faecal microbiota transplantation (FMT) in ulcerative colitis (UC)

Last edited 12/2021 and last reviewed 01/2022

Fecal Microbiota Transplantation (FMT) is the process of introducing faecal material from a highly screened, healthy donor into an unwell recipient’s gastrointestinal tract to restore the healthy homeostatic properties of the gut ecosystem and alleviate symptoms

• most common methods of FMT administration involve liquefying donor stool in saline, filtering to remove solid components, and then infusing the contents either colonoscopically, via enema or less commonly through the upper gastrointestinal tract via nasojejunal tube
  
  
• FMT in ulcerative colitis
  • a small RCT (n=35) found antibiotics followed by orally administered faecal microbiota transplantation was associated with superior induction of remission in patients with active ulcerative colitis vs antibiotics followed by placebo (53% vs 15%;p=0.027; OR 5.0, 95% CI 1.8-14.1) (2)

Reference:

• Borody TJ, Clancy A. Fecal microbiota transplantation for ulcerative colitis-where to from here?. Transl Gastroenterol Hepatol. 2019;4:48. Published 2019 Jun 26. doi:10.21037/tgh.2019.06.04
• Haifer C et al. Lyophilised oral faecal microbiota transplantation for ulcerative colitis (LOTUS): a randomised, double-blind, placebo-controlled trial. Lancet Gastroenterology & Hepatology, ISSN:2468-1253.