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FMTquestionnaire

MaximilianKohler edited this page Aug 22, 2019 · 7 revisions

Here's a bunch of info on FMT: http://HumanMicrobiome.info/FMT

Check this intro page to understand the importance of these questions, and for lots of info on the microbiome: http://HumanMicrobiome.wiki/Intro

Here are two official sources of FMT screening info:
http://gut.bmj.com/content/66/4/569
http://www.openbiome.org/s/The-OpenBiome-Quality-Safety-Program.pdf

FMT screening questionnaire:

The gut microbiome impacts/regulates the entire body, is shaped by genetics, and affects genetic expression. Happiness, intelligence, & athleticism are some of the best signs. Younger is typically better since dysbiosis increases with age, and is looking to be the cause of most diseases associated with aging (as well as most diseases in general). The ultimate donor is probably something like a 2-18 year old Michael Jordan, or a guy like this who is both physically and mentally very fit:

The following is not exhaustive. If you think of something else please include it. If there is something you don't want to disclose then please state that, instead of being untruthful about it.

For example, one person contracted their donor's sweet tooth, another person started having sleeping trouble after their FMT, others have contracted obesity from their obese donors, another contracted their donor's cramping issues, ear issues, some body odors, food intolerances, etc..

Currently I believe kids are ideal donors for 3 reasons: 1) Dysbiosis increases with age, often including an onset at puberty. 2) Less likely to have taken antibiotics. 3) They're unlikely to have picked up an STD.

Babies/toddlers might work but are a bit more risky since it's harder to judge their health & development till they get closer to adolescence. For these cases the health & diet of the parents becomes more important: http://HumanMicrobiome.info/Maternity

Questionnaire for an adult donor:

Age?

Please see this stool chart and note your stool type: https://www.continence.org.au/data/images/bristol_stool_chart.gif

How consistently are your stools each type? Are there foods that cause changes in the type of stool you have? If so, which foods cause what changes?

How often do you have a bowel movement?

Do you have medical coverage for these screening tests? (I should be able to cover any copays) https://gut.bmj.com/content/66/4/569#boxed-text-3

Have you had past/recent blood tests? Any abnormal results?

History of, or known exposure to, HIV, HBV or HCV, syphilis, human T-lymphotropic virus I and II, malaria, trypanosomiasis, tuberculosis?

Tattoo or body piercing within previous 6 months?

Incarceration or history of incarceration?

Known systemic infection or current communicable disease?

Previous reception of blood products?

Recent (<6 months) needle stick accident?

Recent medical treatment in poorly hygienic conditions?

Risk of transmission of diseases caused by prions?

Recent parasitosis or infection from rotavirus, Giardia lamblia and other microbes with GI involvement?

Recent (<6 months) travel in tropical countries, countries at high risk of communicable diseases or traveler's diarrhea?

Surgeries or hospitalizations?

Breast fed? For how long?

Vaginal birth or c-section?

Health status/fitness of self? Including physical fitness, body fat percentage, muscular, thin, toned, etc.. Do you play any sport? Lift weights? How often? College, semi-pro, pro?

Health status/fitness of parents and siblings?

Any diseases or illnesses that run in the family (Alzheimer's, cancers, depression/suicide, heart failure, etc.)? If parents have health problems, at what ages did they develop?

Any congenital/birth defect/disease of self or immediate family members?

What's your current diet like, and your dietary history (especially as a child)?

Any food cravings? Any food intolerances?

Allergies?

Please list all instances of antibiotic, antiviral, or antifungal usage, and at what ages and duration taken.

Any drug use?

Probiotics, medications, supplements?

Risky sexual behavior (anonymous sexual contacts; sexual contacts with prostitutes, drug addicts, individuals with HIV, viral hepatitis, syphilis; work as prostitute; history of sexually transmittable disease, unprotected sex with untested partners)? If so, how frequent/recent?

Smoked or lived with smokers?

Issues with sleep such as insomnia, frequent waking during night, nightmares, sleep paralysis, etc.? Do you dream every night and remember them when you wake? How would you rate the quality of your sleep?

Skin (dryness, excess sweating, rashes, eczema, dandruff, dermatitis, etc.)?

Any problems with hair, eye sight, teeth/mouth (including cavities & fillings - when was the last time you went to dentist?), ears/hearing, body odors including bad breath, weight/fitness issues, sex drive, heart, lungs/breathing, bladder, hormonal, any kind of sensitivities, issues during/with menstruation.

Mental/emotional health, happiness, mood, anxiety, depression, headaches, or any other neurological or psychiatric conditions?

Have A's in class always came easy?

