- Fecal Incontinence
|Current Evidence for the Management of Inflammatory Bowel Diseases Using Fecal Microbiota Transplantation
Jeon SR1,2, Chai J3, Kim C4, Lee CH5,6,7,8. Curr Infect Dis Rep. 2018 May 26;20(8):21. doi: 10.1007/s11908-018-0627-8.
1 Digestive Disease Centre, Institute for Digestive Research, Soonchunhyang University College of Medicine, Seoul, South Korea.
2 University of Victoria, Victoria, British Columbia, Canada.
3 University of British Columbia, Vancouver, Canada.
4 Vancouver Island Health Authority, Cumberland, Canada.
5 University of Victoria, Victoria, British Columbia, Canada. Christine.Lee@VIHA.CA.
6 University of British Columbia, Vancouver, Canada. Christine.Lee@VIHA.CA.
7 Vancouver Island Health Authority, Cumberland, Canada. Christine.Lee@VIHA.CA.
8 Department of Pathology and Molecular Medicine, McMaster University, St Joseph's Healthcare, Hamilton, Ontario, Canada. Christine.Lee@VIHA.CA.
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. 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.