6. Priority Guide: "If I Can Only Change Three Things…"
If you can change only three things per phase, this guide distills the whole handbook into the highest-impact, evidence-based moves to make.
This guide distils the full scientific content of this manual into the three highest-impact lifestyle changes for each phase of FMT treatment. Priorities are evidence-ranked. If you can only do three things per phase, do these.
Note: These are general priorities applicable to most patients. Your clinical team may adjust them based on your specific condition, test results, and individual response.
Priority 1: Complete the Food and Symptom Diary consistently every day. This is the primary data source for donor selection. Missing entries reduces the quality of the compatibility signal. Priority 2: Avoid all antibiotics unless clinically essential and agreed with your clinical team. Antibiotic use during Phase 0 invalidates the compatibility signal. Priority 3: Keep your diet stable and consistent throughout all four cycles. Do not introduce major dietary changes between cycles – this isolates the donor variable.
Priority 1: Follow the bowel preparation instructions exactly. Inadequate preparation reduces colonoscopic FMT efficacy by 30–40%. Priority 2: Rest and eat easily digestible, low-fermentation foods for 48–72 hours post-procedure. This reduces the ecological competition burden during the critical engraftment window. Priority 3: Do not take antibiotics, antifungals, or probiotics for at least 72 hours post-induction without explicit clinical approval.
Priority 1: Maximise dietary fibre intake (target 25–35g daily). Fibre is the primary fuel for engrafting donor bacteria. This is the single most impactful dietary intervention during consolidation. Priority 2: Prioritise sleep quality and duration (target 7–9 hours). Sleep deprivation measurably reduces microbial diversity within days. This is the most underestimated lifestyle factor in microbiota recovery. Priority 3: Manage stress actively. Chronic psychological stress activates the HPA axis, increases intestinal permeability, and directly destabilises the consolidating microbial community. Even basic stress-reduction practices (walking, breathing, structured rest) have measurable microbiota effects.
Priority 1: Do not use antibiotics without clinical necessity. Each antibiotic course can reset microbiota diversity by months. If antibiotics are medically necessary, notify your clinical team to plan supportive measures. Priority 2: Sustain the Mediterranean dietary pattern long-term. This is the single best-evidenced dietary strategy for microbiota diversity and stability. Perfection is not required – consistency matters more than strict adherence. Priority 3: Maintain regular physical activity (150+ minutes moderate exercise per week). Exercise independently increases microbial diversity, SCFA production, and colonisation resistance, independently of diet.
→ Chapter II.6 – Warning Signs: read before your first FMT dose. → Chapter XVI-3 – Food and Symptom Diary: use from Day 1 of Phase 0. → This Priority Guide: consult at the start of each new phase.