As an old Chinese saying goes, physicians cannot heal themselves, which implies that physicians who treat others proficiently may feel helpless when facing their own illnesses.
I am a gastroenterologist at the Affiliated Hospital of Shandong Second Medical University. Over three decades of practice, I have helped hundreds of thousands of patients relieve their suffering. I know every fold of the gastrointestinal tract and understand the complexity and mystery of its microbial inhabitants. Yet, I myself have long been troubled by a chronic headache (migraine), the frustration and pain which have left a lasting mark on me.
Migraine is a painful neurological condition characterized by severe pain on one or both sides of the head. My migraine is a stubborn lifelong affliction. It crept in during my youth. At first, it occurred only a few times a year and could be eased with a few ordinary painkillers (ibuprofen). However, over the years, the frequency climbed from several episodes per year to several per week, eventually becoming a daily occurrence that sometimes lasted for days. The nature of the pain also changed. It shifted from occasional mild discomfort to frequent intense throbbing, often accompanied by severe nausea and vomiting. This refractory migraine severely disrupted my work and undermined my quality of life.
I have come to know the truth of the saying that physicians cannot heal themselves. I consulted many well‐known neurologists across the country and underwent numerous cranial imaging studies of various types, none of which revealed any definite lesion. Instead of providing any comfort, those “normal” reports only deepened my sense of helplessness.
How could I defeat this headache? I embarked on a long journey of drug treatment. It started with nonsteroidal anti‐inflammatory drugs, progressed to zolmitriptan, and evolved from monotherapy to combination regimens. I also tried traditional Chinese medicine and acupuncture. Each approach offered a glimmer of hope, but the relief was always transient, and I continued to live with chronic pain.
My predicament reflects a broader challenge in modern medicine. Despite increasingly precise diagnostic tools, a growing pharmacopoeia, and convenient artificial intelligence tools, medicine remains fraught with uncertainties. The pathogenesis of many disorders is still obscure, therapeutic targets are vague, and individual variability is enormous, leaving countless patients worldwide still suffering. My neurology colleagues were sympathetic, but they had exhausted every option recommended in textbooks and guidelines without offering a satisfactory solution.
I suspected that the cause of my headache might lie outside the conventional framework, so I turned to the gut microbiota—a field I know well. I was the first physician in Weifang, China to perform washed microbiota transplantation (WMT) for treating diseases, and I am fully aware of its potential. In recent years, my team and I have used WMT to cure many cases of diarrhea caused by identifiable pathogens, such as recurrent Clostridioides difficile infection, and we have also observed clinical responses in some patients with refractory diarrhea, abdominal pain, and associated neuropsychiatric symptoms of unknown origin.
WMT is a refinement of crude fecal microbiota transplantation (FMT). It uses machines to perform filtration and microbial washing instead of manual steps to improve safety [
1]. Conventional FMT can be traced back at least 1700 years in the history of Chinese medicine. During the Eastern Jin Dynasty, Ge Hong, a well‐known Chinese medicine physician, described various methods and indications for fecal suspension therapy in the emergency handbook
Zhou Hou Bei Ji Fang [
2]. In ancient times, oral administration was the only route without the support of endoscopy, intestinal tubing, or capsule delivery. Unlike many other countries, China currently has less stringent regulatory oversight of FMT. It is a government‐approved medical technique for treating various conditions [
3]. This may be related to its thousand‐year history in China. The older generation of retired Chinese physicians are familiar with it and acknowledge its safety and efficacy. Clinicians in China have thus expanded its use well beyond recurrent
C. difficile infection [
3]. However, migraine is not a recognized approved indication.
In real‐world studies of gut–brain axis disorders, my colleagues and I have confirmed that some patients with Parkinson's disease, depression, and autism have benefited from WMT, with variable degrees of improvement. I also frequently discuss these cutting‐edge topics with experts at the Department of Microbiota Medicine, Second Affiliated Hospital of Nanjing Medical University. Many of our clinical observations are encouraging, although some findings may take another 5 to 10 years to be published in peer‐reviewed journals. These clinical experiences and the evidence emboldened me to treat myself.
