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A Two-Week Fecal Microbiota Transplantation Course in Pediatric Patients with Inflammatory Bowel Disease

  • Katarzyna Karolewska-Bochenek
  • Pawel Grzesiowski
  • Aleksandra Banaszkiewicz
  • Agnieszka Gawronska
  • Maria Kotowska
  • Marcin Dziekiewicz
  • Piotr Albrecht
  • Andrzej Radzikowski
  • Izabella Lazowska-Przeorek
Chapter
Part of the Advances in Experimental Medicine and Biology book series

Abstract

Dysbiosis plays a major role in the etiology of inflammatory bowel disease (IBD). Fecal microbiota transplantation (FMT) is a new promising option for IBD treatment. We aimed to assess the effectiveness of a two-week FMT course in children with IBD. Ten patients, 10–17 years of age with moderate to severe IBD received a course of eight doses of freshly prepared FMT via a naso-duodenal tube or gastroscopy. All of the patients had pancolitis. There were eight cases of ulcerative colitis (UC) and two of Crohn’s disease (CD). Disease activity was evaluated using the Pediatric UC Activity Index (PUCAI) and Pediatric CD Activity Index (PCDAI) for UC and CD, respectively, CRP, and fecal calprotectin on the day before the first infusion and then on the day before the next course of FMT. Clinical response, defined as a decrease of 15 points in either index, was observed in 9/10 patients (seven UC and two CD). Clinical remission, defined as a PCDAI score ≤ 10 and PUCAI score < 10 measured at the same time point, was observed in 3/8 UC patients and 2/2 CD patients. Side effects observed were self-limiting and benign. We conclude that a short, intensive course of FMT has a beneficial effect on UC and CD colitis. FMT was well-tolerated and safe. Nonetheless, an optimal protocol of FMT administration is crucial for treatment efficacy.

Keywords

Children Crohn’s disease Fecal microbiota transplantation Inflammatory bowel disease Ulcerative colitis 

Notes

Conflicts of Interest

The authors declare that they have no competing interests in relation to this article.

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Copyright information

© Springer International Publishing AG  2017

Authors and Affiliations

  • Katarzyna Karolewska-Bochenek
    • 1
  • Pawel Grzesiowski
    • 2
  • Aleksandra Banaszkiewicz
    • 1
  • Agnieszka Gawronska
    • 1
  • Maria Kotowska
    • 1
  • Marcin Dziekiewicz
    • 1
  • Piotr Albrecht
    • 1
  • Andrzej Radzikowski
    • 1
  • Izabella Lazowska-Przeorek
    • 1
  1. 1.Department of Paediatric Gastroenterology and NutritionWarsaw Medical UniversityWarsawPoland
  2. 2.Preventive Medicine and Rehabilitation CenterInfection Prevention InstituteWarsawPoland

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