which is linked to the overall health of the body, and the well-being of the mind.
According to Dr Pradeep Mahajan, medical director at Mahajan Hospital and regenerative medicine researcher at StemRx Bioscience Pvt Ltd, fecal microbiota transplantation (FMT) is a therapy in which the gut microbiome of the patient is 'restored' by transplanting healthy donor microbiota. "The colonoscopic fecal microbiota transplantation method is an advanced treatment that replaces a patient's colonic ecosystem with a stool derived from a healthy donor," he explains. The doctor adds that it can restore the balance of gut microorganisms to treat various gut-related diseases. And although FMT can be given through capsules, enemas and nasoenteric tubes, the most reliable route is 'colonoscopic', because it ensures 'accurate targeting' of the area.
The gut microbiome helps regulate immune responses, produce neurotransmitters, and support metabolic functions, all of which influence a variety of health conditions. Dr Mahajan explains that through its connection with the gut-brain axis, it plays a key role in 'neuropsychiatric disorders', including depression, anxiety, autism, Parkinson's disease, and dopamine-related deficiencies.
"Microbial imbalances are closely linked to inflammatory and autoimmune diseases such as ulcerative colitis, Crohn's disease, irritable bowel syndrome (IBS), type 1 diabetes, and multiple sclerosis. Similarly, disruptions in the gut microbiome are associated with the development of metabolic conditions like type 2 diabetes and obesity. Additionally, the gut microbiome is crucial in managing allergic conditions like celiac disease. Furthermore, FMT is useful in antibiotic-resistant bacterial infections, multi-drug resistant conditions, and many more conditions and diseases," he states.
According to the health expert, the gut-brain axis is a complex, bi-directional communication network linking the gut and brain through the central and enteric nervous systems, the immune system, and the gut microbiome. "This connection is facilitated by pathways such as the vagus nerve, neurotransmitter production, and immune modulation which influence brain function, inflammation, and the blood-brain barrier. Dysbiosis, or an imbalance in gut microbiota, has been linked to neurological disorders, including autism spectrum disorder (ASD), global developmental delay (GDD), and speech delay."
"The gut microbiome's influence on immune regulation, neurotransmitter synthesis, and gut-brain signalling underscores its pivotal role in neurodevelopment and brain health. The importance of the gut microbiome in regulating immunity, synthesising neurotransmitters, and the gut-brain axis makes it essential in neurodevelopment and the overall health of the brain," says Dr Mahajan.
The gut-brain axis is a technology where the stem cells are given endoscopically in the entire colon so that the inflammation and dysregulation of the bowel will be corrected, and thereafter, the healthy bacteria can be administered along with pre- and probiotics.
"When assessing the advantages of colonoscopic FMT, one may conclude that it surpasses the other modalities because of its accuracy, effectiveness, and ability to reach the whole colon. Unlike colon enema -- which only accesses the lower colon or the nasoenteric tubes where fecal matter is delivered to the upper part of the gastrointestinal tract with risks of discomfort, aspiration, or vomiting -- colonoscopy provides a method of directly placing the microbiota into the cecum and two ascending regions of the colon that serve as critical points in the process of colonisation by the microbes.
"Due to the nature of the intended use, the method's operation mode guarantees evidence-based medicine at a higher rate with expected longer, more stable outcomes. Furthermore, colonoscopic FMT allows the physician to evaluate the pathology of the colon at the time of the procedure, which is impossible with the other technologies. It also allows for slower elimination of transplanted matter, which affords the newly-inserted microbes more time to adapt, as against FMT using enema where ejection occurs quickly leading to smaller amounts of bacteria being retained," the doctor explains.
