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Pyoderma-gangrenosum

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Stool transplantation for treatment of inflammatory bowel disease

Key messages

• Ulcerative colitis (UC) and Crohn disease (CD) are two forms of inflammatory bowel disease (IBD). IBD is an autoimmune disease affecting the gut, as the body's immune system mistakenly attacks healthy cells, tissues, and organs.
• Fecal transplantation may increase the proportion of people with active UC who achieve control of the disease, defined as clinical remission (disease control defined based on clinical symptoms) and endoscopic remission (disease control defined based on endoscopic findings), and may have little to no effect on rates of any adverse events (unwanted events that causes harm to the person).
• The evidence was very uncertain about the risk of serious adverse events and improvement in quality of life when fecal transplantation was used for control of active UC.
• The evidence was also very uncertain about the use of fecal transplantation for induction of remission in people with active CD and maintenance of remission in people with UC or CD.
• Fecal transplantation is an evolving therapy and further studies are needed to evaluate its benefits and risks in both adults and children with active UC or CD, as well as its potential use for long-term control of UC and CD. What did we find? Ten studies (nine in adults and one in children) showed that FMT may increase rates of induction of clinical remission and endoscopic remission and may result in little to no difference in rates of any adverse events in people with active UC. The data on risk of serious adverse events and improvement in quality of life were very uncertain, and no conclusions could be drawn regarding these outcomes. Two studies reported data on use of FMT for maintenance of remission in adults with controlled UC. Overall, the evidence was very uncertain about the use of FMT to maintain clinical or endoscopic remission in controlled UC, as well as the associated risk of adverse events and improvement in quality of life. None of the included studies reported data on use of FMT for control of active CD. One study reported data on use of FMT for maintenance of remission in adults with controlled CD, and the evidence was very uncertain about the benefits and risks of FMT when used to maintain clinical remission in controlled CD.

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