Joint/muscle pain/stiffness?

Digestion: issues with constipation/diarrhea, excessive gas, overly foul BMs, acid reflux, ulcers, heartburn, etc.?

Any addictions or addictive behavior?

Do you get sick often? When under stress?

Questionnaire for a child donor:

This summary & list of studies give a good idea of the kind of things that affect a child's health: http://HumanMicrobiome.info/Maternity

Please see this stool chart and note your stool type: https://www.continence.org.au/data/images/bristol_stool_chart.gif

How consistently are your stools each type? Are there foods that cause changes in the type of stool you have? If so, which foods cause what changes?

Have you had past and/or recent blood/medical tests? Any abnormal results?

History of, or known exposure to, HIV, HBV or HCV, syphilis, human T-lymphotropic virus I and II, malaria, trypanosomiasis, tuberculosis?

Known systemic infection?

Previous reception of blood products?

Recent (<6 months) needle stick accident?

Recent medical treatment in poorly hygienic conditions?

Risk of transmission of diseases caused by prions?

Recent parasitosis or infection from rotavirus, Giardia lamblia and other microbes with GI involvement?

Recent (<6 months) travel in tropical countries, countries at high risk of communicable diseases or traveler's diarrhea?

Surgeries or hospitalizations?

Breast fed? For how long?

Vaginal birth or c-section?

Health status/fitness of self? Including physical fitness, body fat percentage, etc..

Health status of siblings?

Any congenital/birth defect/disease of self or immediate family members?

Current diet & dietary history?

Any food cravings? Any food intolerances?

Allergies?

Please list all instances of antibiotic, antiviral, or antifungal usage, and at what ages and duration taken.

Prescription or OTC drugs or supplements?

Issues with sleep such as insomnia, frequent waking during night, nightmares, sleep paralysis, etc.? Do you dream every night and remember them when you wake? How would you rate the quality of your sleep?

Skin (dryness, excess sweating, rashes, eczema, dandruff, etc.)?

Any problems with hair, eye sight, teeth/mouth (including cavities & fillings - when was the last time you went to dentist?), ears/hearing, body odors including bad breath, weight/fitness issues, heart, lungs/breathing, bladder, hormonal, any kind of sensitivities.

Mental/emotional health, happiness, mood, anxiety, depression, headaches, or any other neurological or psychiatric conditions?

Have A's in class always came easy?

Joint/muscle pain/stiffness?

Digestion: issues with constipation/diarrhea, excessive gas, overly foul BMs, acid reflux, ulcers, heartburn, etc.?

Any addictions or addictive behavior?

Do you get sick often? When under stress?

Screening questions for the father (microbiomes run in families, are passed down from both parents (see zika for recent & popular example), and are shaped by genetics):

Health status/fitness?

Have you had past and/or recent blood/medical tests? Any abnormal results?

Surgeries or hospitalizations?

Any diseases or illnesses that run in the family (Alzheimer's, cancers, depression/suicide, etc.)?

Any congenital/birth defect/disease of self or immediate family members?

Food intolerances?

Chronic digestion issues?

Allergies?

Chronic sleep issues?

History of antibiotic, antiviral, or antifungal usage? How near to time of conception of child?

Drug use around time of conception?

Skin (dryness, excess sweating, rashes, eczema, dandruff, etc.)?

Mental/emotional health, happiness, mood, anxiety, depression, or any other neurological or psychiatric conditions?

Joint/muscle pain/stiffness?

Addictions or addictive behavior?

Hormonal issues?

Screening questions for the mother:

Health status/fitness?

Have you had past and/or recent blood/medical tests? Any abnormal results?

Surgeries or hospitalizations?

Any diseases or illnesses that run in the family (Alzheimer's, cancers, depression/suicide, etc.)?

Any congenital/birth defect/disease of self or immediate family members?

What's your current diet like, and your dietary history (especially around conception, birth, & breast feeding)?

Any food intolerances?

Allergies?

History of antibiotic, antiviral, or antifungal usage? If so, at what ages and before/after which kids?

Any drug use? While pregnant/breast feeding?

Issues with sleep such as insomnia, frequent waking during night, nightmares, sleep paralysis, etc.? How would you rate the quality of your sleep?

Skin (dryness, excess sweating, rashes, eczema, dandruff, etc.)?

Weight/fitness issues, heart, lungs, bladder, etc., hormonal, any kind of sensitivities.

Mental/emotional health, happiness, mood, anxiety, depression, or any other neurological or psychiatric conditions?

Joint/muscle pain/stiffness?

Chronic digestion issues?

Addictions or addictive behavior?

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