Children's Hospital Colorado
Digestive Health Institute
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Digestive Health Institute

About Fecal Microbiota Transplantation

A smiling woman in a bright blue shirt with her brown hair in a bun sits at a table next to a smiling girl with long brown hair and wearing a white shirt.

What is Clostridium difficile (C. diff)?

Clostridium difficile, also known as C. diff, is a bacterium that can cause an aggressive infection in the digestive tract. A child may contract C. diff during hospitalization, from an imbalance of bacteria due to taking antibiotics, or by chance alone.

Doctors treat C. diff with specific types of antibiotics to help eliminate the infectious bacteria from the digestive tract. However, in up to a one third of patients with a C. diff, the infection returns after treatment with oral antibiotics. At Children’s Hospital Colorado, our experts in the Digestive Health Institute and Infectious Diseases use fecal microbiota transplantation to treat kids with C. diff whose bodies aren’t responding to antibiotics.

What is fecal microbiota transplantation?

Fecal Microbiota Transplantation is a procedure that transfers a donor’s stool into the recipient’s digestive system. This procedure replaces infectious bacteria with healthy bacteria in the digestive tract to eliminate C. diff.

Fecal Microbiota Transplantation is not a new treatment. However, in the past few years, it is gaining recognition for its effectiveness as more researchers are studying the treatment. At Children’s Colorado, our experts see positive results in cases of C. diff where antibiotics have failed kids in the past.

Benefits of fecal microbiota transplantation

  • No side effects
  • Works for many patients, including those with conditions like cystic fibrosis or inflammatory bowel disease, where C.diff is more likely to cause infection.
  • It’s a quick outpatient procedure
  • Low (or no) odor
  • Costs less than some antibiotics
  • Covered by most insurance companies (contact us to see if your insurance covers it)

Where does Children’s Colorado get the stool?

The stool for your child’s transplant comes from a donor stool bank. The bank uses a rigorous screening process to ensure that donors are healthy and there isn’t an existing disease that could be spread in the stool. The fecal matter is shipped and delivered frozen to preserve the healthy bacteria. Before your child’s transplant, it is thawed.

What can patients and families expect from the fecal transplant procedure?

At Children’s Colorado, our pediatric nurses are trained and experienced in performing this procedure. When you arrive for your child’s appointment, the nurse will explain the procedure to you and your child in an age-appropriate way to help put them (and you) at ease.

Before the procedure, your child picks a scent (like Skittles) that is rubbed onto the upper lip to help mask any odor from the stool.

Then, the nurse places a nasogastric tube (NG tube) into your child’s nose. It is a very thin, soft, flexible tube that goes into the nose, through the throat and down into the stomach. Your child is awake for the tube insertion and may find the procedure to be unpleasant, but not painful. X-rays are taken to confirm that the tube is in exactly the right place for the transplant.

After confirmation, the nurse moves the end of the tube so your child doesn’t see the rest of the procedure. The nurse inserts 30 ML or one ounce of liquid stool into the NG tube. The donor stool is flushed into the stomach, where it passes through the intestinal tract over the next few hours.

After about 20 minutes, the tube is removed and your child can go home and eat a regular diet.

What happens when the tube cannot be placed through the nose?

If your child cannot pass an NG tube through his or her nose, then the transplant can be delivered through a procedure called a colonoscopy. A colonoscopy is done through a thin tube that a surgeon places directly into the colon. Patients are usually asleep for this procedure.

How long does fecal microbiota transplantation take?

The transplant is done as an outpatient visit and takes around two hours to complete. The transplant portion of the visit is typically finished in less than 10 minutes.

Patient eligibility

Families considering fecal microbiota transplantation for a child’s C. diff infection will first have a consultation with either the gastroenterologists or infectious disease specialists at Children’s Colorado. During that consultation, all the options for treatment of C. diff infection will be discussed and if fecal microbiota transplantation is the best treatment, you will come back for the transplant at a second appointment.

To be considered for the transplant, children must:

  • Be older than 1-year-old
  • Have taken antibiotics, including 10 days of oral vancomycin (an antibiotic to treat bacterial infections) and had C. diff infection return again.

Life after fecal microbiota transplantation

After fecal microbiota transplantation, most children recover from C. diff within three to four days. Once the symptoms disappear, you child can return to normal activities. A nurse in the Digestive Health Institute follows up with you and your child one week, one month and six months after the transplant.

Why choose Children’s Hospital Colorado for fecal microbiota transplantation?

We are the only pediatric Fecal Microbiota Transplantation Program in Colorado

Experts in the Digestive Health Institute are always looking for ways to help kids heal faster and easier. That’s why we are the first and only Fecal Microbiota Transplantation Program in Colorado treating kids for C. diff. Our nationally recognized digestive experts are leading the way in pediatric care.

Our nurses have been awarded Magnet recognition

Not only are our nurses trained in providing pediatric care, but they have also received the prestigious recognition for excellence in nursing. When your child visits Children’s Colorado, they are in the best place for kids.

Specific conditions treated

Clostridium difficile (C. diff)

Helpful resources