Indian Journal of Gastroenterology

, Volume 35, Issue 5, pp 393–395 | Cite as

Successful colonoscopic fecal microbiota transplantation for active ulcerative colitis: First report from India

  • Avnish Kumar Seth
  • Pawan Rawal
  • Ruchika Bagga
  • Priti Jain
Case report


Forty-four-year-old male with ulcerative colitis (UC) for 11 years reported frequent relapse despite daily sulfasalazine 4 g, azathioprine 125 mg, and rectal 5-aminosalicylic acid. Repeated use of corticosteroids led to cataract. At enrollment, he was passing eight stools a day with blood with a Mayo score of 9 (3+1+3+2). Stool was negative for ova/cysts/acid fast bacilli and Clostridium difficile toxin assay. Rectal biopsy showed cryptitis, crypt abscess, and crypt distortion with no inclusion bodies, and cytomegalovirus DNA was negative. Following informed consent and approval from IEC, three sessions of fecal microbiota transplant (FMT) were performed at intervals of 2 weeks. The donor was a 34-year-old relative with no history of gastrointestinal illness, no use of antibiotics over 3 months, and free from transmissible disease as per standard protocol. At colonoscopy, 350 mL of blended and filtered donor stool, drawn into seven syringes of 50 cm3, was instilled from terminal ileum to sigmoid. Follow up sigmoidoscopy and rectal biopsy were done monthly for 6 months. There was symptomatic, colonoscopic, and histopathological improvement with the Mayo scores of 4.1 and 0 at 4.8 and 12 weeks post FMT. Azathioprine and sulfasalazine were tapered sequentially between months 4 and 6 of FMT. He remains in clinical and endoscopic remission 8 months after FMT and 2 months after withdrawal of all medication. Colonoscopic FMT may be effective in inducing drug-free remission in patients with active UC.


Fecal microbiota transplant Ulcerative colitis 


  1. 1.
    Cammarota G, Ianiro G, Gasbarrini A. Fecal microbiota transplantation for the treatment of Clostridium Difficile infection: a systematic review. J Clin Gastroenterol. 2014;48:693–702.CrossRefPubMedGoogle Scholar
  2. 2.
    Junjie Q, Ruiqiang L, Jeroen R, et al. A human gut microbial gene catalog established by metagenomic sequencing. Nature. 2010;464:59–65.CrossRefGoogle Scholar
  3. 3.
    Colleen RK, Stacy K, Purna K, et al. Update on fecal microbiota transplantation 2015: indications, methodologies, mechanisms, and outlook. Gastroenterology. 2015;149:223–37.CrossRefGoogle Scholar
  4. 4.
    Bennet JD, Brinkman M. Treatment of ulcerative colitis by implantation of normal colonic flora. Lancet. 1989;1:164.CrossRefPubMedGoogle Scholar
  5. 5.
    Borody TJ, Warren EF, Leis S, Surace R, Ashman O. Treatment of ulcerative colitis using fecal bacteriotherapy. J Clin Gastroenterol. 2003;37:42–7.CrossRefPubMedGoogle Scholar
  6. 6.
    Colman RJ, Rubin DT. Fecal microbiota transplantation as therapy for inflammatory bowel disease: a systematic review and meta-analysis. J Crohns Colitis. 2014;8:1569–81.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Moayyedi P, Surette MG, Kim PT, et al. Fecal microbiota transplantation induces remission in patients with active ulcerative colitis in a randomized controlled trial. Gastroenterology. 2015;149:102–9.CrossRefPubMedGoogle Scholar
  8. 8.
    Rossen NG, Fuentes S, van der Spek Mirjam J. Findings from randomized controlled trial of fecal transplantation for patients with ulcerative colitis. Gastroenterology. 2015;149:110–8.CrossRefPubMedGoogle Scholar
  9. 9.
    Petrof EO, Gloor GB, Vanner SJ, et al. Stool substitute transplant therapy for eradication of Clostridium Difficile infection: ‘RePOOPulating’ the gut. Microbiome. 2013;1:3.Google Scholar
  10. 10.
    Damman CJ, Brittnacher MJ, Westerhoff M, et al. Low level engraftment and improvement following a single colonoscopic administration of fecal microbiota to patients with ulcerative colitis. PLoS One. 2015;10:e0133925.Google Scholar
  11. 11.
    Weingarden A, Gonzalez A, Vazquez-Baeza Y, et al. Dynamic changes in short- and long-term bacterial composition following fecal transplantation for recurrent Clostridium Difficile infection. Microbiome. 2015;3:10.Google Scholar
  12. 12.
    Grinspan AN, Kelly CR. Fecal microbiota transplantation for ulcerative colitis: not just yet. Gastroenterology. 2015;149:15–8.CrossRefPubMedGoogle Scholar

Copyright information

© Indian Society of Gastroenterology 2016

Authors and Affiliations

  1. 1.Department of Gastroenterology and Hepatobiliary SciencesFortis Memorial Research InstituteGurgaonIndia
  2. 2.Department of PathologyFortis Memorial Research InstituteGurgaonIndia

Personalised recommendations