Overview of FMT Preparation
Proper preparation is crucial for FMT success. The preparation process varies depending on the delivery method, condition being treated, and specific clinic protocols. Most preparations begin 3-7 days before the procedure.
Pre-Treatment Timeline
7 Days Before
- Begin dietary modifications
- Stop unnecessary medications
- Start pre-treatment antibiotics (if prescribed)
- Avoid probiotics and fermented foods
3 Days Before
- Begin clear liquid diet
- Increase hydration
- Final medication review
- Complete pre-procedure labs
1 Day Before
- Begin bowel preparation (if colonoscopy)
- Fast as directed
- Complete pre-procedure checklist
- Arrange transportation
Dietary Preparation
Foods to Avoid (7 days before)
- Fermented foods: Yogurt, kefir, sauerkraut, kimchi
- Probiotics: All probiotic supplements and drinks
- High-fiber foods: Beans, lentils, whole grains
- Raw vegetables: Salads, raw fruits with skin
- Spicy foods: Hot peppers, curry, spicy sauces
- Alcohol: All alcoholic beverages
Recommended Foods
- Lean proteins: Chicken, fish, eggs
- Refined carbs: White rice, white bread, pasta
- Cooked vegetables: Well-cooked, soft vegetables
- Clear broths: Chicken or vegetable broth
- Simple fruits: Bananas, applesauce
Medication Management
Medications to Stop
- Probiotics: All forms, including supplements
- Non-essential antibiotics: Unless prescribed for FMT prep
- Antacids: Proton pump inhibitors, H2 blockers
- Anti-diarrheals: Loperamide, bismuth subsalicylate
- Herbal supplements: Especially those affecting gut bacteria
Continue Taking
- Essential medications: Heart, blood pressure, diabetes meds
- Prescribed antibiotics: For FMT preparation only
- Critical supplements: Vitamin B12, iron (if deficient)
Important: Never stop or start medications without consulting your healthcare provider. Some medications require gradual tapering.
Bowel Preparation
For colonoscopic FMT delivery, thorough bowel preparation is essential:
Standard Preparation
- Clear liquid diet: 1-2 days before procedure
- Bowel prep solution: As prescribed (GoLYTELY, Suprep, etc.)
- Timing: Usually split-dose preparation
- Hydration: Extra fluids to prevent dehydration
Alternative Methods
- Enema delivery: Fleet enemas before procedure
- Upper GI delivery: Fasting only, no bowel prep
- Capsule delivery: Minimal preparation required
Special Considerations
C. Difficile Patients
- Vancomycin therapy usually continued until procedure
- Isolation precautions may be maintained
- Close monitoring for symptom changes
IBD Patients
- Continue immunosuppressive medications
- Monitor for disease flares
- Coordinate with gastroenterologist
Immunocompromised Patients
- Enhanced screening requirements
- Additional safety precautions
- Specialized donor selection
Pre-Procedure Checklist
24 Hours Before
- ☐ Completed dietary restrictions
- ☐ Stopped prohibited medications
- ☐ Began bowel preparation (if applicable)
- ☐ Arranged transportation
- ☐ Confirmed appointment time
Day of Procedure
- ☐ Completed fasting period
- ☐ Taken morning medications as directed
- ☐ Brought insurance cards and ID
- ☐ Arranged for companion if sedation used
- ☐ Wore comfortable, loose clothing
What to Expect
- Arrival: Check-in 30-60 minutes early
- Pre-procedure: Vital signs, IV placement if needed
- Sedation: Conscious sedation for colonoscopy
- Procedure time: 30-90 minutes depending on method
- Recovery: 1-2 hours observation period