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Fecal Transplant for Ulcerative Colitis (UC): Does It Work?

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On June 27, 2025
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Fecal Transplant for Ulcerative Colitis (UC): Does It Work?

Because the gut microbiome — which is a mix of bacteria, fungi, and viruses that live in your digestive system — plays a significant role in UC, finding better ways to support and nourish those beneficial gut bugs is crucial, says Seifeldin Hakim, MD, a gastroenterologist at Memorial Hermann in Houston.

Strategies for managing your microbiome can include stress reduction, probiotic-rich foods, and high-quality sleep, but FMT has the potential to be a major shortcut, he says

“The whole goal of fecal transplantation is restoring the balance between good bacteria and bad bacteria,” he says. “We’ve seen in clinical trials and also in instances where FMT is done in patients with a recurrent Clostridioides difficile (C. diff) infection that it works quite well and also very quickly.”

In terms of how the process works, it’s fairly straightforward. A donor for FMT is identified based on a number of criteria, including being generally healthy, not having any chronic gastrointestinal disorders, and not having taken antibiotics within the past six months.

That donor provides a small sample of fecal matter which is collected and then purified so only the beneficial bacteria remains. In some cases, a sample will involve stool from multiple donors in order to get more strains of bacteria that can colonize a recipient’s gut.

 Whether from one or more donors, the sample is mixed with saline and delivered to a recipient’s digestive tract during a colonoscopy or upper endoscopy.

Newer, less intrusive methods of delivery are also available, says Dr. Polman. For example, a technique approved for the treatment of recurrent C. diff — which is currently the only condition that FMT is approved by the U.S. Food and Drug Administration (FDA) to treat — involves a device called Rebyota that delivers the sample through a type of enema (a liquid solution inserted into the anus). That means it can be done in a doctor’s office, without the type of multiday bowel prep you’d need with a procedure like a colonoscopy.

There are also fecal transplant pills, which contain live bacteria that have been freeze-dried and can reactivate when they reach your colon. The FDA has approved one called VOWST, also for treating recurrent C. diff, which is taken over a course of three days.

If you have some healthy friends with bulletproof digestive systems, you might be tempted to do it yourself and try an at-home process. Don’t do that, says Polman.

“Trying to do this on your own can significantly increase your risk of developing a bacterial infection,” he says. “Also, without proper donor screening, you may be introducing new, chronic diseases into your system.” For example, research on DIY FMTs found that lack of donor screening may lead to viral hepatitis or human immunodeficiency virus (HIV) in the recipient.

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