Faecal transplantation for IBD management—pitfalls and promises

Abstract

Background

Faecal microbiota transplantation (FMT) as a potential treatment for inflammatory bowel disease (IBD) is an area of active current research, having been stimulated by the remarkable efficacy of FMT in treatment of Clostridium difficile-associated colitis.

Sources of data

This review is based on data from numerous case series on FMT in IBD since 1989 and results of four RCTs in ulcerative colitis (UC); three fully published.

Areas of agreement

Early signals of short to medium-term efficacy of FMT for UC are promising

Areas of controversy

Methodology, underlying mechanisms and questions regarding safety of FMT remain controversial.

Growing points

Many trials of FMT in adults and children are currently recruiting.

Areas timely for developing research

Future trials of FMT will likely revisit Crohn's disease and patients undergoing pouch surgery. Advances in microbial culture complementing genetic sequencing and investigations into the virome and mycobiome in IBD will be of great future interest.

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