Manipulation of the intestinal microbiome-a slow journey to primetime

World J Clin Cases. 2023 Jul 26;11(21):4975-4988. doi: 10.12998/wjcc.v11.i21.4975.


Ofra Kriger-Sharabi 1Stephen D H Malnick 2David Fisher 3


Author information

1Institute of Gastroenterology, Assuta Medical Center, Ashdod 7747629, Israel.

2Department of Internal Medicine, Kaplan Medical Center, Rehovot 76100, Israel. steve_m@clalit.org.il.

3Department of Endocrinology, Soroka Medical Center, Beer Sheva POB 151, Israel.


The gut microbiota has important functions in the regulation of normal body functions. Alterations of the microbiota are being increasingly linked to various disease states. The microbiome has been manipulated via the administration of stool from animals or humans, for more than 1000 years. Currently, fecal microbiota transplantation can be performed via endoscopic administration of fecal matter to the duodenum or colon or via capsules of lyophilized stools. More recently fecal microbial transplantation has been shown to be very effective for recurrent Clostridoides difficile infection (CDI). In addition there is some evidence of efficacy in the metabolic syndrome and its hepatic manifestation, metabolic associated fatty liver disease (MAFLD), irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD). We review the current literature regarding the microbiome and the pathogenesis and treatment of CDI, MAFLD, IBS and IBD.

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