Something old, something new, something borrowed...

Although knowledge of the complex interactions within our intestinal microbiota is relatively new, fecal microbiota transplantation (FMT) has been practiced for a long time. For more than a millennium, human fecal suspensions have been used to treat various ailments. The first literary evidence of oral fecal administration for the treatment of food poisoning and diarrhea dates back to the fourth century in China as detailed in the first Chinese handbook of emergency medicine written by Ge Hong (1). Later, in the 16th century, Li Shizhen described the use of several different human stool preparations for the treatment of various gastrointestinal diseases (1). The first report of FMT for the treatment of pseudomembranous colitis dates back to 1958 (2). In this case series involving four patients, all responded spectacularly. In 1983, Schwan et al (3) published the first report of FMT in a patient with a confirmed Clostridium difficile infection (CDI). Since then, the experiences of more than 250 CDI patients treated with FMT has been published in the medical literature, with an overall success rate of approximately 90% (4,5)..