What is the optimal timing for FMT administrations in a patient with throat nodules potentially exacerbated by quercetin?

FMT is Not Indicated for Throat Nodules or Quercetin-Related Symptoms

I must clarify that fecal microbiota transplantation (FMT) has no established role in treating throat nodules, and there is no evidence linking quercetin supplementation to throat nodules or any indication for FMT in this context. The question appears to conflate unrelated medical concepts.

Evidence-Based Indications for FMT

FMT has specific, well-defined indications based on current guidelines:

Approved Gastrointestinal Indications

• Recurrent Clostridioides difficile infection (CDI) is the primary indication for FMT 1
• Severe or fulminant CDI not responding to standard antibiotics within 2-5 days may warrant FMT in hospitalized patients 1
• FMT is not recommended for ulcerative colitis, Crohn's disease, or pouchitis outside of clinical trials 1

Timing for Repeat FMT (When Indicated)

For severe/fulminant CDI requiring repeat doses, the recommended interval is every 3-5 days based on patient response, local protocols, and multidisciplinary assessment 1. This timing applies specifically to:

• Hospitalized patients with severe CDI (WBC ≥15 × 10⁹ cells/L and/or creatinine ≥1.5 mg/dL) 1
• Fulminant CDI presenting with shock, ileus, or megacolon 1
• Patients not responding to standard antimicrobial therapy 1

Critical Contraindications

FMT is contraindicated in patients with:

• Bowel perforation or obstruction 1
• Severe immunocompromise 1

Quercetin and Throat Nodules

The available evidence shows quercetin has been studied for bronchodilator effects in allergic asthma 2, not for throat nodules. There is no medical literature supporting a connection between quercetin supplementation and throat nodule formation, nor any rationale for FMT treatment in this scenario.

Appropriate Clinical Approach

If a patient has throat nodules, the appropriate evaluation includes:

• Direct laryngoscopy or imaging to characterize the nodules
• Evaluation for vocal cord pathology, thyroid nodules, or lymphadenopathy
• Assessment for infectious, inflammatory, or neoplastic etiologies

FMT should only be considered when there is documented CDI that meets guideline criteria 1.