Question

I’ve read some positive feedback on the internet about a new form of treatment called a faecal microbiota transplant (FMT). It is supposed to help with a number of chronic conditions, including ME. Apparently there is a private gut clinic in the UK that is carrying out this type of treatment. Do you know if and how FMT works? Is it safe? And how much will it cost?

Answer

There is limited research evidence indicating that changes to the gut microbiome (i.e., the bacteria and viruses that normally live quite happily inside our intestines) might have occurred in people with ME/CFS. However, this has to be regarded as no more than interesting research findings at the present time. We need more reliable and significant research in this area before we can deterime the extent of the microbiome's involvement. It is too early to conclude that any of these gut microbiota abnormalities could be diagnostic biomarkers, be involved in the causation or maintenance of symptoms, or that people with ME/CFS can effectively be treated with probiotics or faecal microbiota transplants.

The theory behind faecal microbiota transplantation (FMT) is that it can be used to restore gut bacteria back to their normal composition and diversity and so improve gut function. The process involves implanting normal or beneficial intestinal bacteria and yeasts from a healthy donor into the colon of a person where there has been evidence of harmful changes to the gut microbiota.

FMT is a highly speculative form of treatment in our current state of knowledge and there have not been any proper clinical trials to establish that FMT is a safe and effective form of treatment in ME/CFS. It is not available on the NHS and to go privately will cost quite a lot of money – in the region of £3000 according to the fees on one clinic website that I looked at – and will carry no guarantee of improvement. This is not an approach that I would want to endorse or recommend. And on a website for another such clinic, I could not find any medically qualified gastroenterologists – which was rather worrying.

• Please let us know if you have tried probiotics or FMT in the treatment of ME/CFS: Feedback@meassociation.org.uk

More information:

• Research Review: The Gut Microbiome in Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS) | January 2022
• Research Review: The Emerging Role of Gut Microbiota in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): Current Evidence and Potential Therapeutic Applications | November 2021