At just 16, Amanda was told she had ulcerative colitis, a lifelong disease that inflames the bowel and disrupts daily life. For decades, she cycled in and out of hospitals, relying on treatments including intravenous fluids and steroids to manage her condition.
Her condition eased in her 20s, but in recent years it came back with force. The flare-ups left her drained, often too unwell to work, and facing the possibility of major surgery.
"Ultimately, I was becoming resistant to my medication and probably would have lost my bowel in the end," she said.
That turning point came in 2024, when her long-time specialist, Epworth gastroenterologist Professor Jon Watson, suggested faecal microbiota transplant (FMT).
"I was sceptical at first. I thought, how is that going to work?" Amanda said.
"We were running out of options and basically if this didn't work, I was in a bit of trouble. It was expensive, but it was a risk I was willing to take."
FMT relies on healthy donors, whose stool samples are frozen at minus-70 degrees and shipped on dry ice from BiomeBank in Adelaide to Epworth Geelong. Once thawed, the specimen is introduced into the patient's bowel in a day procedure, similar to a colonoscopy.
For Amanda, the results were life changing.
One year on, Amanda has not required steroid treatment since her transplant. She is now working in a role that involves frequent travel - something she never thought possible. She has even returned to the gym, embracing a lifestyle she once believed was out of reach.
"I am not cured. I still have bouts with symptoms, but I haven't had steroids in a year since I received the transplant. If I experience a flare-up, it goes back to normal on its own. I think it's amazing," she said.
Prof Watson provides faecal microbial transplants to help treat inflammatory bowel diseases such as ulcerative colitis and Crohn's disease.
"Both of these diseases can be longstanding, sometimes patients need surgery and quite often they need powerful medication that supresses their immune system," Prof Watson said.
"There is the 'yuck factor' with faecal microbiota transplants, which is completely understandable. But in many ways, it is like any other transplant. You're having good bacteria put into you – it's the same principle.
Prof Watson cautions, "It's a promising option, but not universally effective. It won't replace all treatments, but for some, it can be transformative."
So far, Prof Watson has treated about 15 patients at Epworth Geelong. He and his team are also working with Deakin University and BiomeBank to better understand when and why the treatment works best.
"There's still much to learn, but this approach is opening new doors for patients who once had very few choices and we are very pleased to bring this new treatment to Geelong for our patients," Prof Watson said.
