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Current Evidence for the Management of Inflammatory Bowel Diseases Using Fecal Microbiota Transplantation

  • Intra-abdominal Infections, Hepatitis, and Gastroenteritis (T Steiner, Section Editor)
  • Published:
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Abstract

Purpose of Review

Fecal microbiota transplantation (FMT) has been investigated as a potential treatment for inflammatory bowel disease (IBD). This review examines current evidence around the efficacy and safety of FMT for patients with IBD.

Recent Findings

Randomized controlled trials (RCTs) and meta-analyses have suggested that FMT may facilitate clinical and endoscopic remission in patients with active ulcerative colitis (UC). Although the evidence for FMT in Crohn’s disease (CD) is more limited, positive outcomes have been observed in small cohort studies. Most adverse events (AEs) were mild and included transient gastrointestinal symptoms. Serious adverse events (SAEs) did not differ significantly between the FMT and control groups, and a marginal increased rate of IBD flares following FMT was observed. Microbiota analysis following FMT showed increased intestinal bacterial diversity and a shift towards the donor microbial profile in recipients’ stools.

Summary

FMT for patients with IBD is promising as RCTs have shown the benefit of FMT for UC, although the efficacy of FMT for CD is less clear. Further large and well-designed trials are necessary to resolve critical issues such as the donor selection, the ideal route of administration, duration, frequency of FMT, and the long-term sustained efficacy and safety.

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Authors and Affiliations

  1. Digestive Disease Centre, Institute for Digestive Research, Soonchunhyang University College of Medicine, Seoul, South Korea

    Seong Ran Jeon

  2. University of Victoria, Victoria, British Columbia, Canada

    Seong Ran Jeon & Christine H. Lee

  3. University of British Columbia, Vancouver, Canada

    Jocelyn Chai & Christine H. Lee

  4. Vancouver Island Health Authority, Cumberland, Canada

    Christiana Kim & Christine H. Lee

  5. Department of Pathology and Molecular Medicine, McMaster University, St Joseph’s Healthcare, Hamilton, Ontario, Canada

    Christine H. Lee

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  1. Seong Ran Jeon
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Correspondence to Christine H. Lee.

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Seong Ran Jeon, Jocelyn Chai, Christiana Kim, and Christine H. Lee declare that they have no conflict of interest.

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This article is part of the Topical Collection on Intra-abdominal Infections, Hepatitis, and Gastroenteritis

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Jeon, S.R., Chai, J., Kim, C. et al. Current Evidence for the Management of Inflammatory Bowel Diseases Using Fecal Microbiota Transplantation. Curr Infect Dis Rep 20, 21 (2018). https://doi.org/10.1007/s11908-018-0627-8

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  • DOI: https://doi.org/10.1007/s11908-018-0627-8

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