Therefore, I hypothesized that my chronic recurrent headache might also fall within the spectrum of gut‐brain axis disorders, and that its root might lie hidden in my gut. Gut microbiota dysbiosis has been noted as a possible cause of migraine [
4,
5]. If this hypothesis were correct, then remodeling the gut microbiota through WMT could offer a definitive test of whether it was a cause or a key contributing factor in this disease. Therefore, this approach remains a reliable strategy for probing its pathogenic role.
Admittedly, there is no direct evidence to support using FMT for headache, nor is it easy to establish a reliable animal model for this condition. Therefore, I decided to experiment on myself.
I resolved to undergo WMT on myself. The preparation was identical to that for a colonoscopy. I took oral bowel‐cleansing agents the night before, and the next morning I lay on the procedure table in the endoscopy unit, a place I knew intimately, but this time as a patient under my team's care. The anesthetist induced general anesthesia intravenously, and my skilled colleagues successfully performed colonic transendoscopic enteral tubing (TET). Then, in the ward, the nursing staff injected one unit of fecal microbiota through the soft TET tube daily for three consecutive days. At least 10
13 bacteria from a healthy donor entered my gut [
1], and I hoped that they would keep the harmful bacteria responsible for my headache in check. The treatment did not interfere with my work or daily life. I still saw outpatients every day, returned home to my family, and almost forgot that a soft tube with a diameter of 2.7 mm was still in my intestine. After the course, the tube was smoothly removed. The frozen washed microbiota preparations were sourced from the Second Affiliated Hospital of Nanjing Medical University, which has established a central bank (China Microbiota Transplantation System, fmtbank.org) to provide nonprofit WMT services nationwide. The donor screening was performed by the center bank [
1].
A remarkable change appeared within the first month after transplantation. In the first 1 to 2 weeks, the headache diminished noticeably, and by 1 month, the symptoms had greatly improved. Previously, I needed two types of analgesics daily, and in severe episodes, I had to take them twice a day to obtain only modest relief. After transplantation, my medication use decreased steadily. When pain did occur, it was mostly mild and I needed painkillers only occasionally—sometimes just once a week. It felt as if a tight band that had been constraining my head had been loosened. The long‐lost clarity of mind almost moved me to tears. I rediscovered my ability to concentrate at work and regained the peaceful mood to take walks with my family. Over the following 2 months, the good state persisted and I was almost certain that I had found an effective treatment.
However, in the seventh month after the first transplantation, the headache gradually returned and I again needed increasing amounts of painkillers. Although my overall condition was still better than before the transplantation, the trend of relapse was unmistakable. I suspected that, as the host, I did not provide an ideal “soil” for the donor‐derived beneficial microbiota to survive in the long term, so they could not maintain their competitive dominance in the intestinal niche. Clearly, I needed another course of WMT.
Tenth month after the initial transplantation, I received the second course of WMT. Once again, the headache episodes came under effective control, and my mental state, sleep quality, and work efficiency all improved substantially.
I do not know how long this remission will last. Perhaps a third course, or even long‐term maintenance therapy, will be needed in the future. Although I still require medical intervention, I have clearly gained benefit from this therapy. Compared with my previous condition, my current state is already much better, with less suffering and pain, and a better quality of life. There is a huge unmet need for pharmacological treatments. Increasing studies on acupuncture, physical therapy, psychological therapies, biofeedback, and neuromodulation point to modest but clinically significant benefits, although heterogeneity in outcomes and study designs limits the strength of recommendations [
6]. My pursuit of WMT therapy is also an exploration of nonpharmacological treatments.
My experience and perspective should not be interpreted as encouraging unsupervised self‐administered FMT outside of formal clinical trials or approved indications. My story is deeply personal. There are no microbiome sequencing and control. To my knowledge, I may be the first reported case of using FMT to treat migraine based on a literature search of PubMed up to August 2026. It is not a rigorous case report, but a medical narrative. In sharing it, I hope to make a contribution to medicine, to offer my own experience to the medical community, and to provide, from a different perspective, some inspiration for both my peers and patients who suffer from similar conditions.
2026 The Author(s). Microbiota Medicine Research published by John Wiley & Sons Australia, Ltd on behalf of Higher Education Press.
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